General Dentist and Clear Aligner Educator · Clear Aligner Advisor
Clear Aligner Advisor
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Dr. Avi Patel, DDS is the founder and CEO of Clear Aligner Advisor, an education platform that helps general dentists confidently integrate clear aligners into their practices. Dr. Patel has helped over 300 dentists implement aligner systems with clarity and confidence through his training programs - Aligner Blueprint, Aligner Launchpad, and the Clear Aligner Confidence Bootcamp.
Recognized as the Dentist Influencer of the Year (2024) and one of the most-followed aligner educators online, Dr. Patel's teaching style simplifies complex orthodontic principles into practical, step-by-step systems that help dentists offer aligners more predictably and profitably.
Are you sitting on a goldmine of untreated cases in your own practice? Most general dentists don't realize that approximately 80% of their existing patients have some form of misalignment that could benefit from clear aligner therapy.
Dr. Avi Patel is a general dentist, founder and CEO of Clear Aligner Advisor, and recognized as the Dentist Influencer of the Year (2024). He has helped over 300 general dentists successfully integrate aligner systems into their practices through his training programs including Aligner Blueprint, Aligner Launchpad, and the Clear Aligner Confidence Bootcamp. Dr. Patel's teaching approach simplifies complex orthodontic principles into practical, step-by-step systems that help dentists offer aligners more predictably and profitably.
This episode reveals the reality behind predictable clear aligner outcomes for general practitioners. Dr. Patel shares his journey from burnout to building a thriving aligner practice, emphasizing that successful integration requires more than platform certification. The conversation explores why mentorship is crucial, how to avoid common setup mistakes that lead to posterior open bites, and why understanding force distribution animations is critical for treatment planning success.
Episode Highlights:
Case selection fundamentals focus on addressing chief complaints like crowding-related oral health issues rather than pursuing complex movements. Dr. Patel emphasizes limiting molar movement and using bite ramps to prevent passive intrusion that causes posterior open bites. Simple cases in the first six months allow skill development while maintaining predictable outcomes.
IPR precision requires verification with calibrated gauges after diamond strip use, as insufficient space creation directly impacts treatment predictability. The treatment plan may call for 0.4mm of IPR, but achieving only 0.2-0.3mm creates space deficits that compromise tooth movement and final positioning.
Attachment placement technique demands precise composite application using etch and bond only where attachments belong, followed by black light verification for complete removal. Fluorescent composites designed for aligner attachments improve visibility during removal and prevent residual composite retention that affects patient comfort.
Treatment planning modifications should optimize for patient chief complaints rather than accepting initial animated proposals from aligner companies. The animation shows force distribution on teeth, not predicted before-and-after results, requiring clinical interpretation and case-specific adjustments for successful outcomes.
Patient communication strategies position aligner therapy as oral health improvement rather than cosmetic treatment, particularly effective with existing patients who already demonstrate trust. This approach works across all age groups, including patients over 65 who remain excellent candidates for alignment therapy and often become strong referral sources.
Perfect for: General dentists considering clear aligner integration, practitioners seeking to improve existing aligner outcomes, and dental teams looking to expand comprehensive care offerings through evidence-based orthodontic treatment.
Discover how proper case selection and clinical technique can transform your aligner success rate while building long-term patient relationships.
Transcript
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This transcript was automatically generated and may contain errors or inaccuracies. It is provided for reference and accessibility purposes and may not represent the exact words spoken.
If you're in a practice and you don't currently offer aligners and let's say you bought the practice from somebody else and so it's an existing population and they didn't offer it. I mean, you're sitting on a goldmine and it costs you nothing to market to them. It's just a conversation. In the beginning, you may not even be that good at talking about it. A lot of dentists will ask me like, hey, how do I start talking about this? I've never talked about this before. How do I start the conversation? The beauty is, is if it's an existing patient, they already trust you.
Welcome to Austin, Texas, and welcome to the Phil Klein Dental Podcast. Clear aligner therapy is everywhere in dentistry today, but let's be honest, predictable results don't just happen automatically. In this episode, we take a real-world, no-hype look at what it actually takes for GPs to succeed with aligners. We talk about why our guest first brought clear aligner therapy into his practice, the game-changing role of mentorship,
common mistakes that can derail cases, and practical clinical pearls, especially when it comes to case selection and dealing with attachments. This conversation goes beyond the marketing and dives into what really matters, sound clinical decision-making, patient communication,
and setting yourself up for consistent outcomes. Whether you're just starting out or looking to refine your approach, this episode will help you think more strategically and more confidently about clear aligner therapy in your practice. Our guest is Dr. Avi Patel, general dentist and founder of Clear Aligner Advisor. He's helped hundreds of dentists successfully integrate aligner therapy into their practices through hands-on training, mentorship,
virtual collaboration, and real-world implementation support. Before we bring in our guest, I do want to say that if you're enjoying these episodes and want to support the show, please follow us on Apple Podcasts or Spotify. You'll be the first to know about our new releases, and our entire production team will really appreciate it. Dr. Patel, thanks for joining us. Great to be here. Thanks for having me. We're very happy to have you on the show, Dr. Patel. We thank you for your time. I do want to mention to our audience that you did an excellent webinar.
back in February, early February, 2026 of this year. The title of it is Mastering Clear Aligner Attachments, Precision, Purpose, and Predictability. You can find that webinar on VivaLearning.com. Just type in Patel, P-A-T-E-L in the search bar and you'll see it. Excellent presentation. Well done. Also, I do want to point out that Dr. Patel's first name is Avi.
And he likes to go by Dr. Avi. So we will address him that way. So if you hear that throughout this conversation, you'll know why that is. That's his preference. So to begin this conversation, let me ask you this. What originally motivated you to start offering clear aligner therapy in your practice? Was it patient demand? Was it your clinical philosophy? Or was it something else entirely? It gets tied into honestly, my why as to why I chose dentistry.
So going back, you know, growing up, I actually thought I was going to be destined for the NBA when I was in middle school, because I was about five foot 10, one of the tallest kids in school. Kobe Bryant was my favorite player. And in my mind, I was like, there's no way I'm not making it to the NBA. And then high school comes around and I go from being one of the tallest to one of the shortest. All of my buddies were well over 6'4".
you know, just like that became not as good at, at the sport. So I listened to my parents at the time who were very encouraging of me going into a profession that probably had a little bit more longevity to it. My uncle is a dentist. I shadowed him and I saw kind of the way he was able to essentially live his life, right. This lifestyle of a dentist that a lot of us are pretty familiar with where, you know, have some, you know, they have time, freedom of their schedule. They're able to make good money.
and have an impact on patients and people. And so I saw that firsthand. And so that's what really drew me in. And the reality was when I came out of school,
out of dental school it was the exact opposite right um i'm working six days a week i have half a million dollars of student debt i'm doing bread and butter dentistry you know still trying to learn uh and get good clinically and it was a grind and and a lot of dentists can relate to this because the expectation wasn't meeting uh reality and um
Yeah, you showed a selfie on your webinar. You know, it was tongue in cheek. You said, look how excited I was to get up in the morning and go to work. And you had this very unhappy, unenthusiastic expression on your face when you took that selfie. So, you know, you're not the only one, Dr. Avi, that has these dreams of what dentistry is going to be like. And then you get out there and then the reality hits you. But you obviously turn the corner quite well because...
As you showed in your webinar, you turn things around. So tell us how you did that. And by the way, my son's favorite player was also Kobe Bryant. We used to go to a lot of Lakers games when we lived in San Diego. We used to drive to LA. So those were some really good days when Kobe was playing basketball. For those basketball fans that are out there listening to this. So you turn the corner with your enthusiasm and you did it.
I think primarily through clear line of therapy. Did you not? Yeah. So, you know, we basically, when I hit that kind of that moment around when I...
took that picture and shared it. Um, we, we had actually moved across the country and that's where, you know, we, we did a change. Um, cause at that point I was burnt out. Uh, I knew that this profession had more to offer. I just wasn't experiencing it. So we, we made a change. We moved down, um, worked for a group. They were providing, um, trainings and mentors and stuff. And they were like, Hey, however you want to grow, here's some tools, go for it.
Found a mentor, leaned on them. I started offering aligners to my patients, very simple cases. I did not want to get in trouble with anything crazy or complex. I just wanted to do the basics essentially, right? Get off the ground with it. And so that's where I started over 50 cases in my first six months.
I was just approaching it from an oral health perspective. I was not in some high-end cosmetic practice. It was a blue-collar state employee, insurance-based practice. And we were just talking about how we can help people improve the health of their teeth. So you didn't really have to go out and market these 50 cases that you started with. They were in your practice. And most of what you did was the typical lower anterior crowding that's very common among patients that...
are past, I don't know, 35, right? Even younger, you start to get some crowding and especially patients in their fifties, you really see it. So what kind of training did you need to get under your belt before you started your first case? Yeah. So before I started my first case, honestly, so I did at that time, I had the Invisalign certification under my belt, but like.
Those are more modules about the platform. They're not necessarily the clinical side. So for me, honestly, I leaned on my mentor. And I think that was something that you've done a lot of cases. You know what to do, what not to do. Can you just give me those guardrails so that way I can start and be safe? And then if I ever get stuck or in trouble, you know. And who is this mentor? Who is the mentor? Dr. Blocker. She's part of Invisalign.
Yeah. She's Invisalign faculty. And at the time she was like, yeah, she's like, just send me. Cause that's the beauty of aligners, right? Is, you know, you're not cutting into anyone's gum. You're not drilling into anyone's bone. You, you have an ability, it's multi-step. Like you have to have a conversation with a patient, you diagnose it.
You treatment, you know, they say, yes, you treatment plan it and you can, you can work with somebody to make sure you're setting up the case correctly. Right. Limiting a lot of the bad negatives that can happen. And then you deliver the case. You're, you're placing some attachments on.
you know, you're doing IPR, but there's these stages almost like the built-in guardrails and checkpoints. And so to be able to learn in this way, it was helpful for me because I knew that I needed to kind of get some reps in. I did take courses as well to kind of expand on this, but primarily, I mean, in my foundation, it was leaning on a mentor, like, but I was sending emails back and forth, sharing clinchecks and stuff.
it wasn't like the most efficient thing um so what did you actually do on the clin checks dr ravi um and also how much did you depend on that animated video that invisalign provides you which indicates where the patient is when they start and where they should end up when it when the treatment is over yeah so when i first started i actually thought that that first
treatment plan that you get back and you play the video and if the video looks good at the end that you accept that and i learned very quickly that that's not the case because the animation is showing you not what's going to happen in terms of a before and after it's actually showing you like the force distribution on the teeth
And so that is like a huge misconception that a lot of dentists don't realize because I was one of them. I would just accept the first case that, you know, the treatment plan that came back. But the modifications that I would start to make was more so around like optimizing for patient's chief complaint. So what is the patient's chief complaint?
Do they, you know, and then solving from that. What are some typical chief complaints? It's, hey, I can't really floss that well in the front. These teeth are all over each other. I get a lot of stuff built up in here. Or, hey, I don't like the spacing between these teeth. I don't like this one gap right here. So there's really two phases of chief complaints. One is before the therapy starts, like, why am I unhappy? Why is the patient unhappy with their smile?
And we talked about the crowding and those are obvious chief complaints and some of which you mentioned. The other complaints are or comments or feedback that you're going to get is during treatment. For instance, on tray 15, I started to get an open bite in the back posteriorly and they complain that they can't engage in their chewing. They can't get maximum intercuspation in the posterior teeth.
How do you approach those kinds of things not being an orthodontist? The problem that you shared is what a lot of dentists face when they don't make changes, right? When patients can't chew on their back teeth, probably because there was something wrong in the original setup. And so, well, how can I just make the original setup avoid that outcome or drastically limit the chances of that happening? So you need to get that knowledge to do that, to anticipate what could go wrong down the road.
You need obviously experience, but you also need more training than just Invisalign certification, I would assume. 100%, 100%. And look, I'm not knocking Invisalign. I think everybody's trying, but at the end of the day, as dentists, we have to remember an aligner company's primary job is to make a really good product. And a good product is a plastic tray that can move teeth. Like that is their job. It is our job as clinicians to learn.
how to clinically, right, do the procedure. And so I think that's a big thing is, you know, we've worked with a bunch of dentists and even like groups where they look to the aligner company to have all the training and the education about this clinical procedure.
Technically, right, this is something that should be covered in dental school if we want to go back into it, but I don't want to open that can of worms. So where did you actually get the, other than the experience, like every time you do a case, you learn something. But on top of that, I should say, not besides that, where did you actually go to learn how to anticipate these problems so you can address them before they actually happen? I mean, you need training for that on top of that certification we talked about.
Yeah. So for, for me personally, it was a combination, right? It was before I started asking my mentor, uh, leaning on some orthodontist that I knew to like, look at the setup and tell me, Hey, based on what you're seeing, right? Does this look good or not? What should I modify? Then you have to go and deploy it and actually do it. And then from there, based on what I would see is where I would try to make adjustments and, and kind of very getting very specific on this, right? Like I did have a post your open bite that happened to me.
And it happened because I didn't listen to my mentor. I listened to one of the support people from the aligner company. What did the mentor say? My mentor said to limit the molar movement on that case specifically. That was part of their protocols. Granted, I didn't get their feedback directly on the case. That was just more of their philosophy for treatment on these types of cases. And then the orthodontist that I was listening to.
told me the opposite so i was very confused but at that point i was directly communicating with that orthodontist so i listened to them and i did it and then i got this posterior open bite um and so i freaked out and i messaged my mentor and you know uh it was you know she told me just take a breath it's okay you know we can we can get through this um what did you do cut back the trade
bicuspid to bicuspid and no no so that if you do that if you cut the tray that is um so the whole thing with posterior open bites is you have to figure out like why did it happen and based on why it happened is how you would then solve it so cutting the trays only works if the posterior open bite was caused by uh passive intrusion um meaning right um meaning throughout treatment the the molars the the posterior teeth
are essentially coming into contact with the trays that are covering them. And so what can happen is over time, that force on the occlusal surface will actually intrude those molars. And so then when you're done with treatment, all of a sudden the posteriors aren't touching. Yeah, and if the patient's clenching at night or grinding, that's going to exacerbate that whole process.
Correct. Which is why if you just start with some, if you have bite ramps on the case, that'll help mitigate that from happening. But if you're in that situation, let's say the listeners right now have some cases going where that is the reason. Yes, you would cut the posterior, you would cut the trace posterior to the premolars and you would let gravity essentially kind of take over and let those teeth come back into occlusion. You'd be fine. For my case though, it wasn't, that wasn't it. For mine, I had tried to rotate the molars or rather buckly translate the molars. And so they actually tip.
And so when they tipped, if you cut the trays, you're only going to make it worse. And so what we had to do was plan extrusion solely on the molars and then do some more IPR and intrusion in the mandibular interiors. You mentioned IPR, Dr. Avi. I assume because that's an irreversible procedure, that has to be performed by a dentist. Yeah, I'll let team members do attachments, but like the actual IPR, like that's something.
I don't know. That's for me, it's, it's just more of as the practitioner wanting to do it. But yeah, I mean, if you are in a state where you're allowed to, like your assistant can do that and you trust them, go for it. It's really, it's really not that bad, but. So looking back on those early cases, Dr. Avii, what, what surprised you the most when you started getting into clear line of therapy? I think that the biggest thing that surprised me when I first started off with the liner cases was probably how.
You know, we try to chase perfection, but at the end of the day, patients really value improvement. And so what I mean by that is I think as dentists, we, you know, I mean, we're perfectionists. Like we want everything to be a hundred percent, you know, very high standard. And if we don't, we failed. Like if you didn't get that margin to seat fully on the crown, you failed. Like this is a failure. And I think it's, it's very, we're very harsh on ourselves. And I think in ortho.
We kind of imagine that like, okay, every case that you do must end like perfect. Like everything needs to look good and all that. But the truth is, is, you know, a lot of patients, especially if you're diagnosing from an oral health perspective, improvement is good. Improvement is a win. Improvement can make a world of difference. And I didn't understand that until I started cases. And I had my patients coming back to me. I had a patient where he had...
a lot of crowding he was wearing down his molars like right just bite issues all that stuff so we we corrected it and we got to the end of treatment and i wanted to do more i want to do refinement i want to do more trays because he had his one of his anteriors on the mandible just like slightly tweaked like just another any dentist looks at it and he's like oh let's just get that into alignment and it would have been easy it would have been probably like three or four trays um but we get to the end and um and he's like doc i'm done i'm like what do you mean he's like can we just stop here i'm like
why i was like we we were right here busy he's like yeah but you know looking out for like we've made such a difference like i can actually floss my teeth i'm like yeah but there's that one tooth right there and he's like be honest with me he's like is my bite balanced am i okay are my teeth gonna get worse and i'm like honestly you're good i hear this quite
frequently actually, that patients tap out very close to the end because they see such a dramatic improvement. It's not noticeable to anybody other than a dentist who's looking through a dentist lens. And that extra four weeks of managing compliance with that tray system, it's a pain in the butt. I mean, let's face it. Every time you go out to eat, you got to take it out. You can't put it back in without.
minimal brushing in the restaurant if you do want to put it in at a restaurant um it's you know it's an ongoing responsibility among many other things that people have to deal with so when they're in that position where they think everything's looking good to them you can't blame them for wanting to tap out and i think it's pretty you know again like you said dentists it's all perfection but who are you trying to satisfy here yourself or the patient so i do want to address one important point and that is the
number of patients that exist in the practice where clear line of therapy would be appropriate and a good service for them. And before a dentist even goes out and starts marketing externally for clear line of therapy services, they should look in their own patients of record and talk to the patients about what the opportunities are for this service.
This seems to me to be a great opportunity for a huge boost in revenue and additional services down the road for restorative once they get their teeth aligned. Basically about 80% of the patients have some type of misalignment or malocclusion. As a GP, can you treat all of those? Probably not, like you should be referring. But 80% of your patients have some type of misalignment or malocclusion. So of the 80%, if you just talk to them,
getting that conversation started, you're planting the seeds, you're going to have a decent amount that'll say yes in the beginning. And even if they don't, it's totally fine. Because as long as you're scanning them, taking photos, showing them what's going on, and then you touch base on it again in six months at your recare appointments.
you can now open the door to this treatment that is honestly helping you become a more comprehensive clinician. Because at the end of the day, if you've got a 40-year-old patient and they don't have any cavities, but they are always having plaque buildup in the mandibular interiors, sure, you can tell them to floss more, but what if you improve the position of the teeth so that they get less plaque buildup?
And then it's actually even easier to floss and maintain. So it's like that mental shift is huge. But to answer your question about how much opportunity essentially is sitting there is if you're in a practice and you don't currently offer aligners and let's say you bought the practice from somebody else and so it's an existing population and they didn't offer it. I mean, you're sitting on a gold mine and it costs you nothing to market to them. It's just a conversation. And I think that is.
And that's the beauty is, is, Hey, in the beginning, you may not even be that good at talking about it. A lot of dentists will ask me like, Hey, how do I start talking about this? I've never talked about this before. How do I start the conversation? The beauty is, is if it's an existing patient, they already trust you. So like, you don't even have to have like the perfect case presentation. You can just talk about what you're seeing. You can include them in on it. If you have scanner scan, show them the scan, talk about it, let them know what's going on because it's a very.
logical conversation when you're addressing it right from this like problem consequence solution aspect um so yeah huge opportunity and practices when you have that conversation do you ever uh talk to them about how it over time let's say you're talking to a 40 year old do you ever say you know in the next 10 years it's going to be your lower crowding is going to be worse than this it's not going to get better and as we age it's very typical for our teeth to malalign like this um
This is just the way it is. Maybe it's a flaw in nature, but this is what happens. And what that will essentially lead to is more difficult home care, a greater chance of periodontal disease and decay.
Also, your smile is going to start to deteriorate. I mean, you're going to lose self-esteem. So you don't want to put the fear factor in there, but you do want to tell them. And I think it's the responsibility of a dentist to tell them what's down the road. Like it ain't going to get better. So why not just do it now and then use retainers? And for the rest of your life, you'll have straight teeth. 100%. So yeah, you nailed it. Like all those pieces come up in the conversation. And I love what you said is it's our job as a practitioner.
to let them know what's going to happen if they do nothing. Because at the end of the day, all treatment planning, case presentation, case acceptance, all that is, is we're just helping our patients make a decision. That's it. And we're using our expertise to showcase what is currently going on, what is going to happen if we do nothing. And I tell every dentist that, hey, if you want to know what's going to happen if you do nothing, just think about your 65 and 70-year-old patients that you see.
And think about the condition of those teeth. And then ask yourself, did these teeth look like this 30 years ago? Or do they look different? And then, right, slowly change. And so I think that's the thing where, sure, you've got a little bit of issues now. It doesn't look that bad. But if we do nothing, it's only going to get worse, right? And so, yeah, it's part of it. You paint the picture. You let them know this is what's going to happen if we do nothing. This is what can happen if we do something.
How would you like to proceed? Yeah, and also a good thing for our audience to understand is that patients that are 65 years old or 70, they're still potential patients for clear line of therapy. A lot of these individuals have very active social lives. They may be retired, they may not be, but they could be involved in organizations where they have to be in front of people and their lower anterior crowding is just very obvious.
And when you start doing straightening of the teeth through clear line of therapy with whitening, those two in combination. Amazing. Yeah. It's like a complete makeover. You're bringing back to life the way their teeth looked decades earlier or even better. Not only is it a great service for the patient, it's a boom for the revenue for the practice because there's lots of patients out there in your practice in that age group that are willing to do the treatment.
And, uh, they just, you know, never really thought about it. They never thought it was appropriate for them. So I'll tell you a quick story on that. So, uh, we're, we're going through it. We're scanning the patients. Uh, and then one of the patients are there and the hygienist comes over for the, to grab me for the check. Like, Hey doc. So Skander, um, I don't really know if you want to talk about aligners. Like.
she's pretty old and I just don't think she's gonna be interested and I'm like okay well we're gonna talk about it anyways because I don't really care how old she was and she had a tooth like her teeth look great like very minimal like very overall healthy mouth um there was some wear on the incisal surface of the incisors and um one tooth was out of place I think it was number 23 and just like it was just a little bit out of place wasn't crazy but I brought it up I'm like hey um
This tooth is out of place. I'm not sure if it's something that's been bothering you or not, but you know, this is what I see. She's like, actually it has. I'm like, well, did you know that we can actually do something about it? She's like, oh, but like, I don't want to do like braces. I'm like, oh, you don't have to, we don't have to do braces. We could just do clear liners. We'll do Invisalign, move the tooth in the right position. It'll take a couple of months and be good to go. And she's like, I actually want to do it. And I'm like, okay. And she paid in full, but then she's like, you're the first dentist that has ever told me that I could do this.
And she's like, thank you so much. Cause I've been always wondering, she's like, I see the commercials all the time on TV and I always wondered if I could do it, but no dentist has ever told me that I could. And then, so we did it. She went through the best patient in terms of compliance. And she got a phenomenal result. And then I actually found out later, like I saw her when I was at the, like months later, I mean, years later, actually, I was at the chiropractor and I saw there was a magazine on the table.
And her face, and she was on it, and she was a real estate agent. And guess how old she was? 70. 81. Wow. Yeah, I mean, that's an amazing story for many reasons. One is that, which really stands out, is that you were unique by identifying her as a patient that could be eligible for clear line of therapy in spite of her age.
where most other dentists or all the other dentists she's ever come into contact with just said, no way, she's too old. And secondly, she has a lot of friends in her age group, and she's going to be bragging about her dentist who just presented her with the opportunity to straighten her teeth and whiten it. I'm sure you use whitening gel with the therapy. And now you're going to have her friends coming over, you know, who she hangs out with.
aligners are like the gateway procedure to all the fun dentistry. That's what I like to say, right? It's if you can get your patients into treatment and you can improve the health of their teeth and the position of it, they are going to come to you multiple reasons. One, they're going to come to you. They're going to start asking you different things that they can do to improve the appearance.
You didn't talk about the appearance. You just talked about the position. That's a psychological thing that's been demonstrated many times before. And I'm glad you brought it up. And 100% correct. Patients will now look at their own teeth in a completely different way because they're straight. And now they have even whitened them to whatever level they've taken that whitening to. But they're seeing a chip or they're seeing one tooth is a little shorter.
And then they're starting to look at people on TV that have these beautiful white straight teeth. And they're going, you know, I'm almost there. I can get there now because before my teeth were so malaligned, it was like too many steps to go to even investigate that.
And then actually doing the cosmetic work at that point, right? Restoring those teeth. Like it's so much easier when they're in a better position. And more conservative, right? Way more conservative. Everybody wants to do no prep veneers these days. And my thing is like, cool, do you know how to do aligners? And most of them say no. And I'm like, well, you're missing out on so much opportunity because if you just align the teeth, it took six to eight months just to align the teeth.
You could have so many more no-prep. Especially if your case selection is appropriate. That's the key thing for a GP who's looking to advance their aesthetic restorative work conservatively. They want to be very smart with their case selection, with their clear line of therapy, which obviously you talk about in your webinar and you did that very well. So as we get to the bottom third of this episode, I do want to talk about attachments.
for a bit, because that is an important part of aligner therapy. So what do you see dentists doing that gets them into trouble and leads to less predictable outcomes because of the way attachments are placed? Yeah. So I think the biggest roadblock and challenge that dentists face when it comes to attachments is honestly the placement and the removal of them. And so what I mean by that is when you're placing the attachment, you have to be very, very
about where you're placing the material and you know a quick story on this uh one of the team members that i was working with was working for another doctor in the practice she was helping me out for the day um i have i trusted uh assistants to do that she put the attachments on and come back on and the trays weren't fitting it sounds like what's going on um and i'm like looking and you know the attachments are there there's composite all over the tooth and and but the trays wouldn't fit and so i was just like okay what's what's going on so i
I took a black light, shined it on the, on the tooth. And I saw the whole tooth lit up. I'm like, Oh my God, she put composite on this entire tooth flash all over the place. And so I was like, so at that point I had to remove all of that. And with that flash, like she, you know, whatever her, her whole thing was like the dentist that she works like, that's the way that they do it. And so I'm like, okay, cool. Like that is, you know.
No wonder that dentist doesn't think Invisalign works. Let's be careful. Be careful. They may be listening to this podcast episode. Yeah. Well, again, you have to put the attachments on the right place. So to answer your question, it is very much so only put etch and bond wherever you want the attachments to go. And then when you're using the composite, right? Fill it such that you're not underfilling. And then if you do a little bit of excess, that's totally fine. Bond it.
go through it when you're removing it. This is, this is huge. And this is where, you know, if you can pick a composite, like I'm, I'm not here to plug any, any composites, but you know, Voco, they're going to have a composite for attachments. That's very hypofluorescent. Why is that important? What's the name? What's the name of that? What's the name of that product that Voco makes? I think, I believe it's a liner flow. I believe that's what it's called. Okay. They have one, they have one, you know, just that, that's, that's the one that, that they've made for attachments.
Was that made specifically to be sensitive to black light? Yep. That's really cool. It was made specifically. Yeah, I'm looking at it right now online. Aligner Flow LC, it's called. Fluorescent composite for aligner attachments. Correct.
So it makes your life easier because, you know, composites in general, they do light up a bit, but like it can be sometimes a little iffy with this. You shine a black light on it. It's very clear where the composite is. And the reason why I like that is because let's say you have a team member who overfilled, you know, the attachment well and there's composite all over the tooth. You want to know when you're removing the attachment, what is composite and what is tooth structure, right? This is something a lot of dentists are afraid of is, hey.
It's translucent. I can't really see. I don't know if I'm removing tooth structure or composite, right? Because at the end of the day too, you want to make sure you get all the composite off at the end because you don't want any of that residual composite on the patient's tooth that's not comfortable. So yeah, so that's part of our protocol is making sure we can see that and remove it. And with that composite from VOCO, I assume you use an adhesive.
to bond it to the enamel? We use the universal bond one. So it's the one that where you can kind of pinch it and it comes right into the wall. Okay. That's a futuro bond. Correct. Yeah. So that's a nice thing to, that's a nice tip to keep in mind is using that black light. And of course, if you use the template that comes from the aligner company to place the attachments and you use it properly, you shouldn't have too much flash.
correct yes uh as long as you're placing you know the composite directly into the well you shouldn't really
have too much flash unless you have a team member that. There we go back to that team member. Yeah, you're loving that team member. I hope you have a job next Monday. So for those that are looking for super predictable aligner outcomes, which is everyone, right? We all want predictable clinical outcomes.
Can you recommend to our audience one or two clinical or planning habits that would make the biggest difference? Yeah. So the first one is definitely case selection, right? So clinically, you want to select cases that are more predictable and you don't want to get in over your head on that. And I share that, I believe, in the training. But then chair side technique, I would say when you're doing IPR.
use an IPR gauge afterwards to actually see that you did the correct amount of IPR. Because if you, let's say the treatment plant is calling for 0.4 millimeters of IPR.
And you only do 0.2 or 0.3. Well, you're not going to get the predicted outcome, which will make the case less predictable just because you didn't do enough IPR. So I think that's something is just having that IPR gauge can go a long way just to make sure that you're actually getting that. Because it's space creation, right? Everything in ortho is space. Either you have it or you don't. And if you don't have it, you want to make it. Are those diamond strips they use, aren't they pre-calibrated?
as far as the thickness? They are, they are, but it doesn't hurt to just double check. Because, you know, everything in dentistry is, nothing is right 100%. So I always say, if you can at least just have that gauge at the end to kind of check, it'll go a long way to ensure that you're getting the space that you need.
So as we get to the bottom of this podcast, I do want to say that Dr. Avi is actually quite an entrepreneur. He started a company that has orthodontists on staff that help general dentists start with their clear liner cases and follow through with them. And it's a really pretty exciting concept and it seems to be doing very well. So if you would, Dr. Avi, tell us about that.
Yeah. So it's called Aligner Blueprint. It is a virtual program where we help dentists who either have no idea how to do aligners or they kind of do, but they're really just looking to get their foundations in check. And then we offer case support and monthly mentorship for them.
Basically, I don't like to really call it a course. I like to call it more of an implementation and support system where doctors who are looking to get going with this in their practices, we work with them and help them through all those early challenges and struggles. We've helped over 350 dentists at the time of this recording.
It is brand agnostic. So whether you're using Invisalign, SureSmile, Candid doesn't matter. We've supported doctors across all platforms. We have a team of orthodontists as well. They do this virtually. Correct. Correct. So, you know, a lot of GPs, they may not have a local orthodontist or what have you. They just want faster feedback on their cases. So we've built that. Yeah. This sounds like an amazing opportunity for general dentists to get started, to have something all set up so that they could collaborate.
with orthodontists on their cases. But I think also one of the most valuable parts of this is that your organization will communicate to the general dentist that this case may not be the case to do for them. It should be referred to an orthodontist. So case selection is really a big factor here.
So I work with the orthodontists and I also coach them on different coaching principles, right? They're beyond qualified on the clinical side, but on the actual coaching side, I try to kind of give them pointers. And I'm like, hey, our job is not to turn these GPs into orthos. Our job is to make sure these GPs are doing cases safely and predictably. And if you feel like this case should not be done by a GP and should be referred, we encourage that. Because at the end of the day, one of the best messages I've ever gotten when I was doing a lot of the...
case reviews in the early days was a GP told me like, thank you for telling me to refer it. And I was like, oh, why? And they're like, because I can go to sleep at night knowing that I don't have to worry about that. That was stressing them out. And of course, there are plenty of cases that are manageable by the GP that they can do that'll keep them busy. So why go into something very complex that will cause stress in the practice and have unpredictable clinical outcomes? And if you would, Dr. Avi, share with us the website that our listeners could visit to get more information.
Yeah. So our website is clearaligneradvisor.co.
And on there, it has access. We've got free trainings. We've got our aligner blueprint program. If anybody's on social media, you can follow me, Dr. Avi. And you can send me a message if you have questions. I put out videos daily. Okay, Dr. Avi. And that's AVI. Correct. Just for our audience. Happy to help and answer any questions. And this was a lot of fun. And I appreciate you having me on. Yeah, our pleasure. Thank you. You take care.
Clinical Keywords
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