Dental Asia January/February 2019

Under the Spotlight
What are the advantages and indications
of using clear aligners?
Currently, there are a lot of evidencebased
studies and research that can help
us better understand how clear aligners
work. Let us look at the benefits of clear
aligners for patients. Firstly, the pain level
is reduced. There is no doubt that all
studies show proof that clear aligners are
more comfortable, less painful and have
a positive effect on the patient’s quality
of life. Secondly, the gingival health or
periodontal health are improved especially
for patients who are predisposed or often
have periodontal disease/problems.
Thirdly, there is less enamel damage on
the teeth as there are no brackets or
molar bands attached to tooth structure,
resulting in reduced enamel decalcification.
Aside from all these benefits, the invisibility
of clear aligners is a plus for most patients
who are very conscious about how they
look. Nowadays, with the advent of social
media applications such as Snapchat,
Instagram and Facebook, there is no
denying that many care about their
physical appearances. Finally, there are
some studies showing clear aligners can
work a little bit faster than traditional
fixed braces/appliances – shortening
orthodontic treatment down by about
five months for some simple to moderate
Class I cases.
Clear aligners are primarily indicated for
simple to moderate malocclusion cases,
which is majority of the cases that we see
in our practice. Clear aligners are now
becoming common and popular for teens.
But for cases that require uprighting
molars or more complex movements
such as extrusion of impacted canines,
traditional braces would still be used. Also
in cases where surgery is needed, oral
surgeons still prefer traditional braces over
clear aligners.
In your practice, do you prefer using
clear aligners over traditional braces?
Why?
Clear aligners are very powerful and can
move teeth comfortably. At the moment,
80% of our cases are clear aligners and
only 20% are fixed appliances. We find
that with clear aligners, we don’t have
to make unnecessary appointments.
There are also studies that show patients
are more motivated while wearing clear
aligners over traditional appliances and
we have noticed this as well. Overall, we
are a happy practice and we have happy
patients who love the fact that they can
have comfortable treatments with reduced
emergencies and oral health impacts.
It has been said that digitalisation is
already the way of the future in dentistry.
Presently, Dental
Monitoring (DM)
is being used in
orthodontics.
Kindly tell us more
about it and how it
works.
Dental Monitoring is
a simple application
for monitoring
patients, which
gives dentists a lot
of control in their
patients’ treatment such as when to
change aligners, how often and what stage
the patient needs to be checked. I consider
myself as a pioneer in the orthodontic
industry, being one of the very first
orthodontists in Australia to use DM mainly
on clear aligners. Now we use DM for every
treatment, including maxillary expanders
and retainers. For example, in our practice,
we ask our patients to take a weekly video
of their face and teeth with and without
an appliance using their smartphone and
upload them into the application. The DM
application uses artificial intelligence (AI)
to recognise photographs, videos and
backgrounds and from there, monitor
gum health, teeth movement, and rate
of teeth movement and predictability of
movement of each patient week after
week. For me, as an orthodontist, this
is the definition of providing ultimate
care for my patients. Not only now we
are giving them customised treatment
but also personalised to their biological
response and compliance. Before DM, we
would traditionally see patients every six
to eight weeks for adjustments and have
no idea what the condition of the patient
is like in between dental visits. Now, we
can monitor patients outside the clinic and
catch problems early and troubleshoot
early. This is a clear advantage of DM. With
the weekly monitoring, patients have the
peace of mind and are reassured as they
know their dentists are keeping a close
eye on them.
However, there is a misconception that
DM is fully-automated and completely
driven by AI. DM is only semi-automated
JANUARY / FEBRUARY 2019 DENTAL ASIA 19