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Success with Clear Aligners

This week's blog post gives you an overview of what it takes to achieve a clinically and financially successful implementation of clear aligners in a general dental practice.

Through our collaboration with ClearCorrect, SureSmile and Invisalign, we have conducted a series of analyses on what it takes to achieve success with clear aligners. This knowledge is now being used in clear aligner intro courses in 7 different countries in Europe. The blog post draws on some of the knowledge drawn from these studies.

Hatt - Close-up of front teeth taken from the side

Basically, it looks super easy to achieve a successful implementation of clear aligners in general dental practice.

Overall, 3 elements are needed:

  • Enthusiasm

  • Clinical confidence

  • Financial profitability

If even one of these elements is missing, the practice will fail to implement clear aligners.

Of the 3 elements mentioned, clinical confidence is the most important in all dental practices.

Every dentist I know has an absolute requirement that the treatments we perform in the practice must meet the golden standards of the profession. In other words, we all want to treat our patients to the best of our ability.

If we delve into the 3 basic assumptions, it starts to get more complex than it first appears.

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Concertgoers enthusiastically raise their arms as confetti is shot at them

Is the easiest to achieve.

Once the practice has completed 5 successful clear aligner treatments. The entire clinical team has experienced how the teeth can be moved to a better position. In addition, everyone experiences the joy and gratitude patients express during and after treatment.

It " only " requires that the first 5 treatments are successfully completed (Success in this context is defined by the dentist)

Clinical confidence

This is where things start to get tricky. At least if the dentist wants to do it all by him/herself. Because there is a reason why it takes dentists 3-4 years of postgraduate training to specialise in orthodontics.


When you take a classic "certification course" with one of the major clear aligner manufacturers, you are trained only in the company's software (ClearCorrect has a different and more appropriate training in the use of their clear aligner system - they don't require "certification" to order their aligners, by the way. The design and content of the starter courses vary from country to country)

The classic "certification" often leaves course participants with some frustration, as nothing is learned about diagnostics, treatment planning, optimizing the digital plan, or problem solving during treatment.

Case selection

When it comes to selecting suitable patients for treatment with clear aligners, most dentists want to have a number of parameters from which to select patients. There's just one problem. Case selection requires having a relatively extensive orthodontic knowledge, combined with a lot of clinical experience.

It takes about 200 treatments to get a rough idea of which patients are easy, difficult and which should be referred. After about 500 cases, it starts to become routine. The figures are based on treatments where the dentist performs all parts of the treatment herself - treatment planning, modification of the digital plan, monitoring of the treatment, final restorative treatment, choice of retention and subsequent continuous check-ups of the patient.

By the way. This is not the most appropriate way to run a clear aligner department in the dental practice.

Treatment planning & modification of the digital plan

Screenshot of Invisalign ClinCheck showing a complex treatment with clear aligners

This is an extremely broad topic. Therefore, I am not going to go into detail about this important part of clear aligner treatment in this week's post.

Teeth can't tell the difference whether it's metal braces or plastic aligners moving them. Professor Birthe Melsen

Instead, I will point to an alternative path that addresses the challenge of achieving biologically safe, realistic and predictable treatments.

The reason so few get started.

As you would expect, starting to treat patients with clear aligners is relatively complex. It is not easy to achieve clinical confidence if you want to deal with this part yourself. Therefore, I recommend working with a dentist/orthodontist who has extensive experience with clear aligners and whom you trust.

Do you want to start clear aligner treatments in your dental practice in a safe and secure way? Then sign up for "ClearCorrect smart start", where you will get all the tools for an ideal implementation of clear aligner treatments in your dental practice in just one day.

Get external assistance

If you don't have an expert at hand to help you with everything from case selection, diagnostics, treatment planning, the orthodontic record, modifying the digital plan and support when something in treatment doesn't go quite according to plan (it is biology after all). I would recommend you to look at AlignerService. Here you will get expert help throughout your treatment.

At AlignerService, only dentists and orthodontists with extensive clinical and theoretical experience with clear aligners help dentists with their clear aligner treatments.

Yes it costs money to get outside help. But the price you pay is earned back several times over when you count the time you save. Partly on the planning but also on the time at the dental chair. Although I could handle this part myself when I was practicing, I outsourced it as much as I could, as it saved me a lot of chair time that I could spend on other procedures. Making my everyday much more profitable.

Financial profit

If the practice finds that there is no profit in performing clear aligner treatments. The dentist will stop performing this type of treatment.

If the dentist is responsible for everything him/herself, through the entire clear aligner treatment, it is much more profitable to perform traditional restorative dentistry instead.

Man entering a maze drawn in the sand on a beach

In order to make a satisfactory profit from this type of treatment, you have to delegate large parts of the treatment to your staff. It is possible to delegate about 95% of the treatment to a dental hygienist or a clinic assistant.

Often this delegation will even create a better quality of treatment. Why and how we tell more about in our "smart start" courses.

Master clear aligners vs. Clear aligner Master

We see it over and over again.

Dentists prefer to master all parts of any kind of treatment.

We would prefer to be clear aligner masters before starting any treatment with clear aligners.

.... And it does look tantalizingly easy. Clear aligner treatments are being planned on a screen by a company. It looks great- and super easy.... There's just one problem. Everything can be done on a screen. The question is whether what you see on the screen can -or will happen in reality.

It is your responsibility

It is the responsibility of the dentist to achieve a biologically sound, realistic and predictable result.

As I have written previously, there is a reason it takes 3-4 years of continuing education to become a specialist in orthodontics.

It is important to be aware that there is no difference between moving teeth with fixed appliances and clear aligners. The principles behind tooth movements are exactly the same, as is the complexity of the treatments. It is a mistake to think you can move teeth "safely" by simply moving the front 6-8 teeth, just as you should NEVER trust that what happens on the computer screen will happen in reality. This can quickly lead to malpractice. I will write more about all this in the coming weeks.

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Mastery takes time

As you can see, it is not possible to learn everything you need to know in a weekend course. You cannot become a clear aligner master in a short time. It's just not possible.

Instead of striving to become a clear aligner master in one day, I recommend a slightly different approach: Be realistic and therefore less ambitious. Make sure to master clear aligners first, before you start becoming a clear aligner master

Simplify the complex

What these obstacles are and how to deal with them I will write about in the next post.

To learn more

In the next post, I focus on the 5 obstacles that stand in the way of getting off to a good start. We'll look at a manageable way to get started that's within most dentists' comfort zone.

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Currently, a post in Danish is published first and the week after the same post in English. So far I am not able to differentiate between Danish and English users on the technological platform I use.

Dentist Jesper Hatt with blazer and white shirt looking directly at the camera and smiling

See you in the next post😊

Many kind regards

Jesper Hatt DDS

P: +41 78 268 00 78


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