Clear Idea #3

30 www.acasociety.com | info@acasociety.com C lear aligners were something of a mystery to me coming out of university, I remember hearing something about clear aligners and “Invisalign” in one of my lectures but it was quickly dismissed as being an inferior treatment method for moving teeth. One thing I did knowwas that I had a keen interest in cosmetic dentistry, and going through university I had a picture in my head of cosmetic dentistry being all about veneers and whitening, however when I got into the workforce and started to see patients that wanted a beautiful new smile it soon became clear to me (with the help of my mentor) that putting veneers on crooked teeth isn’t always going to get you the desired outcome, and would sometimes be compromising the health and longevity of your work if your patients teeth aren’t in a good position to start off with. It would also go against one of the biggest principles of dentistry – being “minimally invasive.” After seeing the vast amount of cases and complex malocclusions that have been treated with clear aligners at the practice in which I work, it immediately changed my perception of clear aligners and their abilities. How did I get started with clear aligners? I had attended multiple cpd courses, the invisalign certification course and multiple different online education courses for clear aligners before I decided to take my first case on, however I still found it quite intimidating as a recent grad getting into the clear aligner space, because I think it’s quite normal to find it hard to value your work at the same price at a recent graduate as someone who has been practicing for 10 plus years. So the one thing that gave me the confidence to begin treating patients with clear aligners, apart from the understanding I had gained from my continued education, was the fact that I had a mentor who was willing to teach me and guide me through my cases. So the following are the steps I took into getting started on my journey using clear aligners Learning as much as I could It is easy to attend the Invisalign certification course and believe that it is as easy as uploading a few scans and photos and voila you can do orthodontics. Unfortunately this is not the case, and as a young eager dentist it’s hard to accept that you do not knowwhat you do not know. So I think it’s important to proceed with caution and the best way to do this is to find out what you do not know so you can have a better understanding of where your limitations lie. So read text books, attend cpd courses and listen to experts in the field to learn from them. Finding a Mentor This is probably the most important step I found in taking on clear aligners, as it is easy to attend a course and learn the abilities and limitations of clear aligners however when it comes to treating a patient on your own it becomes slightly more intimidating so it’s good to have a senior dentists with clear aligner experience who is willing to walk through individual cases with you. And if you do not have direct access to a mentor the second best thing is a good online discussion forum where you can share cases and get opinions on your treatment setups. See ongoing clear aligner cases If possible, see patients who are currently undergoing clear aligner treatment so you have the opportunity to see what the clinical side of clear aligners is like, understand how patients respond to treatment, what it looks like if treatment is not tracking well, and how to troubleshoot issues that arise. Setting up cases I began by setting up clinchecks for family and friends, by doing a setup without any assistance initially then asking for the help of my mentor to guide me through what aspects of my clincheck’s were predictable and which would be less predictable and why. Another important part of setting up cases was to see patients for orthodontic workups so I could get experience and a better understanding of a patient’s facial aesthetics as well as their orthodontic issues. Take on a straightforward case Using a SAC protocol for determining which cases would be straightforward and which would be more advanced or complex was crucial, as I found out the hard way that you not only have to consider the complexity of the tooth movements but also patient factors such as their aesthetic demand and personality. Now I am in no way a clear aligner expert, but I think that as with everything in dentistry, clear aligners included, repetitions and continued clinical practice is the only way to improve, whilst still knowing your limitations. Another tool that I feel has really helped me with my understanding of clear aligners and has given me peace of mind that I am keeping a close eye on my clinical cases is Dental Monitoring. WithDental Monitoring I get my patients to use their smartphone to take a scan of their teeth with and without their aligners in each week, which enables me to monitor treatment progress and see immediately when treatment is not tracking as expected, rather than seeing them once every 6-8 weeks and trying to figure out when issues started to arise. I’ve found this an invaluable tool not only for making treatment more efficient and reducing the amount of chair time for patients but also, most importantly for me, to use it as an educational tool to see first hand how teeth track and what movements are working from your clin check and which are not working as predictably. So for those that are interested these are the clear aligner education companies and text books which I have been using and have found invaluable in helping me get started with clear aligners • Aorta – Dr John Hagiliassis and Dr George Abdelmalek • Aorta Handbook • Clearly Better – Dr Tony Weir • Clear Aligner Technique – Dr Sandra Tai I’m also currently studying the Boss orthodontic post Graduate Diploma in digital orthodontics.. Clear Aligners as a New Grad. About the author James graduated from Latrobe university in 2019, and has been working across 2 private practices in Melbourne since he graduated. He has a keen interest in cosmetic dentistry and orthodontics. James also enjoys using his social media account (@dr_james.b) to help educate and inform the public about responsible cosmetic dentistry. James Bartalotta By Dr James Bartalotta