How has technology advanced in orthodontics?

Aamir Vaghela discusses how technology has transformed orthodontics, how he sees technology advancing in the future and how he would feel if he had to go back to analogue dentistry.

Please introduce yourself

My name is Aamir and I work in a practice in St Albans, Hertfordshire. I primarily provide cosmetic dentistry focused around the use of Invisalign and composite bonding.

What role does technology play in your practice?

Technology plays a huge part, from examination to diagnosis and assessment. We use scanners, AI for monitoring of orthodontic treatment and digital X-ray machines, all on a daily basis.

The most important piece of technology we have is definitely the Itero scanner. You can demonstrate a wide variety of things such as alignment, caries, gum disease, plaque, hygiene – and it’s all visual. This means the patient is a lot more understanding of what you’re saying and what you’re trying to explain. It’s so obvious for the patient, which makes life so much easier with communication.

Secondly, with the development of AI, it can work out a before and after visualisation of people’s faces with Invisalign treatment. The interface visualisation is brilliant. Again, it just brings their smile to life so patients see it and become a lot more motivated to have treatment. Therefore, it helps with communicating treatment and goals, as well as a tool to help gain get more Invisalign conversions.

The Itero scanner is also helpful from a business perspective if we want to hit multiple numbers and units as we can be quick and efficient. Impressions are stressful because you’ve got to book a lot more time. Accuracy can also be an issue, leading them to being rejected or damaged by the time they’ve been posted.

It’s also so uncomfortable for the patient.

Accuracy, comfort, and speed

Impressions take a lot longer, they are a lot less comfortable, and they are less accurate. They are very technique sensitive compared to a scanner which is quick, easy, comfortable, and means we can see more patients effectively. It’s just better for the patient who wants to come in and out – they don’t want to be messing around, and they don’t want to be gagging.

In addition, you can get a lot more people involved with a scanner, such as nurses and treatment coordinators. This means you have more of a team approach.

Smile design is also massive at the moment – you can show people’s smiles on a photo and print models from a 3D-developed image.

Another huge use of technology in our practice is monitoring and treatment. Using AI, patients can scan their teeth on a weekly basis, which means they’re getting weekly check-ins. They’re also reassured about the progress of their teeth and they can see before and afters of their week-by-week progress.

It also means that compliance goes up because they’re getting weekly check ins. Previously, we would see patients on a four to six-week basis. But a lot can go wrong in four to six weeks and patients are not as compliant.

As a result, this can cause delays and hiccups in the whole treatment. Whereas, with AI you can be on top of things from the beginning. It’s a massive help.

How has the advancement of technology transformed orthodontics?

Everything’s better. Speed, accuracy, comfort for the patient, quality.

From both a clinical and patient perspective, it’s a better experience because there are no impressions and it’s quicker because of the ease of use. When things are digitalised, they are processed quickly, meaning you get plans back a lot quicker too.

This means that, when we’re fitting things, it’s a lot more accurate which, again, means that it’s a quicker appointment for the patient. As a result, there’s fewer refits because it’s so accurate. We’re not having to send work back. I’ve done over 500 Invisalign cases and I’ve never had to send work back.

It has also transformed communication within the dental team. The technology really helps treatment coordinators and nurses are discussing treatment with patients. And with labs as well, it’s easier to communicate in terms of linking up photographs to digital files. Developing a smile design digitally is so much easier, rather than just working on a plaster model.

How would you feel if you had to go back to analogue dentistry?

I couldn’t do it. I wouldn’t do it. There’s no way. If that was the case, I would find someone else to do it!

For me to carry out the volume of work that I do, I need speed. And to manage all my patients and see the influx of patients that want to come and see us, I need to work effectively.

If we stopped using technology, patients would get put off because things take longer, so we would lose patients. Analogue dentistry is not as effective, and treatment times would be longer so you can’t see as many people.

Where do you see technology in orthodontics going in the future? What’s next?

Firstly, I think scanning could become even quicker.

Secondly, more effective monitoring of patients at home. Right now, we use mobile phones, but I think it could get to a stage where it’s done via a scanner. Either through the phone, or they will give out little devices to use at home.

Visualisation will also advance in the future. I think it could become something where the image is in 3D and can move around – you could also see yourself speaking with your new teeth.

In addition, clear aligners are currently printed in factories, but I think one day you will be able to get them printed within your surgery, or within a day or week. Patients would come in in the morning, get their treatment plan, and then by the evening the aligners are ready.

I can also see analogue orthodontics becoming extinct in the future. Eventually, it will naturally phase out. There are people who have been doing analogue dentistry for years and they’re set in their ways. They’ve got a workflow that works for them which is completely fine and they don’t want to change. It’s completely understandable.

But it’s all probably down to the way universities are, so if they are going to be teaching more digital dentistry, then that’s going to be what becomes phased out.

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