In Conversation with Dr. Luis Huanca

The Value of Clear Aligners Therapy in Orthodontics

 

  • The existing distrust of clear aligner therapy in Switzerland

  • The orthodontist must curate every step of the treatment process

  • The possibilities with clear aligner therapy vs. braces

  • Ensuring the patient has the endurance to wear the clear aligners consistently

  • Monitoring the patient’s treatment progress

  • Warning about direct-to-consumer orthodontics

  • Advice to younger orthodontists learning about clear aligners

          

Dr. Luis Huanca

Orthodontist and Owner of “Presso 3D Orthodontist” in Lausanne

Chemin de la Bérée 4A,  Lausanne, Switzerland

In Conversation with Dr. Luis Huanca

 
 

Over the past two decades, clear aligner therapy has risen as the ideal alternative to traditional braces. However, despite their significant advantages and broad appeal amongst patients, orthodontists and dentists are still hesitant about offering clear aligner therapy in their practices. The stigma against clear orthodontics has a lot to do with false misconceptions, existing biases, and the lack of sufficient education. However, Dr. Huanca, the orthodontist and owner of  3D Orthodontist in Lausanne, is here to set the record straight.

Our team at Zircon Medical recently hosted Dr. Luis Huanca on our podcast series to discuss the value of clear aligner therapy in orthodontics.

Introducing Dr. Luis Huanca, the owner of  3D Orthodontist in Lausanne

Dr. Luis Huanca is an orthodontist with a shared private dental practice in Peseux (NE), and Epalinges (VD), the latter very soon shifting to a new orthodontics only practice opening at Chemin de la Bérée 4A, Lausanne. He specialized in orthodontics in 2009 and achieved his PhD with a focus on 3D imaging in 2013. He worked as a dentist in numerous hospitals and his father’s dental office before finally setting up his private orthodontic practice in Lausanne. He currently specializes in clear aligner therapy, which he believes can be as effective if not superior to traditional braces.

Dr. Huanca’s desire to join the medical field was cemented at a fairly young age — his father had been a dentist, and his mother worked in a pharmacy. Once he entered dentistry, he found himself leaning towards fields requiring significant “thought.” He also had a love of engineering and problem-solving. As such, orthodontics seemed like a natural fit because it was the equivalent of engineering within dentistry. It involved significant thought and the ability to solve unique problems at every step of the process.

The existing distrust of clear aligner therapy in Switzerland

Dr. Huanca says clear aligner therapy is still considered pretty new in Switzerland, even though it has been popular in the rest of the world for over 20 years. According to him, many orthodontists distrust clear aligner therapy and believe traditional orthodontics are better at tackling complex cases and situations. Dr. Huanca attributes that prevalent distrust to insufficient education on clear aligner therapy in Swiss universities. As such, although clear aligner therapy is incredibly popular across the globe, orthodontics in Switzerland are struggling to keep up.

However, Dr. Huanca attests that clear aligners are just as effective as traditional braces if the orthodontist knows how to use them. Furthermore, he prefers clear aligners because they significantly reduce chair time while emphasizing brain time in front of the computer. The orthodontist has to spend more time in front of the computer trying to find the ideal path towards the end goal. To make up for the lack of education, Dr. Huanca now teaches clear aligner therapy at the University of Geneva.

The orthodontist must curate every step of the treatment process

“With clear aligner therapy,” Dr. Huanca says, “the sky’s the limit. Or at least biology is the limit.” However, he emphasizes the need for the orthodontist’s involvement in the process. Some orthodontists, he says, believe they can simply sit back and let the system do the treatment planning since they’ve paid for the service. However, he believes that’s a lazy point of view, and orthodontists should be intimately involved in the treatment planning.

The computers can’t determine all cases. The orthodontist must determine when and if attachments are necessary, where and how to place the attachments, and how to create space before the movements. The orthodontist must use the computer programs to innovate their unique treatment plans and overcome clinical cases. According to him, clear aligner therapy is fairly complex, especially when it comes to thinking of all the steps that will take a patient from the beginning to the end.

The possibilities with clear aligner therapy vs. braces

Dr. Huanca emphasizes that with clear aligner therapy, human biology is the only limit. “Technically,” he says, “you can do anything as long as the tooth crown is present.” However, he acknowledges that certain movements are more practical with traditional braces than with clear aligners. He cites the example of an extrusion of a tooth that’s really high up, which doesn’t permit effective movement with clear aligners. However, even in these situations, the orthodontist can ideate potential workarounds to solve the problem. 

At one point, deep bite cases weren’t deemed suitable for clear aligner therapy. However, deep bite cases are now far easier to solve with clear aligners than braces. With traditional braces, the upper teeth are always impinging on the braces on the lower incisors, so the orthodontist has to raise the bite, which prevents the patient from chewing. However, with clear aligners, the patient’s ability to chew isn’t impacted, making them more suitable for deep bite cases. 

Dr. Huanca believes orthodontists must shift their perspectives from traditional braces to clear aligners to realize that the possibilities are endless. He currently completes 70% of his treatments with clear aligners and only 30% with traditional braces. 

Ensuring the patient has the endurance to wear the clear aligners consistently

The clear aligner therapy’s success depends on the patient as much as the orthodontist. Traditional braces can’t be taken off at all, so there’s no scope for the patient to affect the treatment plan. However, clear aligners can be taken off during meals and before brushing, making them more vulnerable to careless patients. However, Dr. Huanca isn’t very fussed about that possibility, and he has certain practices in place to ensure the right patients receive aligners.

For adults, Dr. Huanca trusts that they’re responsible and willing to wear the clear aligners for the necessary period to ensure success. However, he only recommends lingual braces for adults whose professions prevent them from wearing aligners consistently. For example, cooks need to taste different foods every two seconds, so he advises them against aligners. But other than those special circumstances, he trusts that most adults seeking aligners would be willing to wear them consistently.

For adolescents, Dr. Huanca clearly communicates the availability of two possible therapies. He informs them (and their parents) that clear aligners are more hygienic, more comfortable, more aesthetic, and more economical (since they involve less clinical work in the mouth), BUT they must be worn all the time, or they won’t work. He asks the kids and their parents if they’re confident they can commit to the treatment. And if they agree, he trusts them.

So far, Dr. Huanca has treated around 700 cases with clear aligners, and, amongst young patients, only 3 of them have had to shift from clear aligners to traditional braces.

Monitoring the patient’s treatment progress

Dr. Huanca sees his patients every 10 to 12 weeks, and he has them change their aligners every 5 days. As such, he sees his patients after every 15 to 20 stages of the treatment. He trusts his patients when they start the journey. In some cases, however, he has seen his patients once every 5 or 6 months, especially during the pandemic. Furthermore, he has also had patients who have traveled abroad for education, so he has seen them after 9 months. The treatment has been successful in all these cases, also because refinement treatments are available to achieve a great result.

When asked about virtual monitoring, Dr. Huanca says he’s open to monitoring his patients’ progress virtually, but he prefers in-person monitoring. Since the patient only has to see him once every 2 to 3 months, it’s not much of an issue, even during the pandemic. Furthermore, as mentioned previously, he can also see patients after 6 or 9 months while being assured that the treatment would continue. Because of this, clear aligner therapy has been particularly useful during the pandemic since his patients could continue the treatment at home without seeing him for months.

Warning about direct-to-consumer orthodontics

When asked about the phenomenon of direct-to-consumer orthodontics, Dr. Huanca emphatically stated his disapproval. To him, the idea of direct-to-consumer orthodontics is a dangerous and unethical means for big companies to make more money. These companies usually look for young and inexperienced dentists requiring minimal payment. They’re not interested in orthodontists so much as dummy medical figures who can allow the business to run uninterrupted. Their treatments may work in 60% to 70% of the situations, but they can also lead to dangerous complications for the patient. 

Advice to younger orthodontists learning about clear aligners

Dr. Huanca says younger dentists and orthodontists must invest their time and finances in a good education, even when it’s hard to find. “When I was young,” Dr. Huanca says, “I constantly spent all my money to travel around the world and learn.” He believes one must invest in their education when they’re young and have time, i.e., before other aspects of life get in the way and make education difficult. He also believes than young orthodontists should bravely venture into advanced courses to broaden their vision. It’s an investment that will certainly pay off.

Dr. Luis Huanca currently offers online courses on orthodontics and clear aligners with a colleague, Dr Frederick Berardinelli. You can learn more about Dr. Huanca and his online course from https://orthodonticstyle.com, his website or follow him on LinkedIn. You can also listen to him in our Zircon Medical podcast or continue reading for a detailed article on how clear aligners can add value to your dental clinic. 

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How Clear Aligners Can Add Value to Your Dental Clinic

An independent article by the Zircon Medical Team

Clear aligners certainly offer significant benefits to the patients. They’re transparent, aesthetically pleasing, comfortable, and efficient — what’s not to love? Due to their significant appeal for patients, clear aligners can also add value to your dental clinic. However, as our podcast with Dr. Huanca showed, a lot of orthodontics are still hesitant about embracing clear aligners due to misconceptions or the lack of sufficient education.

A new study conducted by Align Technology surveyed dental clinics in North America, Europe, Japan, and China, to gauge how integrating clear aligner therapy affected their business. The study looked at key business metrics, such as the increase in new patients, willingness to accept other dental procedures, the quality of the dentist-patient relationship, patient retention rate, and other factors. 

If you’re still on the fences, this article highlights how clear aligners can add value to your dental clinic.

#1. Business Growth

Offering clear aligner therapy as a treatment option can help your dental practice grow. According to the study cited above, 67% of the surveyed dentists in North America, 69% in Europe, 72% in Japan, and 88% in China reported an increase in new patients after integrating clear aligner therapy. As clear aligner therapy becomes more widely available, most patients considering orthodontic treatments specifically look for dental clinics specializing in clear aligners, bringing them to your clinic. 

#2. Acceptance of Other Procedures

The study conducted by Align Technology discovered something interesting. Patients undergoing clear aligner therapy were more likely to accept other recommended procedures. In Europe, 89% of patients undergoing clear aligner therapy accepted other procedures, and the statistics are similarly high in other regions, ranging from 87% in Japan to 95% in China. As such, this can significantly increase your dental clinic’s income from each patient, improving your overall efficiency and profits.

#3. Dentist-Patient Relationship

Building a strong dentist-patient relationship is essential for your business. It increases your patient retention rate, makes your existing patients more likely to trust your recommendations, and it helps you overcome potential slumps due to unforeseen circumstances such as the COVID-19 pandemic. According to the Align Technology study, clear aligner therapy improved dentist-patient relationships in 75% to 95% of the surveyed dentists, and it improved trust in 83% to 99% of the surveyed dentists.

#4. Loyalty

Integrating clear aligner therapy can certainly help your dental clinic get new patients. Furthermore, those patients are more likely to trust the dentist’s recommendations for other procedures. And since orthodontic treatments last for several months or years involving regular communication, they also contribute to dentist-patient trust and relationships, which, in turn, improves the dental clinic’s patient retention rate. According to the Align Technology study, 63% to 84% of the surveyed dentists reported significant increases in patient retention.

#5. Patient Experience

The primary goal of all dental clinics is to improve the patient’s experience and wellness — business growth comes as a natural by-product of the improved patient experience. According to the Align Technology study, 97% of the dentists in Europe and China, 98% of the dentists in Japan, and 100% of the dentists in North America reported significant improvement in the patients’ confidence and experience after clear aligner therapy.

Potential Concerns

Integrating clear aligner therapy into your dental clinic is a no-brainer — the advantages are well-studied, obvious, and significant enough to warrant exploration. However, providing clear aligner therapy also involves potential concerns that you must defend against.

With traditional braces, the patient has no control over the treatment. They must wear the braces until the dentist takes them off. However, with clear aligner therapy, the patient can take the aligners off or wear them insufficiently, affecting the treatment outlook. Furthermore, if the treatment doesn’t work, the patient is more likely to blame you, so you must take active measures to protect the patient from their potential carelessness. 

Furthermore, some patients develop temporary lisps due to clear aligners, and others experience discomfort while switching the aligners every two weeks. You should ideally be honest about their potential experiences — if you don’t prepare the patient, they may assume the aligners aren’t working correctly or blame you. Furthermore, while the patient can continue the treatment at home without seeing the dentist regularly, you should ideally enforce regular appointments to ensure they’re progressing correctly.

If you keep an eye out for the potential concerns listed above, your dental clinic and patients are sure to benefit from clear aligner therapy. For more insight and context on the statistics mentioned above, you can read Align Technology’s study.

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