Chapters
Introduction to Clear Aligners
(0:03 – 1:14)
Eon Engelbrecht introduces the episode and sets the stage for a deep dive into
the world of clear aligners. Dr Clifford Yudelman briefly recaps the previous
episode on braces versus clear aligners, highlighting what will be covered
today.
How Clear Aligners Work
(1:14 – 3:34)
Dr Yudelman explains how clear aligners are custom-made, transparent braces
that gradually shift teeth into the desired position. He discusses the importance
of regular check-ups, the technology behind Invisalign, and the difference
between genuine Invisalign and generic alternatives. Predictable teeth
straightening with Invisalign: Listeners learn about the predictable teeth
straightening with Invisalign, which offers a more streamlined and less
invasive approach compared to traditional metal braces.
Comparison with Traditional Braces
(3:35 – 5:06)
This segment contrasts the functionality and appearance of clear aligners with
traditional metal braces, highlighting the discreet nature of aligners and the
ease of maintaining oral hygiene during treatment.
Materials Used in Clear Aligners
(5:07 – 6:58)
Dr Yudelman provides insights into the materials used in creating clear
aligners, emphasising the high-quality, medical-grade plastic used by
Invisalign, which ensures durability, comfort, and biocompatibility.
History and Evolution of Clear Aligners
(6:58 – 9:17)
A brief history of Invisalign, from its inception in the late 90s to its current
status as the leader in clear aligner technology, is discussed. The conversation
also touches on the technological advancements and ongoing research that
continue to set Invisalign apart.
Benefits of Choosing Clear Aligners
(9:17 – 10:15)
The episode explores the key benefits of clear aligners, such as aesthetic
appeal, comfort, and predictability of results. Dr Yudelman explains how the
treatment is often quicker and more convenient compared to traditional braces.
Integrating Clear Aligners into Daily Life
(10:15 – 12:31)
Dr Yudelman discusses how clear aligners fit into a patient’s daily routine,
including wearing, cleaning, and maintaining them. The ease of removing the
aligners for eating and brushing makes them a preferred choice for many
adults and teenagers.
Typical Treatment Duration and Follow-Up Visits
(12:31 – 15:29)
This section details the typical duration of clear aligner treatment, the number
of aligners used, and the importance of regular dental visits. The innovative
use of virtual care technology for remote monitoring is also discussed.
Expected Results and Success Stories
(15:29 – 16:33)
Dr Yudelman shares the remarkable results patients can expect from clear
aligner treatment, including improved aesthetics and confidence. The episode
also touches on the positive life changes many patients experience as their
treatment progresses.
Limitations and Challenges of Clear Aligners
(16:33 – 20:56)
The conversation shifts to the potential challenges of using clear aligners, such
as the need for frequent removal and cleaning and the difficulties some
patients might face if they have certain habits like snacking or drinking
frequently. However, Dr Yudelman reassures listeners that these challenges
are manageable and highlights the advanced techniques used to overcome any
limitations.
Conclusion and Future Outlook
(20:57 – 22:28)
The episode wraps up with Dr Yudelman and Eon discussing the broader
impact of clear aligner treatment on patients’ lives, including improved self-esteem and lifestyle changes. Listeners are encouraged to visit OptiSmile’s
website for more information and to explore the services offered.
Transcript
[Eon Engelbrecht E-Radio] (0:03 – 0:41) This is the go-to podcast where curiosity meets dentistry, straight from the experts. Welcome to Save Your Money, Save Your Teeth. I’m Eon Engelbrecht E-Radio, and I’m joined by Dr Clifford Yudelman from OptiSmile. We’re ready to take a deep dive into the world of dental care from a consumer’s perspective. Whether you’re looking to brighten that smile or just protect your wallet, we’ve got you covered with practical advice and the latest insights, so stick around as we uncover the secrets to maintaining both your dental health and your finances. Welcome once again, Dr Clifford Yudelman.
[Dr Clifford Yudelman OptiSmile] (0:41 – 1:04) Thanks, Eon. Thanks for having me back. I’m really looking forward to today’s episode after last week’s discussion about braces versus clear aligners. Today, we’re going to get more in-depth on understanding clear aligners.
I know you’ve got some great questions for me, Eon.
[Eon Engelbrecht E-Radio] (1:04 – 1:14) Exactly. Let’s start with the basics. What are clear aligners, and how do they work?
[Dr Clifford Yudelman OptiSmile] (1:14 – 3:26) Clear aligners are custom-made, transparent braces designed to straighten teeth. They apply gentle, consistent pressure to shift teeth into the desired position over time. The way the treatment process works is that you get a series of aligners.
If it’s genuine Invisalign, you wear them for one week before switching to the next one. If you’ve got some generic or South African aligners, then you would change them generally every two weeks. Invisalign aligners are very accurate because they move each tooth by 0.2 millimetres. The software used is very precise, and it’s not easy for copycat products to replicate the same thing, which is why you can change them out every week without discomfort. You also have regular check-ups to ensure the treatment is progressing as planned. With Invisalign, we can scan you and do what’s called a progress assessment.
The other brands of aligners and copycats don’t offer that. Next week, we’ll be talking about Invisalign versus other brands, so I won’t get into too much detail today. I’ll stick with the commonalities.
The plastic, the actual aligners or trays, are made from a medical-grade plastic. They’re safe and comfortable to wear. They all use advanced 3D imaging and computer modelling to design and personalise the treatment plan.
You need to wear them for at least 20 to 22 hours a day. You can’t just wear them at night; you have to wear them most of the time. You remove them only for eating, drinking, brushing, and flossing.
It’s essential to follow instructions to ensure your teeth move according to plan.
[Eon Engelbrecht E-Radio] (3:27 – 3:34) How do clear aligners differ from traditional braces in terms of function and appearance?
[Dr Clifford Yudelman OptiSmile] (3:35 – 4:58) Our whole episode last week was about that, as you know. I’m glad we’re addressing it again today for those who might have missed last week’s episode. In a nutshell, the appearance of clear aligners like Invisalign is very discreet. They’re called Invisalign because they align your teeth and are almost invisible.
Traditional metal braces, on the other hand, are much more noticeable. They can affect your confidence. In terms of comfort, clear aligners are smooth and less likely to irritate your gums and cheeks. Braces are adjusted every month or so and can be more uncomfortable or even painful.
Clear aligners are removable, making it easy to brush and clean your teeth without anything getting in the way. With traditional braces, it’s challenging to keep your teeth clean. Dietary restrictions are another factor; with clear aligners, you can eat whatever you want because you remove them before eating. With metal braces, there are many restrictions because you can damage brackets and wires.
I think that summarises it well. For more information on Invisalign or clear aligners versus braces, I recommend going back and listening to last week’s episode.
[Eon Engelbrecht E-Radio] (4:59 – 5:06) Doctor, I’m also interested in knowing what materials are used in making clear aligners.
[Dr Clifford Yudelman OptiSmile] (5:07 – 6:45) Invisalign, which is based in the US, is the largest manufacturer of custom 3D printed products in the world. They’ve produced 17 million aligners so far, and they’re treating over a million patients a year.
Each patient might receive 20 or 30 sets of aligners for both the upper and lower teeth. That’s 60 aligners if it’s upper and lower. They’re literally making millions of these aligners globally. The material used is medical-grade plastic, and while some copycat brands might use different materials, the quality and consistency aren’t always guaranteed.
The material is designed to withstand daily wear without breaking or becoming discoloured. If worn for two or three weeks, some aligners can get soft, but Invisalign’s material is very biocompatible and retains its springiness throughout the week without any issues. Generally, there are no allergic reactions or adverse effects. It’s safe for all patients, including those with sensitive mouths.
The advanced manufacturing with 3D printing and 3D technology allows for a series of aligners that gradually move your teeth into the desired position. The comfort and durability of the material are exceptional.
[Eon Engelbrecht E-Radio] (6:46 – 6:58) Okay, they sound very tough. Perhaps we can turn back the clock a bit and discuss the history and evolution of clear aligners, Dr Yudelman.
[Dr Clifford Yudelman OptiSmile] (6:58 – 9:05) The first company to create clear aligners was Invisalign, which emerged in the late 90s as an alternative to braces. They started with version 1 and are now on version 8. Every few years, a new update is released, enabling more advanced movements, often better than braces.
The initial versions were less advanced, but they laid the groundwork for future innovations. Originally, moulds were taken and sent to America for scanning. It’s always been a digital process, but not everyone had 3D scanners.
At OptiSmile, we have two genuine iTero scanners. For Invisalign, one of the barriers to entry for dentists is the cost of the scanner, which is just under R1 000 000 each. It’s an expensive technology, but the accuracy is remarkable.
The design and effectiveness of the aligners have improved significantly over time. They’re now more precise, comfortable, and effective than earlier versions. The market for clear aligners has grown significantly, and while there are competitors, Invisalign continues to lead the market. They invest heavily in research and development, spending around a billion Rand a year.
The advancements include being able to show you what your teeth will look like in your mouth. We can take a video of you and then move your teeth around on the 3D model to show you what they’ll look like in a video.
[Eon Engelbrecht E-Radio] (9:06 – 9:17) Wow, that’s amazing technology. Doctor, what are the key benefits of choosing clear aligners over traditional braces?
[Dr Clifford Yudelman OptiSmile] (9:17 – 10:04) The key benefits include aesthetic appeal, comfort, convenience, and flexibility. It’s a predictable and efficient treatment. Typically, we can straighten your teeth with just 20 aligners.
We create 20 aligners, and in many cases, by the time you finish your last aligner, your teeth are where they’re supposed to be. There are cases where we may not achieve all the planned movements, in which case we’ll scan you and order additional aligners at no extra charge. It might take another four or five aligners, and then you’re done.
With braces, as you know, the treatment can last 18 months or longer, requiring multiple visits. People should go back and listen to last week’s episode for more details on this.
[Eon Engelbrecht E-Radio] (10:04 – 10:15) Yes, definitely. We had quite a discussion on that in the last episode. Doctor, how do clear aligners fit into a patient’s daily life?
[Dr Clifford Yudelman OptiSmile] (10:15 – 11:09) They’re easy and simple to use. You wear them throughout the day and night, except when you’re eating or cleaning your teeth. Patients quickly adapt to the routine of wearing and caring for their aligners.
The aligners need to be cleaned with a toothbrush and cold or lukewarm water, using a specialised cleaning solution or dish soap. We don’t recommend using toothpaste, as it can abrade them. You just continue with your regular oral hygiene, brushing and flossing.
Since they’re removable, you can eat your favourite foods without restrictions. It’s also much easier to maintain your oral hygiene, with a lower risk of cavities or gum disease. And, of course, people can’t see them, which makes them popular with both adults and teenagers.
[Eon Engelbrecht E-Radio] (11:10 – 11:14)
Okay. And what is the typical treatment duration with clear aligners?
[Dr Clifford Yudelman OptiSmile] (11:15 – 12:25)
Typically, many of the patients we see have around 20 aligners. Remember, each aligner moves your teeth by 0.2 millimetres in any one direction, so every five aligners move your teeth approximately one millimetre.
With 15 or 20 aligners, we can move teeth up to four millimetres, which is significant. Some movements are easier to achieve than others. For instance, pushing a tooth in or intruding it isn’t as easy as tilting a tooth. We can assess all of this using specialised software.
However, there are cases where patients require very significant movements, and in such instances, the treatment might involve up to 40 or more aligners. But generally, we see that most patients need around 20 to 25 aligners. There’s also an option called Invisalign Lite, which involves only 14 aligners, and we get quite a few cases like that as well.
So, if you’re using 14 aligners, that’s 14 weeks, and if you’re using 20 aligners, that’s 20 weeks.
[Eon Engelbrecht E-Radio] (12:25 – 12:31)
How often do patients need to visit the dentist while using clear aligners?
[Dr Clifford Yudelman OptiSmile] (12:31 – 15:29)
We like to see patients approximately every four aligners, which translates to about once a month, to give them the next set. There are cases with generic aligners where patients receive one or two aligners and wear them for two weeks at a time. After every two or three aligners, they are rescanned to check progress, and more aligners are ordered if necessary.
To be honest, and not to offend anyone, I find this approach a bit of a hack compared to genuine Invisalign. With Invisalign, we receive all the aligners for a patient upfront in a single box. We don’t hand all of them to the patient at once because we monitor their progress closely.
For instance, today I saw a patient and gave her the first two aligners. I showed her how to use the first one and provided the second to change after exactly one week. We’ll see her again when she’s ready for the third aligner. At that point, we use a little template to apply tiny blobs of clear or tooth-coloured plastic, called attachments, to her teeth. We’ll get into more detail on attachments in a future episode.
After that, we’ll give her aligners three through seven or eight, and then she’ll come back so we can scan her teeth again to assess the progress. This is called a progress assessment. Sometimes, during the treatment, we may need to lighten up the contacts between the teeth, but we’ll discuss that more in a future episode.
In essence, if a patient has 20 aligners, we might see them three or four times and then again at the end to remove the attachments or order additional aligners if necessary. The process moves quickly.
We also offer something called virtual care for patients who don’t live locally. In such cases, we can give them eight or ten aligners at once, and they can take photos using a special app that uses AI to track their progress. The app sends us a message, and we can then advise the patient if they need to wear the aligners for longer or if they’re changing them too quickly. The AI also alerts us if something isn’t right.
This technology hasn’t caught on as well in South Africa as it has overseas, where dentists have been using it extensively since the COVID-19 pandemic. In the US and other countries, some dentists give patients ten or fifteen aligners upfront and only see them again when they’re ready to check the progress, using this virtual care technology.
[Eon Engelbrecht E-Radio] (15:29 – 15:36)
That’s so cool. Doctor, what kind of results can patients expect from clear aligner treatment?
[Dr Clifford Yudelman OptiSmile] (15:37 – 16:24)
The results are amazing. Honestly, the word “amazing” doesn’t even do it justice. Patients are often in disbelief at how beautiful their teeth look after the treatment.
A lot of the time, we give patients bleaching gel to use with their aligners if they haven’t whitened their teeth before starting the treatment. The aligners can actually double as a bleaching tray. By the end of the treatment, if they don’t need any additional dental work, we remove the attachments and scan them for retainers. Their teeth are left looking beautiful, straight, and white. The results are really unbelievable.
If I sound like I’m selling it, it’s because I am. We never have anyone who’s not thrilled or who regrets straightening their teeth with Invisalign.
[Eon Engelbrecht E-Radio] (16:25 – 16:33)
Exactly. Our final question for today’s podcast, Doctor: Are there any limitations or challenges associated with clear aligners?
[Dr Clifford Yudelman OptiSmile] (16:43 – 19:00)
If you don’t have fingernails, it can be quite difficult to remove the aligners because they clip in tightly. But someone has invented a little hook with a handle that helps with this, so it’s not a big issue anymore.
If you’re someone who snacks every hour or enjoys chewing gum all day, or if you have a habit of sipping on red wine for hours each night, clear aligners might not be ideal for you. Every time you eat or drink something other than water, you need to remove the aligners and then clean your teeth before putting them back in. This can be a hassle for some people, and it may lead them to snack less, which might actually help with weight loss.
If you’re constantly taking the aligners out and putting them back in, they may start to feel tight, and you might need to extend your treatment duration. What was supposed to be a 14-week treatment could end up taking six months or longer if the aligners aren’t worn as instructed.
These are some of the challenges, but overall, clear aligners can accomplish almost everything that braces can, and in some cases, even more. We sometimes need to add little attachments or bond a small button onto the teeth to hook an elastic band, similar to traditional braces, to aid in certain movements.
These elastics are usually worn after dinner through the night and removed in the morning, so they’re not visible during the day. With these additional aids, we can achieve the same, if not better, results compared to traditional braces.
[Eon Engelbrecht E-Radio] (19:00 – 19:13)
I love how they can even help with dieting by curbing snacking habits. That sounds like an advantage!
[Dr Clifford Yudelman OptiSmile] (19:13 – 20:34)
Absolutely. Patients often report that they not only get straighter teeth but also gain confidence as their treatment progresses. Many people find that their entire persona changes as their teeth straighten. We’ve had patients who were too embarrassed to smile or were perceived as grumpy due to their crooked teeth, but as their treatment progresses, they become more confident, join a gym, or even start dating.
I’m not exaggerating when I say we’ve had several patients who, after starting Invisalign treatment, found a partner and ended up getting married. There are at least ten or fifteen cases I can think of over the last seven or eight years where this has happened. It’s truly amazing to see how much a smile can change someone’s life.
[Eon Engelbrecht E-Radio] (20:34 – 20:53)
That’s wonderful. It seems like clear aligners offer benefits in more ways than one! That’s all for this edition of Save Your Money, Save Your Teeth. Dr Yudelman, thank you so much for sharing your expertise with us once again.
[Dr Clifford Yudelman OptiSmile] (20:53 – 20:56)
It’s my pleasure, and I look forward to speaking with you again next week.
[Eon Engelbrecht E-Radio] (20:57 – 21:25)
Yes, do join us again next week. Thanks for tuning in. And remember, while we strive to provide valuable insights, always consult with your own dental professional for advice tailored to your personal health.
Also, don’t forget to subscribe for more enlightening discussions. Join us again next week as we continue to explore the fascinating intersection of dental health and financial savvy. Until then, keep smiling and taking great care of your teeth.
[Announcer] (21:43 – 22:28)
Discover the world of dental excellence with OptiSmile. Join us for a weekly podcast featuring Dr Clifford Yudelman, a seasoned expert with 40 years of dental experience across four continents. Gain unique insights and expert dental advice by visiting optismile.co.za for articles that illuminate the path to optimal oral health. If you’re seeking unparalleled dental care in Cape Town, get in touch with OptiSmile or book directly online on optismile.co.za. OptiSmile, where global expertise meets local care.
Disclaimer: The content provided in this podcast, “Save Your Money Save Your Teeth” on Medical Mondays, is for informational and educational purposes only. It is not intended to serve as dental or medical advice. The insights and opinions expressed by Dr. Clifford Yudelman and any guests are designed to foster a better understanding of dental health, preventive measures, and general well-being, but should not be interpreted as professional dental or medical recommendations.Dr. Clifford Yudelman does not diagnose, treat, or offer prevention strategies for any health conditions directly through this podcast. This platform is not a substitute for the personalized care and advice provided by a licensed dental or healthcare professional. We strongly encourage our listeners to consult with their own dental care providers to address individual dental health needs and concerns.The information shared here aims to empower listeners with knowledge about dental health but must not be used as a basis for making health-related decisions without professional guidance. Your dental care provider is the best source of advice about your dental and overall health. Please always seek the advice of your dentist or other qualified health professionals regarding any questions or concerns about your dental health.
