How and Why to Offer Clear Aligners in Your Practice

  • by Eric M. Block, DMD, CAGS, FICOI, FICD
  • Oct 24, 2022
Episode 1: A New Hope to Defeat Burnout 

I am a huge sci-fi nerd, and I really enjoyed the recent “Obi-Wan Kenobi” series, so please excuse the “Star Wars” references, as they are fresh in my mind. 

The Beginning 
If you told me I would be writing an article about anything orthodontic-related when I graduated from dental school in 2002, I would have said you were delusional. Back then, I learned how to print up and write a referral to the local orthodontist, and that was it. That was my education in orthodontics while at Nova Southeastern University in Ft. Lauderdale, Florida. 

But now, here I am sharing with you that I not only learned to add clear aligners to my general practice, but this treatment has helped me continue fighting off the feelings of work-related burnout. There is light when you add something exciting into your practice. Something new can be exhilarating. 

The Hamster Wheel 
For years, I went through the motions of an average everyday general dentist. I would show up to the office and do fillings, crowns, more fillings, more crowns and some implants. Rinse and repeat. This was my schedule for almost 20 years. I was just going through the motions. 

I was burnt out and tired of dentistry. I had developed such anxiety, fear and regret that I thought about leaving the profession altogether. I couldn’t see myself doing this rat race for the next 30 years. Something had to change. 

The Phone Call 
I graduated with a bachelor’s degree in psychology from Tulane University and knew I wanted to get involved with therapy as a patient, but I never pulled the trigger. Then, about halfway into my dental career, I decided to call a local therapist. I finally did it. I was ready to face my issues and take some action. It took years of biweekly visits, but I was finally able to overcome my dental burnout and anxiety by figuring out what made me tick and why I was the way I was. Ultimately, I learned that I had to take care of myself before taking care of others. There were many mental pivots I had to make, but I also had to make many clinical changes within my practice. 

Technological Sparks 
These changes in my practice helped me become more efficient, more productive, and less stressed. There are so many clinical and nonclinical game-changers that helped me. One example was when I ditched traditional impressions and went digital. This was facilitated with the help of Dandy Labs and the 3Shape Trios® intraoral scanner. I rarely use analog materials. My staff and I no longer have to deal with wet or bloody impressions — sterilizing, pouring into stone, boxing them up, and shipping them out to the lab. Not only does the digital scanner create fewer cross-contamination touch points, but I also believe it is even more accurate than alginates or polyvinyl materials. 

I also upgraded my 3D printing from an old filament-style printer to a new Einstein™ digital light projection printer from Desktop Health. I can print up models and surgical guides for my implant cases in minutes. This printer has helped implants become one of the least stressful procedures I do all day. 

Not only have these technological additions to my daily repertoire made me a better dentist, but they have made the daily grind of clinical dentistry so much more fun. I am a firm believer in keeping things fresh with new treatment modalities, digital workflows and technology. I look forward to waking up and walking into the office to do these treatments, and I no longer have those Sunday night blues. 

But I wasn’t done yet. I had one more Jedi trick up my sleeve: I added clear aligners to my practice last year. 

The Decision
Clear aligner treatment was something I had little to no experience with. So why did I decide to integrate it into my practice? 

Like the phone call I made to my therapist, I had to take action within my practice and expand my treatment offerings. Many colleagues have raved about the fun and excitement of clear aligners. For years, I told myself that one day I would enter the clear aligner arena and finally add it to my practice. So I did. 

A colleague recommended that I look into OrthoFX, a clear aligner company founded by three previous employees of Invisalign. OrthoFX held my hand and helped me get this treatment into my office. It also provided a lot of support to get staff on board and patients to say yes to treatment. These steps will be covered in more detail in the second and third parts of this series. 

Why didn’t I do this sooner? 

The Hesitations 
There were many reasons I delayed my blast off into clear aligner hyperspace. One was the lack of dental school education and the “stay in my lane” mentality that many general dentists share. I also felt a sense of betrayal to my local orthodontists. My practice is one of their biggest referral sources, and I didn’t want to disrupt their gravy trains. 

But once I got started implementing clear aligners into my practice, that feeling faded quickly. And it wasn’t just because I felt business is business or they would find other referral sources. I actually thought the opposite would happen. I felt that by adding clear aligners to my practice, my orthodontist friends would actually get the same or even more referrals. 

I still refer all children to an orthodontist, and pediatric cases made up the vast majority of my referrals anyway. But now my practice is marketing clear aligners to adults, which is bringing in cases that previously wouldn’t have been treatment planned. However, I just focus on mild to somewhat moderate cases. If an adult case looks too complex, then the patient is getting referred to an orthodontist. 

My point is that there are plenty of cases and patients to go around. And the more awareness you create in your community, the more treatment cases there will be. 

Observe and Assist 
After having the heart-to-heart clear aligner conversation with yourself, ask a specialist or colleague if you can watch and observe them for a day. Take them out to lunch and pick their brain. Take an afternoon to assist the local orthodontist. Tell them your plan and how you expect to increase the number of referrals you send their way by increasing your own expertise and capabilities. Be honest and tell them you are starting out with simple clear aligner cases but want to learn what cases to refer to them. This should be a win/win relationship. 

Go to their office and watch their clinical and nonclinical flows. Learn their systems and how they get patients to say yes and move forward with treatment. Watch the front desk get handed the baton and schedule the patient. Learn from the insurance administrator or treatment planner. And, finally, watch the orthodontist plan and implement the case. Learn from their successes and failures. Ask lots of questions. Why did you treat it this way? What were some of your biggest failures or mistakes? What were some of your greatest innovations or game changers? If you don’t ask, you won’t know. 

There is no better time than now to reenergize yourself and your practice with a new treatment or technology. Clear aligners could be that very spark to get you excited to go to work every day. But, make no mistake — you must be willing to learn and get educated. Train, train, and then get trained some more. 

Go to live or virtual courses and webinars. Join social media groups, read books, and watch videos on YouTube. There are so many educational options right at our fingertips in this day and age. Just like a Jedi, the first step toward reaching your full potential is training. 

The second part of this series will appear in the November issue of AGD Impact. 

Eric M. Block, DMD, CAGS, FICOI, FICD, is a general dentist practicing in Acton, Massachusetts. To comment on this article, email