Dentist Helle Hatt clear aligner expert and clinical lead

DSO / Dental Groups

Clinical risk management for scalable aligner treatment

Managing aligner treatment across multiple clinics is not a clinical challenge alone.
It is an operational, financial and brand-related responsibility.

AlignerService works with DSOs and dental group practices to reduce clinical variation, contain risk and ensure predictable aligner outcomes - without building heavy, costly internal aligner support structures.

The DSO challenge with aligner treatment

As dental groups scale, aligner treatment introduces several systemic risks:

Large variation in case selection between clinicians
Inconsistent treatment planning quality
Increasing number of refinements and treatment delays
Hidden operational costs and chair time loss
Risk to patient satisfaction and brand reputation

These challenges are rarely caused by lack of effort or competence at clinic level.
They are structural problems, not necessarily individual ones.

Why internal aligner teams are difficult to scale

Many DSOs consider building internal aligner support or specialist teams as a way to standardise treatment.

In practice, this often introduces structural challenges:

High fixed personnel costs
Internal specialist teams require high utilisation to justify their cost structure. This often reduces flexibility and makes it difficult to allocate specialist resources where they create the most value.

Limited specialist availability for core clinical tasks
Orthodontic specialists are a scarce resource and create the greatest value when focused on complex patient treatment that cannot be delegated.
Clear aligner treatment requires a distinct, aligner-specific planning expertise built through volume and systematisation. Using specialist capacity for routine aligner planning can reduce overall clinical efficiency and scalability.
Limited capability for scalable clinical support
Orthodontists are rarely trained to provide structured, scalable clinical support to dentists across locations. While the concept is sound, implementation often lacks efficiency and consistency at scale.

Internal conflicts of interest
When specialists are responsible for both patient treatment and internal support, misaligned incentives can arise. This may reduce collaboration, limit knowledge transfer and negatively affect internal referral dynamics.

Long response times and lost momentum
Internal support is often deprioritised compared to direct patient care. Delayed feedback on aligner cases leads to lost treatment momentum, lower patient conversion rates and reduced patient satisfaction.

Inconsistent clinical decision-making across clinics
Without a centralised, independent framework, clinical decisions can vary significantly between specialists and locations.

Difficulty maintaining uniform standards at scale
As groups grow, ensuring consistent quality and risk control across clinics becomes increasingly complex.

Lack of operational flexibility
Fixed internal structures struggle to adapt to fluctuating case volumes and changing clinical demand.

AlignerService provides an alternative that is scalable, flexible and cost-efficient - without internal conflicts or structural bottlenecks.

The AlignerService Risk Management System™

Built for dental groups

Our collaboration with DSOs is based on the
AlignerService Risk Management System™ - a structured clinical framework designed to reduce risk across the entire aligner workflow.

The system focuses on three key areas:

1. Standardised risk-based case selection

Before treatment starts, every case is assessed using a consistent, independent clinical risk framework.

This:

reduces variation between providers and clinics
prevents high-risk or unrealistic cases from entering treatment
protects the brand from avoidable treatment failures and patient dissatisfaction
improves predictability at both clinic and group level

By identifying clinical risk early, DSOs can reduce the likelihood of escalations, complaints and reputational damage associated with prolonged or failed treatments.

2. Experienced, brand-independent treatment planning

All treatment plans are created exclusively by experienced dentists and orthodontists - never technicians.

Plans are:

biologically and biomechanically sound
aligned with group standards and protocols
compatible with multiple aligner brands

This ensures consistent clinical quality without dependence on a single manufacturer.

3. Ongoing clinical support without bottlenecks

Clinics receive fast, written clinical support throughout treatment.

No waiting lists
No scheduling challenges
No disruption of clinical workflows

This allows clinicians to focus on patient care, while maintaining consistent clinical decision-making across the group.

What DSOs gain from working with AlignerService

Dental groups working with AlignerService typically achieve:

Reduced clinical variation across clinics
Fewer refinements and treatment delays
Lower hidden operational and chair time costs
Improved predictability, oversight and reporting
Higher and more consistent patient satisfaction
Stronger brand protection through early risk control

Most importantly, aligner treatment becomes manageable and controllable at scale.

Flexible implementation - no structural dependency

AlignerService integrates with existing clinical workflows and aligner suppliers.

No requirement to replace current aligner systems
No need to build internal aligner departments
No lock-in to proprietary platforms

This allows DSOs to maintain strategic flexibility while strengthening clinical governance..

A partner - not a replacement for your clinicians

AlignerService does not replace clinical responsibility at clinic level.
Clinical ownership always remains with the treating dentist.

What we do take responsibility for is reducing risk and operational friction across the aligner workflow.

We:

remove clinical risk before and during treatment through structured, risk-based case selection and planning
design predictable, biologically sound treatment plans that reduce refinements and chair time
provide immediate, ongoing clinical support, replacing slow or unavailable aligner manufacturer support
bridge orthodontic and restorative perspectives, with deep understanding of aligner biomechanics, restorative-driven planning and multiple occlusal philosophies

This allows clinicians to focus on patient care, while DSOs maintain clinical control, predictability and brand protection at scale.

Who we work with

AlignerService collaborates with:

National and international DSOs
Multi-clinic dental groups
Group practices transitioning into aligner treatment
Organisations focused on quality, predictability and brand protection

Dr. Jesper Hatt Dentist coach speaker author

Let’s talk about risk, predictability and scale

If you are responsible for aligner strategy, quality or operational efficiency across multiple clinics, we are happy to explore how risk-based aligner management can support your organisation.

👉 Contact us to discuss DSO collaboration