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Should my patients get a clean before starting Clear Aligner Treatment?

In short, yes, for two reasons:

1) Improved oral health during treatment

2) Improved fit of the aligners

Starting with a good foundation

Orthodontics and periodontology are closely linked; patients with malocclusion are more likely to suffer from periodontal disease [link].

Proceeding with orthodontics despite active periodontal disease is a terrible idea.

There is long-standing evidence (mostly from retrospective studies) that undertaking orthodontic treatment in the presence of periodontal disease can cause a multitude of problems including increased bone loss and recession [link].

Note- it is hard to systematically and prospectively study the granular impact of orthodontics on patients with known, active periodontal disease. It's just not ethical!

Starting a long course of clear aligner therapy is like running a marathon, you don't want to be starting with a sprained ankle

More on this in a future topic about periodontal considerations...

Improved Aligner Fit

Clear Aligners exert very deliberate forces on specific areas of each tooth sequentially during treatment. 

The aligner must fit both the tooth and the gums perfectly to exert these pushing forces, and reliably generate your carefully planned movements. 

High quality Clear Aligners are created from models 3D printed to an accuracy of <50 microns. The finest difference will be translated into the model. 

See below case study of a patient with significant gum disease. A scan was taken prior to treatment over several sessions with a skilled hygienist. A second scan was taken after successful completion of treatment. 

You will notice the significant difference in the anatomy, and these can impact the accuracy of programme tooth movement.

Intraoral scan before
Intraoral scan after thorough cleaning with a skilled hygienist

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