therapy and practice
Tips and things to avoid
James Mah, DDS, MSc, DMSc
IN 2012, it was estimated that 11% of orthodontic care was provided with clear aligners. 1
This utilization seems to increase steadily by 1%–2% per year. Several companies
currently manufacture clear aligners (figure 1), and many dentists and orthodontists offer
them to patients. However, like many products and services available to the public, there
are several aspects to clear aligners that consumers should understand. Anyone
interested in clear aligner therapy is urged to research the scientific literature, using sites
such as PubMed to learn about this type of treatment.
I would emphasize reading articles on treatment outcomes and those that follow stringent
research protocols including higher levels of
evidence such as randomized clinical trials
and systematic reviews. 2 Additionally, a focus
on the biomechanics of tooth movement with
aligners is important to successful treatment
planning with regard to staging and setups.
A common misconception is that the manufacturer of the aligners and branding is what
provides the result of a good smile. Rather, it
is the dentist or orthodontist who works on
the treatment through thorough diagnosis,
treatment staging, planning, clinical observa-
tion, and followup that provides a good result.
In other words, clear aligners all can be effec-
tive in the hands of an experienced clinician.
Indeed, the scientific literature has not shown
superiority of one manufacturer’s product over
Related to the above, another misconception is that the dentist or orthodontist merely
needs to dispense the aligners the manufacturer provides; however, treatments in which
all of the aligners are made in advance rarely
work out as planned. Quite simply, the biology
of humans is complex and not as predictable
as computer models. For this reason, the