A threat to patient health

I am on my way to Finland to give a course in the use of clear aligners for beginners. In the process, I have come to think about some of the reasons why treatment with clear aligners often stops in most dental practices, after only a few attempts with the treatment.

Stop sign in New York - red hand


Treatment with clear aligners is just as complex as treatment with fixed braces. The material we use to move the teeth is simply different. Just as the way we plan tooth movements is done in software that can help give a better overview of all the factors at play during any treatment.... If we know what to look for.


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The most complex form of patient care

My claim is that orthodontic treatments are the most complex kind of treatments dentists can deal with. We should perceive any clear aligner treatment as a treatment involving all teeth in a dynamic environment that cannot be predicted 100% (as it otherwise appears in the aligner software). This places great demands on our abilities to design biologically sound and realistic orthodontic treatment plans, predict the realism of all the planned movements and know what to do when the biology does not behave as expected.

Hand cut out of wood, supporting a thick branch on a very large tree, so the branch does not snap off the tree

Industry promises

Of course, this is not possible when you start treating patients with clear aligners. If you start out on your own, there is therefore a relatively high risk that you will experience one or more problems with the treatment process.

This is despite the industry's attempts to convince us that we are on "safe ground" as long as we treat only the front 8-10 teeth. If you attend my courses you will discover why this is an absurd claim whose sole purpose is to sell more aligners.


This is why I believe that starting with the right support all the way through the treatments is essential for us to be able to look ourselves in the mirror every morning and know we have made a positive difference in our patients' lives. Not from a cosmetic perspective, but from a functional and long-lasting perspective.


Doctor: "wake up!"

It's time for dentists around the world to wake up. More and more patients are being exposed to orthodontic treatment every day in fancy shops that promise nice white teeth in a short time at a low price.


The common denominator of these direct to consumer offerings is based on a business model whose primary purpose is to make as much money for the owners as possible. With the many treatment results we have seen over time, it does not seem that much thought is given to the health of the patients. A quick Google search on the best before and after pictures from these companies, will prove my statement.


Variants of "direct to consumer" aligner business

There are variants of direct-to-consumer alignment shops on the same theme, where online marketing on a large scale attracts patients to dental practices where a corresponding treatment is performed. Often, the practice is lured with a free intraoral scanner, free marketing and a small fraction of the profits from the aligner treatments it performs - under the authorisation of the dentist. How anyone can be lured by such an offer remains a mystery to me. At least, if you know what you are getting and what alternatives there are.

If you would like to know more about the alternatives, please feel free to contact me, as it is too extensive to write about here.


The "direct to consumer" companies mentioned are super good at 2 things:

  1. Sales

  2. marketing

Two areas that the dental industry in general has a strained relationship with and is therefore far from mastering.


A dentist is rarely present.

Treatment planning is handled by a centralized design team, which in the best cases has a dentist to do spot checks of the thousands of treatment plans carried out on a weekly basis! Treatments are limited as far as possible to front teeth, with no attachments and no use of IPR. This means that many major compromises have to be made. This results in teeth not being moved to their ideal position in about 95% of all treatments.


You can do better!

Dentists look at photos of teeth and make a treatment plan

I would argue that the vast majority of patients will receive better treatment in a dental practice that takes a more comprehensive view of teeth, muscles and joints. Teeth straightening by a dentist is most often done with an eye on how to position the teeth correctly and then build them up to their natural beautiful shape, where they fit into a harmonious occlusion and function.

In other words, it is a comprehensive treatment. Rather than an extreme compromise that only aims for "straight" teeth at a low price.


See how you can confidently get started using clear aligners in your practice.


Resistance to clear aligners in general practice

For many years, orthodontists were opposed to general dentists performing orthodontic treatment with clear aligners. The resistance is understandable. These are extremely complex treatments that require a completely different mindset and approach to treatment than the one we are used to. Incredibly, many colleagues have not gotten off to a good start in an otherwise well-intentioned attempt to help their patients achieve better oral health.


In general, I have argued against the "scarcity mindset" that lies behind the traditional resistance to allowing general dentists to perform orthodontic procedures. Because the more colleagues who start treating their patients with clear aligners. The more colleagues become better and better at diagnosing malocclusions. This leading to more dentists starting to notice all the patients whos oral health could be improved with orthodontics.


Advantages of aligner treatment at GP's

The better we get at diagnosing our patients, the more patients are referred to specialists for treatment, because many conditions are too complex to treat with clear aligners. In this way, we give orthodontists more work and more patients better treatment.


However, I can understand the resistance of orthodontists in the past. After all, it is typically the orthodontists who have to correct the treatments that go wrong. Which can give a certain bias around the perception of how well, or badly, it goes overall, when general practitioners, venture into clear aligner treatments. Because the less we know when we start treating patients with clear aligners, the greater the risk that we will plunge into treatments that should never have been started in general practice.


So there is a balance and I do acknowledge that it can appear to be a delicate one.


How to solve the challenges of clear aligners in your dental practice

In the coming weeks, I'll focus on the areas that often pose challenges to dentists and their teams when they first start performing clear aligner treatments. As well as describing how to easily establish a clear aligner business model in a dental office that benefits patient health, team job satisfaction and practice finances. With less stress and higher productivity.


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At the moment, a Danish post is published first and the week after the same post in English. I am not yet able to differentiate between English and Danish users on the tech platform I use - apologies for that!