Dental Asia Jan/Feb 2019

Under the Spotlight JANUARY / FEBRUARY 2019 DENTAL ASIA 19 What are the advantages and indications of using clear aligners? Currently, there are a lot of evidence- based 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 fromall 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 theway of the future indentistry. Presently, Dental Monitoring (DM) is being used in o r t h o d o n t i c s . Kindly tell us more about it and how it works. Dental Monitoring is a simple application f o r mon i t o r i ng 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 DMmainly on clear aligners. Nowwe 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 canmonitor 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