March24, 2023

Abstract Volume: 5 Issue: 6 ISSN:

Clear Aligner Treatment, and its Requirement of Knowledge and Understanding of Orthodontics

Hasse Lundgaard *

Corresponding Author: Hasse Lundgaard, Orthodontist, Ferryhill. England, United Kingdom.

Copy Right: © 2022 Hasse Lundgaard, This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received Date: July 19, 2022

Published Date: August 01, 2022

Clear Aligner Treatment, and its Requirement of Knowledge and Understanding of Orthodontics

There is a saying:

“The true measure of one’s skills, is how one makes a success of a case that does not go ‘by the book’”. 

And a statement:
“The expected high quality of an Aligner treatment, is a result of the quality of the treatment information from the dentist to the ALIGNER technician, who in turn uses this information to program the ALIGNER software”.

It is very important to understand that ALIGNER TREATMENT is an ORTHODONTIC treatment. Hence, any Dentist who is offering this TREATMENT to Patients, needs therefore, to have a basic understanding of biomechanics and the general orthodontic principles and fully make use this essential knowledge in their ALIGNER TREATMENTS.

 It is worrying, and not at all good for the future reputation of Dentistry, that it is expected that more than half of all dentists who are offering ALIGNER TREATMENT to their Patients, ONLY send in scans or impressions of their Patient’s teeth to the ALIGNER Laboratory. They then leave it to the Laboratory Technicians to program the software with only this information.  That is because those Dentists have very little, or even no knowledge about orthodontic principles, or what they are doing, and rely on the technicians and their computer software alone to design the treatment.

Let’s compare this to what could happen in a parallel situation in medical surgery, where robots - via a software program - take over and do some kinds of surgery, with the Doctor knowing little or nothing about what is going on!

This is naturally of course NOT the case, NOT the case at all.

It is obvious that the medical Doctor has done extensive preparatory work, made a full and detailed TREATMENT plan etc. before using the computer- based robot. The medical doctor is of course, at all times in full overall control of what the robot is doing and understands every single part of the treatment in detail. And again of course, the doctor bears full RESPONSIBILITY for the TREATMENT and if he did not have a full and detailed knowledge about it all, he would be in serious trouble with the Medical Association or even worse, with possibly causing serious damage to the Patient.

It is a fact that some general dentists are starting using the Aligner Therapy, without the necessary basic orthodontic knowledge and it is taking precedence over other kinds of their dental treatments. This means that these dentists are starting a new kind of Dental Treatment, without really knowing what they are doing. Patients would of course at some stage become aware of this and step by step this would ruin the patients trust and eventually would damage the reputation of the dental clinic.

It is not understandable at all that some highly professional dentists are practicing the ALIGNER treatment, without having the necessary basic orthodontic knowledge.

 Because ALIGNER TREATMENT is a reasonably new orthodontic system and it is computer based, Patients do not clearly understand as yet what to expect and who has the responsibility of the treatment when something does not go to plan.

When the new Aligner System arrived, it was seen as a much more aesthetically  and comfortable orthodontic appliance to wear than the fixedsystem  Orthodontists would now take this system into consideration when they needed to inform Patients about the different options to treat a malocclusion, crooked teeth etc. But in the end, the treatment system to be offered to the patient  should always be the one that the orthodontist  believed to be the one that would give the best result. And the Orthodontist will of course have an overall picture of all the orthodontic problems and state if the problems were skeletally or dentally related etc., which a dentist without some orthodontic knowledge would be unable to perceive. A correct and detailed diagnosis is so vital for making the  detailed overall treatment plan.

It is obvious to assume that aligner patients will soon be more aware of the reasons when a treatment Orthodontists have for decades used the Fixed Brace System to align teeth in the most optimal way, where the quality of the TREATMENT was always the first priority of the aims of the treatment; to obtain perfectly aligned teeth, and an optimal static and functional occlusion, within a framework of excellent aesthetics. does not end up as the computer software predicted and not will accept answers like: “It is computer based”, or “Something has gone wrong with the calculation”, or “Sorry but that is what can happen with a computer software and that is out of our hands”, (That means - it is not our responsibility!).

And then the dentist who does not have the appropriate and required knowledge and understanding of the orthodontic ALIGNER treatment will really have problems and that can very easily ruin the trust from the Patient and consequently can damage the reputation of the dental clinic.

Aligner Patients will normally, at the start of a treatment, be shown the final result that the software has calculated. But research studies have shown that on average, at least 20-30% of all cases show that the final outcome is NOT as the computer has predicted and a computer prediction is as well not always showing the best and most optimal solution of the orthodontic case. This is also  very important to understand.

Orthodontics is a BIOLOGICAL PROCESS that no computer software program nor any Clinician has full control over.
In the Fixed Orthodontic treatment System, it is possible to change the strategy, appliance design and the the treatment system as soon as something does not go to plan. But in the ALIGNER TREATMENT SYSTEM everything must be planned in advance or at the REFINEMENT stage.

The other important issue is Patient’s compliance and cooperation, which will not be known at the start of a treatment. 

All this means that on average in at least 20-30% of the cases, REFINEMENT will be needed, where extra Aligners are required to finish the Treatment and obtain the optimal results, to which all aspire.

 In this case the Aligner Dentist , after consulting with the patient, must now modify the treatment and send the new details to the CAD Aligner Technician to alter the software program and thus finish the patient?s  ALIGNER TREATMENT satisfactorily.

 It is very important to understand that the Dentist is the ONLY person who has seen the patuent, talked to the patuent , heard about the patients  MAIN problems, concerns etc. and therefore knowing all the details, can inform the ALIGNER Laboratory about the appropriate treatment plan.  It is also important to bear in mind that the software cannot consider or control the soft tissue, does not know about the gingival situation, the functional occlusion etc.

It is very evident that all the essential details from a Patient’s Questionnaire and all the essential details of a thorough Clinical Examination and correlated analysis of the patient in full, all MUST be informed to the ALIGNER Technician for him to program into the software.

 It is important to understand that it is the dentist alone who has the full responsibility of the ALIGNER TREATMENT and its outcome. It is NOT the Dental Technician, nor the ALIGNER software. An ALIGNER Dentist CANNOT blame the computer in any way for a bad TREATMENT result.

 There are now more and more articles in newspapers   and information from Orthodontic Societies that state it is very evident that “ALIGNER DENTISTS” must have essential knowledge, understanding and professional insight of the ORTHODONTIC ALIGNER SYSTEM, and that it is, in itself, an ORTHODONTIC TREATMENT.   ALIGNER lawsuits have already started in relation to companies and Dental Clinics offering Aligner TREATMENT without a COMPETENT CLINICIAN  and a fully appropriate and professional treatment assistance.

It is now more than ever important that all dentists who are offering the ALIGNER treatment to patients, have found ways to educate themselves about Orthodontics and Aligners, so that they have a very good basic understanding of Biomechanics and the Orthodontic Principles.

The “ALL in ONE”, ORTHO X ALIGNER program has been created and developed as a unique tool to obtain, step by step, this basic and essential knowledge of the ORTHODONTIC ALIGNER THERAPY, by “LEARN by ACTION” and the “LOGIC APPROACH”.

This required ‘mind changing’ of dentists, to obtain that essential orthodontic skill, will first and foremost benefit the MOST IMPORTANT PERSON of all, THE PATIENT. But certainly, it is also for the benefit, pride and self-esteem of the Dentist, and it will of course, also very much benefit the REPUTATION of DENTISTRY in general.

By using the ‘ORTHOXALIGNER’ program for each new Patient, the dentist will benefit from continuous learning and understanding about the ALIGNER TREATMENT and this basic knowledge will be invaluable and important for the dentist in the future competitive World of Aligners.

To tell the patients, in a professional and very informative way, about the ALIGNER Treatment from the very start and throughout the whole treatment, is very important.  Consequently, we have also created and included ORTHO- ALIGNERS PAMPHLETS in our Program, to fully inform and impress the ALIGNER patients..

One of the Pamphlets is EXTREMELY IMPORTANT. The “Patients General Information and Explanation” pamphlet. This informs them about all the important and necessary responsibilities a patient has in connection with their Aligner Treatment and also states that they have been clearly informed about all parts of an Aligner Treatment, including the possible risks etc. The contents also include information about what a patient can and cannot complain about; what they cannot blame the dentist for etc. There is extensive and important information in this 15 Page Pamphlet that we call:

 “The Legal Paper”




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