Dental Asia November/December 2022

CLINICAL FEATURE
In just one scan, multiple types of
information are captured within
minutes and visualised on-screen
for communication with patients:
iTero NIRI (Near Infra-Red Imaging)
technology for early enamel/dentinal
interproximal caries (Metzger, et al.,
2022); iTero Occlusogram for bite
force/malocclusion/arch contact
relationship; iTero TimeLapse
technology and integrated 3D intraoral
camera for teeth, tooth structures and
oral soft tissues (Figs. 1a-b).
These features can be used to
identify cracks and visualise trauma
as well. If needed, the scanned
results can be used to demonstrate
the needs of orthodontics
treatments to patients (in certain
versions of scanners) and the
expected treatment outcomes can
be visualised through an application
called Invisalign Outcome Simulation
(IOSim)/IOSim Pro at chairside.
The strength of iTero Element
scanners is the scan report feature,
which packages the oral health
condition pictures/data of a patient
into one document and is formulated
to be sent to the e-mail or mobile
device of a patient.
This is the reason why iTero Element
scanners could be advantageous over
mirrors and transilluminators which
are far more affordable. It is the
report and shared communication
with patients that help clinicians
build stronger relationships with
patients.
In addition, the record-sharing
practice is effective to raise
patient awareness of oral health
management as well as for patients
to take their time to understand and
appreciate the additional time and
resources spent on the assessment.
The visualisation and the handson
copy of oral conditions support
patients to comprehend their oral
conditions and accept diagnosis and
treatments. Moreover, it is a practice
to provide warnings for potential
dental problem risks, educate how
their oral conditions need to be
taken care of, and therefore reduce
the liability of dental professionals.
PRACTICE SHARING
To provide an example of how oral
health assessment is integrated into
my clinical practice, I will introduce
a workflow. Upon arrival at the
clinic, patients are asked to fill out
an initial visit survey (from Kois
Centre, Seattle) to assess their oral
health conditions and report their
daily oral management behaviours
while they are waiting. This is a
great gateway for patients to think
about their oral health and feel the
need for comprehensive check-ups.
The survey provides oral health
assessment recommendations based
on the number of answers requiring
the monitoring of oral health. Thus,
if patients are willing to assess their
oral health conditions or if a certain
number of answers are ticked, an
assessment is recommended.
Once patients are under the oral health
assessment, multiple diagnostics tools
including IOS are used to analyse the
oral conditions. The core value of IOS
such as iTero Element scanners is that
oral health conditions can be visualised
and communicated with patients at the
chairside concurrently. While scrolling
over different angles of oral health
components, dental professionals can
explain the current oral conditions to
patients, what oral problems are being
suspected, and possibly share the
treatment plans if needed.
Since the saying “seeing is believing”
is often a very fundamental belief
system in humans, patients tend to
trust and accept the diagnosis and
treatment plans more easily after the
visualised oral health assessment.
Additionally, patient’s decision
to accept treatment is heavily
affected by their relationship with
their dentists which is the first and
foremost factor over cost and time
(Kalsi and Hemmings, 2013).
Figs. 1a-b: Clinical condition of attrition detected during oral health assessment which is difficult to detect without magnification
DENTAL ASIA NOVEMBER/ DECEMBER 2022 35