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Inside Dental Hygiene
December 2022

Clear Aligners

Inside Dental Hygiene (IDH): What is the dental hygienist's role in clear aligner therapy?

Jacqueline Harrison, RDH: The hygienist might play an even bigger role than the dentist. Most states require only one recall examination with the dentist per year, and that typically only takes 10 minutes or less. The hygienist, however, sees that patient at least twice a year, perhaps more, for 45 minutes to an hour each time. As a result, the hygienist tends to know the patient more intimately, and the trust factor tends to be stronger, which is important when discussing aligner options.

IDH: How does aligning teeth affect dental hygiene?

Harrison: Most clear aligner cases are not severe, but crowding, spacing, and malocclusion can make cleaning very difficult. Aligning those teeth makes it so much easier to brush and floss. Sometimes, crowding is so severe that floss snaps. If a condition like that is left untreated, then it often leads to some form of periodontal disease and potentially tooth loss.

IDH: What should dental professionals be looking for in an aligner solution?

Harrison: We should educate ourselves on what is available, because there are a lot of orthodontic options. We should also consider each patient's individual needs. Some require or desire frequent visits. With others, remote monitoring fits their lifestyle better. For many patients, a strong follow-up program to help with compliance is important and this is a winning scenario for a lifetime guarantee of better oral health. For less severe case—such as a patient who has orthodontic relapse and very slight crowding—a remote program might be a better option. Many patients are surprised by the level of discomfort on the first or second day of aligner therapy, which can lead to noncompliance, so a program that starts with thinner aligners and builds up to thicker ones is worth considering. Some patients, for various reasons, prefer not to wear their aligners while working or in other public settings, so a nighttime-only option might be best for them.

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