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The first 50-100 clear aligner treatments

Updated: Feb 4, 2023

In this post, I provide a description of how you can implement a "plug and play" system in your dental practice. It's a way to treat patients where you and your team are assured clinical confidence and biologically realistic, safe and predictable treatments with clear aligners.

Have you tried assembling your own PC?

Have you sat for hours trying to figure out which case, motherboard, processor, cooler, fans, power supply, graphics card, ram, etc. you should put together to get the ultimate computer built to your specific requirements. And then to install all the operating systems, programs and set them up to work seamlessly with all the other systems and wireless systems in the dental practice? And maybe... maybe also sit and tweak your hardware so it can perform better than the specs suggest?

Or are you more the type who wants a simple, system that just works seamless, so you can focus on, for example:

  • Handle emails seamlessly

  • Use text editing programs

  • Surf the Internet

  • Watch video

  • Listen to music

  • Use the practice management software

  • Edit photos

  • Send and receive signals from other handheld devices, like phones, cameras, iPads, etc.?

If you belong to the first group, you might also want to know everything about orthodontics before you start straightening your patients' teeth. That means you need to train to become an orthodontist before you start straightening teeth.

If, on the other hand, you are the type who focuses on how you can use orthodontics to support your way of treating patients functionally and restoratively, in a biologically more gentle way. Then it is much more appropriate to focus on how you can set up a simple system in your practice that gives you and your staff a clinically safe workflow, rather than training to become an orthodontist.

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Invisalign patient sits with aligner in hands and smiles at camera

Clinical confidence

90% of dentists who want to start, or have started, treating patients with clear aligners feel they lack clinical confidence. As a consequence, 90% of all dentists fail to treat their patients.

At first glance, it may seem very reassuring that so many colleagues are aware of their lack of clinical competence and thus refrain from treating their patients with clear aligners. There are just a few challenges:

First, there is a markedly growing demand for adult orthodontics with clear aligners. This is creating a gap in the market where companies with peripheral knowledge of dentistry and orthodontics are starting to set up shops that offer nothing other than orthodontics with clear aligners. Or so-called "do it yourself" or "direct to consumer" clear aligner treatment. It goes without saying that such businesses are unable to meet professional standards.

Secondly, it results in many patients never being offered orthodontic treatment and thus not achieving optimal oral health.

The golden promises of the industry

There is a challenge in our current mentality in dentistry. We want to know everything about a given treatment before we start treating our patients.

We are lured into attending industry courses, with promises of becoming competent to independently treat patients with orthodontic appliances, after a single day's course, supplemented by a few online modules of a few hours' duration.

Therefore, it is important to know what you want to achieve before you start to train and before you start to treat patients with clear aligners.

How complex is it?

There is no difference in the theoretical and clinical skills required to perform treatments with fixed appliances and clear aligners. Both are orthodontic treatments. Whether you use plastic appliances or brackets and wires to move the teeth is irrelevant. The teeth don't feel the difference. The way they move is based on the same physical and biological principles. A clear aligner treatment, therefore, requires just as much insight and planning as a treatment with fully fixed appliances - even if the clear aligner treatment may only involve the front teeth.

When we, as dentists, attend a clear aligner beginners' course, we often end up disillusioned. We can see that we are not getting anywhere near the theoretical or clinical skills needed to start performing orthodontic treatment. At least not if we are to master the treatment ourselves. Not even after numerous courses.

External help

In-house aligner expert online

Orthodontic patient care is undoubtedly one of the most difficult dental disciplines. It requires extensive additional training to be able to oversee even relatively simple treatments and their possible consequences.

Therefore, it is also important to consider what help you can get when starting out.

In addition, it is important to consider where and how to start the implementation of the treatment.

Our recommendation

We recommend that you redefine how you view your needs for knowledge before you start working with clear aligners.

Instead of starting with an expectation of having to be a master in the use of clear aligners before you start treatment. We, at AlignerService, recommend that you start by mastering the workflow of your chosen clear aligner system, while getting help from an external expert in the particular clear aligner system you wish to work with.

Definition of a clear aligner expert

An expert can be either an orthodontist or a dentist. What they have in common is that they must have extensive theoretical knowledge and practical experience of the system. Orthodontists are fully equipped to make diagnoses, understand the complexity of treatment needs and draw up treatment plans. The challenge is that not many people are yet familiar with the ways in which the different aligner systems transfer forces from the aligner to the teeth. Just as they are not necessarily familiar with how to work with the modification of the digital treatment plans that the aligner companies prepare and thus achieve predictable treatment pathways.

A dentist or orthodontist, has extensive experience only after having prepared about 500 orthodontic treatment plans and followed as many treatments clinically.

Important to know about industry support

Telephone suporter talking on mobile phone

It can be nice to draw on the help of the aligner manufacturer's supporters if you have a simple challenge you need help with. However, remember to clarify whether it is dentists or orthodontists with the necessary knowledge who are supporting you. Many industry supporters are not trained dentists at all and therefore do not have the basic skills to understand the implications of complex treatments such as clear aligners. Typically they are dental assistants, dental technicians or dental hygienists.

In addition, you should be aware that industry supporters are legally limited in how much specific help they can provide for a specific treatment. As well, they are required to deal exclusively with the challenges you present to them. So they rarely look at the treatment plan as a whole, but focus instead on the problem you present them with. Therefore, our recommendation is that you ally yourself with an expert who is not employed by the alignment companies. But an expert who is free to give you complete advice and who can take over the communication with the aligner company and edit directly your digital treatment plan. This enables you to develop a comprehensive ortho-restorative treatment plan.

Your first 50-100 treatments

With an expert to help you through your first 50-100 treatments, you'll move on a more secure footing and can concentrate on getting a functional and efficient clear aligner workflow implemented in the practice first and foremost. A workflow where the whole team needs to know what is being done when, by whom and why. Including:

  • Informing patients on the phone, in accordance with descriptions on the web.

  • Welcoming patients

  • Patient interview.

  • Clinical photography.

  • IO-Scan

  • X-rays

  • Management of cloud-based aligner software

  • Uploading data

  • Contact and workflow with the aligner expert. (Case selection, ortho-restorative treatment plan and setup/clincheck modification)

  • Patient information

  • Payment solutions

  • Treatment acceptance

  • Delivery of aligners

  • Bonding of engagers/attachments

  • IPR

  • Checking and ensuring that treatment is tracked

  • Troubleshooting in collaboration with aligner expert

  • Retention in collaboration with aligner expert

  • Post-orto restorative treatment.

  • Final check

The biggest challenge in dental practices

As can be seen, there are relatively many tasks to be handled.

Of all the tasks that need to be implemented, we find that clinical photography is the biggest stumbling block across all dental practices. That's why we're taking a closer look at this particular discipline in the upcoming blog post, where you'll also have the opportunity to take part in an online photography training course for free.

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Make it easy for yourself and your team

Starting with remote help is like starting with an iPad, rather than having to assemble your PC first, install drivers, operating systems and applications before you can get started. With an iPad solution, your workflow becomes intuitive, easy and works every time.

If you don't have an expert you can call on in your local area, AlignerService has dentists and orthodontists on staff with the necessary skills. They are all selected based on the minimum criteria mentioned earlier.

The shortest route to success

Based on the experience from more than 2000 dental offices, our recommendation for a successful implementation of clear aligners in a dental practice is that you start like this:

  1. Get a permanent external clear aligner expert with experience of more than 500 treatments in your chosen clear aligner system attached to the practice.

  2. Use your expert to:

    1. Perform case selection

    2. Help design an ortho-restorative treatment plan

    3. Optimize the digital setup/clincheck to be biologically realistic, safe and predictable

    4. Help you and your team with clinical advice throughout the treatment.

  3. Define who in your team should do what, when and why.

  4. Lay out a plan for how you will implement a clear aligner workflow in the practice.

  5. Post the plan somwhere visible

  6. Develop a set of sub-goals

  7. Display a board where you visualize each time a goal is achieved.

  8. Define how you will celebrate your success when your workflow is implemented and all goals in the plan are achieved.

  9. Follow the plan and celebrate the successes before setting new goals.

Cost of implementation

It takes time and money to implement everything new. Clear aligners are no exception. An external expert costs money too. However, it is an investment that will pay the practice back many times over, as it will save a lot of chair time. With an external expert, you won't have to go through as many extra aligners because the treatment is planned more predictably. Similarly, you typically avoid malpractice and starting treatment on patients who should have been referred to a specialist in the first place.

AlignerService has calculations showing that a dental practice can increase profits on an average aligner treatment from 14% to 56% if an external expert is used correctly to guide the dentist in charge and the team in the practice.

Clinical photos in 2 minutes

In our next post, we guide you through a protocol that enables you to perform IPR in the shortest possible time while being very precise.

Performing IPR is one of the biggest clinical challenges (besides taking af great series of dental photos). With the right equipment, protokols and knowledge IPR becomes a bliss.

In the next post, you'll get a practical, step by step guide including a video showing you exactly what to do in order to implement a precise and efficient IPR protocol.

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In need of help implementing clear aligner treatments, such as ClearCorrect, Invisalign, SureSmile or Spark in your dental practice? Reach out to us and we will help you succeed.

Jesper Hatt DDS smiling to the camera

Many kind regards

Jesper Hatt DDS

Phone: +41 78 268 00 78


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