The hidden truth about clear aligner “AI” technology

Dr. Faris Elsayad
November 23, 2022


The hidden truth about clear aligner orthodontics is that “AI” isn’t the answer to getting great patient outcomes.

Patients (and clinicians) are led to believe that "AI" can replace real clinical expertise - but the data suggests otherwise, on average, the average clear aligner case with conventional systems needs more than double the initial anticipated number of aligners - not good for patients, and not good for clinicians.

We built 32Co to fix this problem by promoting knowledge and experience, for which there is no replacement in healthcare. Along the way, we realised that there are fundamental misconceptions about how clear aligner treatments are designed by manufacturers.

So in this article, we’re going to break down how AI is actually used, and how dentists can retake control of their orthodontic treatments.

What does it mean to have AI help with your aligner cases?

Conventional branded aligner systems often use words like 'AI' to create mystery around how treatment planning for clear aligners is performed behind the scenes.

If you take a peek under the curtain, it becomes clear that technicians with no dental training are designing the majority of clear aligner treatment plans. They are taught to directly follow the dentist's instructions and manually manipulate the tooth movement in 3D in the software.

Let’s get one thing clear - AI technology can’t programme tooth movement. If you’ve used clear aligner treatment planning software, you’ll know that the software can’t auto-align the teeth by itself.

Neither is it regulated to do this. In fact, all planning software requires US-FDA clearance, and is required to be operated by orthodontically trained dental professionals (in this case - this means the dentist, not the technician!).

Once the teeth have been moved into position by a technician, the planning software uses algorithms to calculate the number of stages required to rotate a tooth. Often, what is assumed to be AI, is actually simple algorithms and calculations. For example, if a tooth is planned to rotate by 10 degrees, 2 degrees per stage, it will take 5 stages to achieve this. In other words, 10 divided by 2 equals 5…

Dentists are flying blind

With the rapid clear aligner market growth and the rise of manufacturers pushing their own consumer-facing brands, the focus on clinical knowledge has dwindled - to be replaced by quick fixes that lubricate market growth. This means that GDPs with little orthodontic teaching and unaware of how clear aligner software is really being used are accepting treatment plans that may be unsafe.

So if technicians are helping create the plans, and dentists aren’t receiving sufficient orthodontic training and support, how can every patient be assured of a great outcome?

You can’t automate away clinical expertise

Clinical experience and a thorough understanding of patients is essential in creating a safe and effective clear aligner plan. Orthodontics is a speciality for a reason and involves skill, experience and an understanding of the fundamentals of tooth movement.

A great example is SmileDirectClub, which Invisalign previously part-owned - and provided planning and manufacturing technology for. This partnership led to disastrous results for patients, showing that you can't automate clinical experience and knowledge (yet!).

We’re bringing the clinician back to the forefront at 32Co, instead of trying to automate them away. We’re doing this by upskilling new and experienced providers, by providing free specialist orthodontic guidance with every case they provide.

You can’t take the AI to court, so you better know what you’re doing

We’ve spoken to hundreds - yes, hundreds - of experienced clear aligner providers who have at least one horror story of a patient who did not get the outcome shown on the simulation.

These dentists tell us that they put their trust in what they thought was an “AI-led” treatment design process. But it’s dentists, as the prescribing clinician, who take full responsibility for bad outcomes - not the “AI”.

How to retake control of your clear aligner treatment

To be able to provide high-quality orthodontics you need to truly understand how to move teeth. But for the GDP that just wants to grow their aligner cases, orthodontic knowledge can seem like a black box. This is where 32Co steps in.

We provide dentists with free 1:1 orthodontic supervision as standard, all the training you need and an open clear aligner marketplace selling different materials. We do this all without charging you a penny - meaning you simultaneously increase your revenues, upskill and provide better treatment with half the refinement rates of the industry average.

We’re accepting applications for our free, 4-week Clear Aligner Starter Course, recommended by every dentist who has taken it (yes, really!) In the words of one of our participants - “Other courses felt more like a crash course and off you go!”

Apply to the Clear Aligner Starter Course here. If you have experience with aligners and want to learn more, sign up here.

Looking to further your knowledge about clear aligners and find more fulfilment in your dental career? Click the button below!