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The Art, Science and Numbers of Clear Aligner Therapy by Paul C. Schmude, DDS

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One of the greatest things about dentistry is it's impossible to get bored practicing it. No matter where you practice or how good you are, there are always new things to learn. I own a large family practice in a fairly small town in the "thumb" area of Michigan. I've learned over the years that the size of a practice (or any business), never really stays the same. It's either growing or shrinking.

As a younger dentist (I'm 37, so let's just pretend I'm young, OK?), I feel it's always been in my best interest to see the practice grow. Several years ago, my mentor and now partner suggested I get into orthodontics. I did, and it's been a blast ever since. I soon found "clear aligners" coming onto the scene and was a little skeptical. How could a few clear trays do what my beloved archwires and brackets did? Here are some tips on how to make these neat little trays help both you and your patients.

Start Simple

My first cases were pretty simple ones. I recommend you do the same. Most clear aligner labs offer classes you can take before you do any treating. Just keep in mind that you can always do more difficult cases once you get your feet wet. Start with a case that has a little bit of rotation, maybe a couple millimeters of crowding, and go from there. If you start with a tough case, you'll give yourself a migraine and won't want to do it anymore.

Know Thy Patient

One of the things about clear aligners is that they're all about compliance. If 14-year-old Jimmy hasn't brushed his teeth since the Bush administration, you might not be able to get him to wear aligners 22 hours a day. I've had a lot of success with teens, but you have to read them a bit first. Sometimes I have to be a little stern with them if they're slacking (I'd rather be feared than loved anyway). More often than teens, adults are often stellar candidates for clear aligners. They're often in the public eye, and if they're the ones whipping out the checkbook and writing down a few zeros, guess what? They'll wear those trays. Just remember, those trays must be worn.

Keep an Eye Out for Cases

Clear aligner cases are everywhere. The problem is, however, most patients don't know that they are candidates for clear aligners. A lot of the time, my hygienists will bring it up to them before I come into the room for an exam. They simply say, "I wonder if Dr. Schmude could do those invisible braces on that little bit of crowding there." The patients often say, "Do you really think he could?" I've been thinking of keeping a red cape at the office for just such occasions.

Everything Has its Limits

If you're a wise practitioner (and I know you are) you'll know that there are few "cure-alls" in dentistry, hence the challenging nature of our job. Not every orthodontic patient is a candidate for clear aligners. Just remember, it's similar to any other phase of dentistry. Don't promise what you can't deliver. Massive crowding, Class IIs, Class IIIs... a lot of this is better treated with conventional braces.

Old School is Still Classy

I love treating patients with clear aligners, but I love conventional orthodontics as well. Remember how I said it's good to add new things to your practice? Learn some conventional ortho, too. There are a lot of superb orthodontists who will help you along the way. Then, you can treat your patients with the most suitable option for them (i.e., you'll have an even bigger bag of tricks). The neat thing about this is, if you have clear aligner patients who just won't finish the way you want (probably because they're not wearing their aligners like good little boys and girls), you can glue those brackets on and call it a done deal.

Choose the Right Sidekick

Personally, I decided to go with ClearCorrect for my clear aligners. I've found them to be great folks to work with. Clear- Correct recently teamed up with a company called Objet, adding 3D printing systems to its manufacturing line. Not only do they produce each tray, but they also give you a resin model that corresponds with each tray. Should a patient lose a tray (and they will, I promise), you don’t need to order another one for big bucks (like you do with most other clear aligner companies). You simply make another one in your lab... it only takes me about four minutes. You can charge the patients if you want (I don't). When they ask about the fee, I just wink and say, "Ah, you're worth it, Mrs. Smith." This makes you the hero in your patients' eyes, and it’s better advertising.

The other thing I like about ClearCorrect is the system treats cases in "phases." It sends me a few trays at a time before moving on. It keeps things simple and so much more predictable, which is especially important for those new to clear aligners. There are many other things I like about these guys, but I'll mention just one more. I'm a combat veteran, and these trays are made in the U.S.A., dang it!

We all love what we do, we love our patients, and it's a fulfilling profession. But let's face it, we also have to run a business. It seems like such a dirty word in the health sciences, but it's a simple reality. If you add something to your practice, it has to be good for your patients, but needs to reward you as well. Patients want a happy dentist; trust me. To sum it all up, you can use clear aligners to make life better - for you and your patients. It gives them something wonderful - a nice, confident smile, and it gives you something too - a nice profit. Do good work, be ethical, be profitable and then get out of the office. That's how I work, and how I live. After all, that boat won't wash itself.

Author's Bio
Dr. Paul Schmude is a graduate of the University of Michigan School of Dentistry. He owns a family practice in Lapeer, Michigan, with two partners. He served as a Major in the Army Dental Corps and is an avid boater. He can be reached at 810-664-4542 or paulschmudedds@yahoo.com. His office Web site is www.lapeerdentalcentre.com.
Dentaltown Magazine
September 2025
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