{"id":8964,"date":"2016-11-02T11:03:47","date_gmt":"2016-11-02T00:03:47","guid":{"rendered":"https:\/\/www.bitemagazine.com.au\/?p=8964"},"modified":"2016-11-22T12:48:20","modified_gmt":"2016-11-22T01:48:20","slug":"pick-battles-wisely","status":"publish","type":"post","link":"https:\/\/www.bitemagazine.com.au\/pick-battles-wisely\/","title":{"rendered":"Pick your battles wisely"},"content":{"rendered":"<h2><img decoding=\"async\" class=\"aligncenter size-large wp-image-8966 lazyload\" src=\"data:image\/gif;base64,R0lGODlhAQABAIAAAAAAAP\/\/\/yH5BAEAAAAALAAAAAABAAEAAAIBRAA7\" data-src=\"https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2016\/10\/clear-aligners-1024x683.jpg\" alt=\"clear-aligners\" width=\"1024\" height=\"683\" data-srcset=\"https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2016\/10\/clear-aligners.jpg 1024w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2016\/10\/clear-aligners-300x200.jpg 300w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2016\/10\/clear-aligners-768x512.jpg 768w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2016\/10\/clear-aligners-696x464.jpg 696w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2016\/10\/clear-aligners-630x420.jpg 630w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2016\/10\/clear-aligners-225x150.jpg 225w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2016\/10\/clear-aligners-112x75.jpg 112w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2016\/10\/clear-aligners-285x190.jpg 285w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2016\/10\/clear-aligners-150x100.jpg 150w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2016\/10\/clear-aligners-740x493.jpg 740w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2016\/10\/clear-aligners-400x266.jpg 400w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><noscript><img decoding=\"async\" class=\"aligncenter size-large wp-image-8966 lazyload\" src=\"https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2016\/10\/clear-aligners-1024x683.jpg\" alt=\"clear-aligners\" width=\"1024\" height=\"683\" srcset=\"https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2016\/10\/clear-aligners.jpg 1024w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2016\/10\/clear-aligners-300x200.jpg 300w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2016\/10\/clear-aligners-768x512.jpg 768w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2016\/10\/clear-aligners-696x464.jpg 696w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2016\/10\/clear-aligners-630x420.jpg 630w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2016\/10\/clear-aligners-225x150.jpg 225w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2016\/10\/clear-aligners-112x75.jpg 112w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2016\/10\/clear-aligners-285x190.jpg 285w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2016\/10\/clear-aligners-150x100.jpg 150w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2016\/10\/clear-aligners-740x493.jpg 740w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2016\/10\/clear-aligners-400x266.jpg 400w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/noscript>General practices across the country now offer patients clear-aligner treatment plans\u2014and that\u2019s a good thing. But when should a dentist refer a patient to an orthodontist?\u00a0Kerryn Ramsey investigates<\/h2>\n<p>Clear aligners revolutionised orthodontics by removing the stigma of wearing braces. While teenagers embraced the concept, it\u2019s the adult population that\u2019s really responded to this new technology. Men and women can finally have their teeth straightened without sporting a mouthful of metal.<\/p>\n<p>There are a number of different brands of clear aligners on the market including Clear Correct, ClearPath, Truline and SmileTRU, but the market leader by a significant margin is Invisalign. Align Technology Inc, creator of Invisalign, launched the product in the US in 1999; by March 2015, the company estimated that, worldwide, three million patients had been treated with Invisalign.<\/p>\n<p>The big game-changer associated with Invisalign and other clear aligners is that, with the right training, they can be fitted in a general dental practice.<\/p><div class=\"bitem-article-desktop-720x300-in-text\" id=\"bitem-1659888998\"><!-- Bite 720x300 [async] -->\r\n<script type=\"text\/javascript\">if (!window.AdButler){(function(){var s = document.createElement(\"script\"); s.async = true; s.type = \"text\/javascript\";s.src = 'https:\/\/servedby.engagemedia.com.au\/app.js';var n = document.getElementsByTagName(\"script\")[0]; n.parentNode.insertBefore(s, n);}());}<\/script>\r\n<script type=\"text\/javascript\">\r\nvar AdButler = AdButler || {}; AdButler.ads = AdButler.ads || [];\r\nvar abkw = window.abkw || '';\r\nvar plc705185 = window.plc705185 || 0;\r\ndocument.write('<'+'div id=\"placement_705185_'+plc705185+'\"><\\\/'+'div>');\r\nAdButler.ads.push({handler: function(opt){ AdButler.register(165450, 705185, [720,300], 'placement_705185_'+opt.place, opt); }, opt: { place: plc705185++, keywords: abkw, domain: 'servedby.engagemedia.com.au', click:'CLICK_MACRO_PLACEHOLDER' }});\r\n<\/script><\/div>\n<p>\u201cThe scope of practice that a dental practitioner can provide as outlined by the Dental Board of Australia includes orthodontic treatment,\u201d says Dr Peter Alldritt, chair of the Australian Dental Association\u2019s Oral Health Committee. \u201cClear aligners are an excellent treatment option to offer patients.\u00a0Their popularity has exploded thanks to adults choosing not to have metal braces stuck on their teeth. This has created an added income stream in a lot of dental practices.\u201d<\/p>\n<p>While there has always been some blurring of the roles between general dentist and specialist orthodontist, the growing popularity of clear aligners has seen general dental practitioners doing more orthodontic work than ever before. And this is where problems can occur. While clear aligners can be an effective orthodontic treatment tool, there are limits to what they can achieve.<\/p>\n<p>\u201cThere\u2019s no real issue with dentists doing orthodontics if it\u2019s within their scope of practice and competency,\u201d says Dr Howard Holmes, orthodontist and spokesperson for the Australian Society of Orthodontists. \u201cHowever, there is evidence of some dentists with limited orthodontic experience getting in too deep with orthodontic treatments and then struggling to achieve satisfactory outcomes.\u201d<\/p>\n<p>A lot of these problems centre around training. While an additional three-year master\u2019s degree with clinical, didactic and research components is required to become a specialist orthodontist, undergraduate level orthodontic training is extremely limited. Some clear-aligner accreditation courses are just a couple of days in length with no hands-on clinical training.<\/p>\n<p>\u201cIf a dental practitioner is going to incorporate a new technique into their practice\u2014whether it\u2019s orthodontic, endodontic or cosmetic\u2014they need to have education, training and competency for whatever they are doing,\u201d says Dr Alldritt. \u201cDentists need to be mindful that their attendance at a clear-aligner course does not turn them into a specialist. This sort of belief is disrespectful to registered specialists who have spent years undertaking a Master\u2019s degree to achieve the highest level of knowledge and skills.\u201d<\/p>\n<p>While complex cases should always be referred to an orthodontist, clear aligners are a perfect solution for the correction of less severe tooth alignment problems and minor malocclusions by a GP dentist. However, difficulties can sometimes arise when making a judgement call about your own skill set. The dentist needs to consider their knowledge base, competency, proficiencies and experience before deciding whether or not to refer a patient on to an orthodontist.<\/p>\n<blockquote>\n<h5>\u201cWhen a case becomes problematic and the practitioner feels they\u2019re in too deep, they have to be prepared to tell the patient that the treatment is not going according to plan. They need to explain that there has been some complications and they are going to be referred to a specialist.\u201d\u2014Dr Peter Alldritt, chair, Oral Health Committee, ADA<\/h5>\n<\/blockquote>\n<p>\u201cUnfortunately, for a dentist who hasn\u2019t done a great deal of orthodontic diagnosis and treatment planning, what looks like a simple case can suddenly turn into quite a difficult one,\u201d says Dr Holmes. \u201cThe more complex malocclusions should be referred to a specialist from the outset but even easy cases can end up needing specialist assistance when things don\u2019t go to plan.\u201d<\/p>\n<p>Dr Paul Rollason of Absolute Dental Care in Taringa, Queensland, undertook an Invisalign course in May last year and has been offering the clear aligners in his practice since then. The course consisted of six sessions, a number of theory lessons and a practical component where one of his patients was fitted with Invisalign.<\/p>\n<p>Dr Rollason found the course to be comprehensive and very effective. \u201cThe beautiful part about Invisalign is that they have a team of specialists in Sydney who can help direct you,\u201d he says. \u201cThere\u2019s a lot of support so you\u2019re not left out on your own. It\u2019s an ongoing education, as far as I\u2019m concerned.\u201d<\/p>\n<p>It\u2019s all about picking your cases. While Dr Rollason is happy to treat relatively straightforward teeth straightening cases with clear aligners, he\u2019s also prepared to refer to an orthodontist if required. He was also happy to take the advice of the Invisalign specialists. \u201cI had one case where I sent photos, scans and X-rays to the Invisalign team and they contacted me immediately,\u201d he says. \u201cThey told me to leave this one alone and refer the patient to an orthodontist. Their expertise saved me and the patient a lot of trouble.\u201d<\/p>\n<p>If a dentist offers clear aligners\u2014and only clear aligners\u2014as an orthodontic solution, then there may be a limit to the results they can anticipate. Sometimes clear aligners may not be the best way to treat a condition but their convenience and aesthetic appeal can have the client opting for compromised treatment, especially if they are not offered alternatives. An orthodontist can offer a full suite of orthodontic solutions and is more likely to identify potential complications from the outset. All reasonable treatment options and costs can then be discussed and proper informed consent obtained.<\/p>\n<p><img decoding=\"async\" class=\"alignright size-full wp-image-8968 lazyload\" src=\"data:image\/gif;base64,R0lGODlhAQABAIAAAAAAAP\/\/\/yH5BAEAAAAALAAAAAABAAEAAAIBRAA7\" data-src=\"https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2016\/10\/orthodontics.jpg\" alt=\"orthodontics\" width=\"450\" height=\"300\" data-srcset=\"https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2016\/10\/orthodontics.jpg 450w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2016\/10\/orthodontics-300x200.jpg 300w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2016\/10\/orthodontics-225x150.jpg 225w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2016\/10\/orthodontics-113x75.jpg 113w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2016\/10\/orthodontics-285x190.jpg 285w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2016\/10\/orthodontics-150x100.jpg 150w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2016\/10\/orthodontics-400x266.jpg 400w\" sizes=\"(max-width: 450px) 100vw, 450px\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-8968 lazyload\" src=\"https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2016\/10\/orthodontics.jpg\" alt=\"orthodontics\" width=\"450\" height=\"300\" srcset=\"https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2016\/10\/orthodontics.jpg 450w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2016\/10\/orthodontics-300x200.jpg 300w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2016\/10\/orthodontics-225x150.jpg 225w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2016\/10\/orthodontics-113x75.jpg 113w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2016\/10\/orthodontics-285x190.jpg 285w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2016\/10\/orthodontics-150x100.jpg 150w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2016\/10\/orthodontics-400x266.jpg 400w\" sizes=\"(max-width: 450px) 100vw, 450px\" \/><\/noscript>\u201cClear aligner technology has certainly improved over the past 15 years,\u201d says Dr Holmes. \u201cHowever, there\u2019s still a very steep learning curve, so it\u2019s important to start with simple cases. A decent background in orthodontic treatment planning and biomechanics is also a must. I\u2019ve been an Invisalign accredited orthodontist since 2003 but I still find fixed braces are a better option for some patients seeking aligner treatment. Sometimes these patients choose to proceed with aligner treatment anyway but they do so with full knowledge of other more ideal treatment options. Furthermore, for clear aligners to work effectively, the patient needs to be extremely cooperative and wear their aligners at least 22 hours a day. When this is not the case, ceramic or lingual braces can be offered by an orthodontist.\u201d<\/p>\n<p>Clear aligners have been a valuable addition to the dentist\u2019s repertoire of treatments. They are effective, comfortable, virtually unnoticeable and patients love them. They bring an added income stream into a practice and patient satisfaction is high.<\/p>\n<p>However, Dr Alldritt makes the point that it\u2019s important to be honest in your appraisal and aware of your limitations. \u201cWhen a case becomes problematic and the practitioner feels they\u2019re in too deep, they have to be prepared to tell the patient that the treatment is not going according to plan. They need to explain that there has been some complications and they are going to be referred to a specialist.\u201d<\/p>\n<p>While there has always been a crossover between general dental scope of practice and specialist orthodontic practices, the advent of clear aligners has seen it accelerate in recent years. \u201cInvisalign and other clear aligner courses are often marketed to general dentists as a way to increase their business and build the bottom line,\u201d says Dr Holmes.<\/p>\n<p>\u201cThis is not necessarily a bad thing. However, attempting to treat complicated conditions beyond a dentist\u2019s skill set could actually end up impacting negatively on their practice and reputation. When general dentists treat their patients with clear aligners, they just need to be aware of the product\u2019s limitations and the scope of their own ability. Pick your cases carefully and refer to an orthodontist when necessary.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"<p>General practices across the country now offer patients clear-aligner treatment plans\u2014and that\u2019s a good thing. But when should a dentist refer a patient to an orthodontist?\u00a0Kerryn Ramsey investigates Clear aligners revolutionised orthodontics by removing the stigma of wearing braces. While teenagers embraced the concept, it\u2019s the adult population that\u2019s really responded to this new technology. [&hellip;]<\/p>\n","protected":false},"author":7,"featured_media":8966,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[691],"tags":[68,2575,723,2576,70],"class_list":{"0":"post-8964","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-your-business","8":"tag-braces","9":"tag-clear-aligners","10":"tag-invisalign","11":"tag-orthodontic-treatments","12":"tag-orthodontics"},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v25.9 (Yoast SEO v25.9) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Pick your battles wisely - Bite Magazine<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.bitemagazine.com.au\/pick-battles-wisely\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Pick your battles wisely\" \/>\n<meta property=\"og:description\" content=\"General practices across the country now offer patients clear-aligner treatment plans\u2014and that\u2019s a good thing. 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