I married a general dentist. We met at UCSF Dental School and we were in the same anatomy lab group. I always knew I was going to specialize. I was “gunner” (that’s what we called the high academic students back at UCSF in the 90’s). I was there for one reason only: to become an orthodontist.
Once we both started practicing, my husband wanted to start doing orthodontics, but that door didn’t open until both ClearCorrect and Invisalign launched to general dentists around 2006.
Ever since then, I’ve been helping general dentists launch and scale orthodontics in their practices. I see 4 major roadblocks/push-points that prevent a general dentist from really scaling aligners in their practice:

1. Inaccurate and Ineffective education:

Unfortunately, Invisalign and ClearCorrect don’t teach aligners the right way. They do it backwards. You need to understand basic orthodontics FIRST and then extrapolate that into aligners. The most successful doctors are the ones who did braces and Phase 1 interceptive FIRST. They don’t just take a course, they actively do this kind of orthodontics in their practice. To account for the lack of quality orthodontic education for these doctors, I created my own FREE educational system for aligners on Youtube and it’s available for every doctor all over the world. https://www.straightsmilesolutions.com/classes/educational-videos/

2. Lack of a Proper Accountability Loop for Compliance:

Compliance and removable appliances go hand-in-hand. General Dentists have zero experience with compliance. Orthodontists are masters at it. We know when patients are lying (which is often) and when they aren’t. That comes with experience. For those who want a short-cut, I recommend one of the new AI based virtual monitoring systems like: In-Hand Dental or Dental Monitoring System. Yes, Invisalign does have one that is free, called “invisalign Virtual and although it’s very limited and clunky to use for both doctors and patients, it’s better than nothing. You want your patients checking in EVERy Aligner with their aligners off AND on and trying in both their old aligners and new ones to check bite and tracking and compliance.

3. Manufacturing  and Technology Issues:

This is very rare with Invisalign but I see it all the time with ClearCorrect, Sure Smile, Reveal and In-House Aligners. That’s adding another variable into the equation. I always recommend that doctors OUTSOURCE their first 50-100 in-house aligners so that they can remove that variable and just focus on compliance and treatment planning. https://storagy-itero-production-eu.s3.amazonaws.com/download/en-us/JDC-iTero.pdf  https://austinpublishinggroup.com/orthopedics-rheumatology/fulltext/ajor-v2-id1021.php

I don’t recommend that any dentists get started with any clear aligners  (or Invisalign) without an Intra Oral Scanner. Unfortunately, the USA, Align Technology only permits use of the iTero® scanner. Analog impressions are outdated and do cause additional manufacturing issues to present more frequently and lead to poor outcomes too often. 

4. Interdisciplinary Care: 

Lastly, it is CRITICAL that terminal molars be 100% captured for best outcomes and additional impacted molars, supernumerary teeth, active periodontal disease and oral habits be remove and resolved before treatment begins. This may mean that treatment has to be delayed so that a patient can collaborate with an OMT (Oral Myofunctional Therapist) https://www.straightsmilesolutions.com/get-started/help-with-3rd-party-solutions/beyond-straight-teeth-orthodontics-and-total-body-wellness-cervical-chiro-and-omt/ or an Oral Surgeon or Periodontist. This additional and often unanticipated interdisciplinary care can also add to the expense of the treatment plan to the patient. The good news is that often in a general dental office, these procedures can be kept in-house and add to the overall production of the case and improve outcomes.