Implementing clear aligners in a general dental practice


Dentists do not feel clinically confident about treating patients with clear aligners. Many may have attempted to treat a patient or two in the past where the treatment did not go as expected. Others have just never gotten started. As a consequence, the majority of practising dentists refrain from treating their patients with clear aligners.

This paper is aimed at dentists who want a clinically safe route to implementing clear aligners in their dental practice.

In the following, I review why it is so difficult to get started using clear aligners. As well as providing a number of suggestions that can lead to a clinically safe, successful and profitable way to implement clear aligners in any dental practice.

Dentist Jesper Hatt DDS lecturing

Why is it so difficult?

In the past, the implementation of clear aligners in dental practices has typically followed a course similar to the implementation of any other type of treatment in a regular dental office.

This means the dentist learns the theoretical and clinical skills required to perform the treatment in a fairly short course. The acquired skills and systems are then implemented in the practice over a limited period of time.

The same approach cannot be applied as easily when it comes to orthodontics. Orthodontics involves a great deal of theoretical knowledge. This is knowledge that, with a classical approach, must be mastered in order to achieve clinical confidence.

Much of this knowledge takes a long time to acquire - there is a reason it takes several years to become an orthodontist.

In addition to the theoretical knowledge, it requires a lot of clinical experience as well. Add to this a wide range of other challenges associated with the application of clear aligners in the clinic - including: leadership, management, systems, communication and finance.

How and where to start?

Below you will find a list of frequent challenges that typically stands in the way of a successful implementation of clear aligners in a general dental practice:

  1. The practice lacks a vision that includes clear aligners.

  2. The practice owner does not communicate the vision clearly and continuously to the staff and the patients.

  3. Orthodontics requires extensive knowledge of aesthetics, functional occlusion, bone structure, muscles, soft tissues, joints, airways, biodynamics, biophysics and the dynamic relationships, etc. Which makes orthodontics one of the most complex forms of treatment dentists can perform.

  4. - There is a reason why it takes 3-4 years to become an orthodontist.

  5. It takes time to devise and incorporate completely new workflows

  6. It takes good communication skills, a belief in clinical outcomes and your own abilities to get patients to accept treatment.

  7. Without extensive delegation, it is more profitable to do other types of restorative dentistry.

  8. Delegation requires a great deal of resources for the continuing education of the dental team.

  9. Lack of time in the appointment book for treatment, training and incorporating new workflows.

  10. It takes a long time to achieve the desired clinical outcomes.

  11. Uncertainty about handling clinical challenges when the treatment does not proceed as planned on the computer.

To make it easier for you to successfully implement clear aligners in your practice, here's an overview of how others are getting started.

The good start

Coffee cup with the text: "Go get em" open notebook with blank page and a pen on top

Define the following:

How many treatments do you want to perform per year, starting with the next 12 months?

Who will carry out the various tasks related to the treatment? (Photos, X-ray, IO scan/image, data upload, communication with: aligner manufacturer, external partner and patient, case selection, treatment plan, modification of the digital plan, support of team, IPR, patient control, attachment bonding, retention, instruction, which aligner system will you use and why, etc, etc. The more elements you can include in your vision, the better. It makes it easier to plan for and therefore achieve success)

You can find relevant starter courses here.

Your plan

Create a step-by-step action plan that breaks down your vision into small elements that are easy to implement in your practice. The action plan should spell out exactly what you want to achieve, who is responsible and when it will be achieved.

Be aware that you will need to adjust the action plan as you gain more insight into what you need to know and do, as you gain experience with the different elements of your action plan.

Share your vision and action plan with your team.

Let the team help you adapt the action plan to your practice. They will help you make it as realistic as possible.

Allocate resources to follow the action plan.

Make the action plan visible to all members of the team and follow up regularly on the plan in a way that supports your team's progress towards the goals set out in the plan.

Where are the limits?

First of all, it is important to realise that you cannot acquire all the necessary theoretical and clinical skills in a weekend course.

There is simply too much to learn!

Just as it is completely unrealistic to learn everything about clear aligner treatments by reading a pile of literature.

Instead, it's a good idea to tackle the elements that are within your normal comfort zone. That is:

  • Make a treatment plan that describes your desired end result - how do you want your teeth to look after orthodontics so you can perform the final restorative treatment?

  • Managing the clinical aspects of a typical clear aligner treatment.

Get external help

While you're building systems and workflows, training your team and finding ways to make everything work in your practice, you should ally yourself with an external partner who can help with:

  • Case selection

  • Treatment planning

  • Modification of the digital plan

  • Support for you and your team throughout the treatment

Clinical confidence right from the beginning

Case selection, treatment planning, digital modifications and team support are the most demanding elements to master. They take a lot of time and training to get right. Just as they are outside our normal comfort zone. That's why it is