How and Why to Offer Clear Aligners in Your Practice — Episode 2: The Middle of the Adventure

  • by Eric M. Block, DMD, CAGS, FICOI, FICD
  • Nov 7, 2022
11-7-22_Aligners_AThis is part two of a three-part series on introducing clear aligners to your practice. The first part can be found in the October 2022 issue of AGD Impact.

Now that you’ve decided to take the plunge and get involved with clear aligners, you need to decide on a clear aligner system, get the team on board and put systems in place. 

Choosing a System 
Based on my experience with choosing an implant system, it is best to keep it simple and choose one company to work with, especially at first. 

Interview potential companies as if someone was applying for a job in your office. The company you choose should be as invested in your success as you are. Let’s face it — the more they can help you, the more cases you will treat, and this in turn will make them more money. It’s win-win. 

If you find that the company that you have chosen is not holding up its end regarding customer service, then maybe it’s time to move on or demand that it provides more support. Don’t keep this quiet; interview multiple companies and tell them what you’re unsatisfied with regarding your current company. You will be able to get more incentives because they will be fighting for your business. Ideally, you and the company you ultimately choose will have a thriving relationship for many years. I chose to work with OrthoFX. I hit it off right away with them and appreciated the company’s philosophy, technologies and customer service. 

OrthoFX has an excellent clinical upload and communication portal. This is a Health Insurance Portability and Accountability (HIPAA)-compliant way of communicating the patient’s records and treatment plan back and forth. I am able to collaborate with an orthodontist and make any necessary changes after reviewing the treatment plan. 

The company also handles the financial end of it. No one likes to talk about money with patients, so it’s nice to have a third party do this for you. Its team was also very helpful in coming up with and implementing creative marketing ideas, such as clear aligner demo models, brochures, social media posts and more. 

Getting Staff On Board 
Adding anything new to the office can be difficult, especially something as different as clear aligners. Adding a new treatment is a long game. Don’t do too much at once. How do I know this? I tried, and it’s overwhelming for team members. Focus on adding clear aligners now, then another treatment modality next year. Crawl, stroll, then run. Step by step, brick by brick. 

A New Language 
Adding a new treatment such as clear aligners can be like adding a new language to the office. The insurance codes and appointments are very different than the rest of general dentistry. It may take time for everyone to get on board. Have the clear aligner staff come in virtually or in-person to onboard your team. 

Let’s Be Real 
I always thought of anything orthodontic as a different species of animal. It felt so different from my typical treatments. So, it was no surprise that adding clear aligners created a fear of the unknown. This feeling of fear is a normal response. You may experience nervousness and the ups and downs of getting started and implementing something new into your office, but you can minimize these issues by keeping up with your education, training the staff and having solid systems. 

The Consult
In order for patients to accept treatment, you and the staff will need to rock the all-important clear aligner consultation and subsequent conversations. The consultation is typically now done in my operatory. I like to take the patient out of the hygiene room to have the consult and take their initial scan and photos. 

If you don’t have a scanner, you can take their bite and impressions. I will show them a model of what clear aligners look like as well as the buttons and potential interproximal reduction. We discuss the treatment process, risks and benefits of treatment, and risks of no treatment. Whether they accept or decline, you’ve at least gotten them thinking about treatment. 

Here are some frequently asked questions I get during my clear aligner consultations. 

How much will it cost, and will my insurance cover any of this? 

This is every dentist’s favorite question. I leave it open-ended and give them a strong, “Maybe. Some plans cover orthodontic treatment while others don’t, but we will look into this for you.” I like to tell them my fee and also mention that they can break it down into monthly payments if needed, then I leave the rest of the financial discussions to the administrative team. My team will look into the patient’s insurance and mention third-party financing. OrthoFX also offers its own financing. 

How long will it take? 

The duration of the cases I am treating is typically 20 weeks. I am not doing complex cases, but I will tell the patient that I will get a treatment timeline and animation of what their teeth will look like after I submit their files to OrthoFX. I also like to try not to pin it down to a certain timeline while also pointing out that they may need revisions and more trays after the initial plan. 

Am I too old? 

A lot of adult patients think that they are too old for “orthodontics.” I show them that, unlike traditional braces, clear aligners are made of the latest polymer technology so they’re less visible and that all of my orthodontic patients are adults. I may also mention that they, like many of my other patients, very likely had braces as a child but neglected to wear their retainer, which resulted in teeth shifting. This makes most patients feel more comfortable in their decision because other adults are doing this as well. 

Is it just cosmetic? 

Some patients just don’t care how their teeth look. Lower crowding or spaces do not bother them. But when they hear that it will allow them to better maintain their teeth and understand that it is more than just a cosmetic treatment, then they feel it is more justified. I like to say that the straighter your teeth are, the easier they are to clean because there are fewer nooks and crannies for plaque and tartar to hide in. 

Like Piloting the Ship 

Implementing a new treatment modality into your office can be like in “Star Wars: Episode V — The Empire Strikes Back” when Han Solo needs to navigate and steer through an asteroid belt. Through ups and downs, lefts and rights, and even a 180- degree spin, Solo was able to safely land the Millennium Falcon, and so will your practice at the end of the adjustment period of implementing this new treatment. 

The third part of this series will appear in next month’s AGD Impact.

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