Let's be C.L.E.A.R #1
The right question to ask is rather: what can you do with clear aligners?
Clear aligners are here to stay. It is not something of the future anymore, but it is actual digital dentistry. If you look at the cases shown in Figure 1, can you guess which of these cases are clear aligner cases? The real answer is that none of these cases are clear aligner cases. The right question to ask is: which of these cases are orthodontic cases?
Clear aligners are just tools. What you are doing when you are using them is orthodontics. Plastic does not move teeth. Braces do not move teeth. They are tools that we use to apply the force we need to move the teeth. All the cases you see in Figure 1 were treated with Invisalign clear aligners.
What do you need to move teeth? You need three things: Force, time, and space. If one of these three "ingredients" is not present, forget it! The teeth will not move!
As general dentists doing orthodontics, we get scared by the problem that we see: the malocclusion. We think we will not be able to fix it, we believe it's going to be too hard, and when it comes to clear aligners, we often think that what we can do with them is very limited.
The reality is nowadays, we can do whatever we want with clear aligners. This is why it's not a matter of what clear aligners can do but what YOU are comfortable doing with them.
There is undoubtedly a learning curve, like in everything we do! You have to take the time to learn, to put your hands in saliva, and do some cases. Especially if you know about orthodontics. You should not be afraid to start with clear aligners. If you are beginning and are not yet confident about what you can do, tell your patients (and always put it in your informed consent) that you may need to finish with braces. And what you will find with time is that you don't need to finish with braces. What I am doing today is more finishing some of my fixed orthodontic cases with clear aligners.
Anything can be done with clear aligners! And I am not the one saying it: if you look at scientific articles, you will see that all types of movements can be done. Some are easier than others. It's a matter of knowing how to use the two. Mechanics is mechanics. Orthodontics is orthodontics. The way the tool works is different, and this is what you have to learn. You have to think differently, and there is a paradigm shift to do when you're working with clear aligners, especially if you are used to working with braces.
With clear aligners, you can close some spaces, you can correct cross-bite, open bites, deep bites, rotations, you can make a traction of a cuspid, you can correct midlines, correct the curve of Spee, use elastics, TADS... And you can also move roots. Yes, moving roots! If you compare the pictures in Figure 2, you will see a significant correction of the tip of the incisors. If the root would not move it would mean that we are bending the teeth. That would be something!
Another example in Figure 3 is how we could upright this second lower molar with clear aligners only. In that case, it was, even more, a root movement than a crown movement. If this can be done with clear aligners, then everything is possible. Sometimes the limits are only your imagination. And of course your knowledge and your confidence.
I don't mean to say these things are easy, but these things can be learned. You have to take the time to educate yourself, do some cases, and learn from your cases. Learn from what didn't work. The chances we have when we are treating patients in orthodontics is that it's a treatment that will last over some time, which means that we can change our approach. If something doesn't work out as planned, we can decide to modify our treatment plan to make it work. And this is a big difference from all the other types of treatments we can do for our patients.
Clear aligners are here to stay; your patients want it! Teeth are not selective, and they will not decide "not to move" because it is plastic. They only answer to force.
The most important reason why to integrate clear aligners in your practice is that your patients want it. If you don't offer this treatment or if someone in your practice doesn't offer this treatment, how will you compete? How will you differentiate yourself? In a time where a smile has never been as crucial as it is right now, you have to integrate these tools efficiently and successfully in your practice. Not tomorrow, not next week, not next month... NOW!
There is a clear aligner parade out there; some will lead it, some will follow it, and some will watch it go by. The fact that you read this article through the end shows that you want to be a leader in clear aligner treatments. Give yourself some time; have goals and objectives. Incorporate your team in the process, and you will see that this will be a win for your patients, a win for your team members, a win for your clinic, and a win for you.
How many of your patients have referred you a new patient because of a root canal you did? Clear aligners are a vector of reference. Another good reason to offer this service. It's never easy to change or to incorporate something new in the practice. But it's always easier when YOU decide to do it, rather than when you have no choice. Don't hesitate anymore; Make the MOVE now!