Discover why virtual treatment monitoring revolutionizes orthodontics—enhancing efficiency, patient care, and practice growth.

By Barry Glaser, DMD
Virtual treatment monitoring encourages patients to be more active participants in their treatment outside the orthodontic office.

It is mind boggling how much the practice of orthodontics has changed in the 32 years that I have been in the profession. While the fundamentals of biomechanics and biology remain the same, the delivery of orthodontic services to my patients has very little semblance to what I learned in my residency program. From computerization, self-ligation, and digital radiography to clear aligner therapy, it truly is a brave new world. Both my methodology of delivering orthodontic care as well as my practice systems in place to support that delivery of care have changed drastically and continue to do so to this day.

The emerging technology that I would like to address in this article is virtual treatment monitoring. I was first introduced to virtual treatment monitoring in 2017 and at that time I had many questions and concerns about the loss of control and the maintenance of quality treatment outcomes. I had fears about artificial intelligence taking over treatment decisions as well as concerns about patients and their treatment falling through the cracks. On the other hand, I recognized that it is natural for people to have concerns about change, especially when it comes to AI and automation. Seven years down the road, I have fully embraced virtual monitoring in my practice for clear aligner treatment, and it is my opinion that this technology provides overwhelming benefits to both the orthodontic practice as well as the patient. And so, I present to you my top 10 reasons to use virtual treatment monitoring.

1. Closer Treatment Supervision

As orthodontists, we all recognize that we are in the compliance game. Whether it be fixed appliances or clear aligners, patient cooperation is a cornerstone to achieving consistently excellent results. When using virtual monitoring, patients send images of their teeth with their aligners both on and off on a weekly basis. These images are analyzed by AI and are also checked by my staff for things like aligner fit, oral hygiene and loss of attachments. We now supervise our patients on a weekly basis without the patients having to make an appointment or show up to the office. A common concern that I hear from doctors is “not seeing the patient enough” when using virtual monitoring. On the contrary, we see our patients every week, it just happens to be on the computer.

2. Better patient accountability

Weight loss centers routinely have their customers come in for weekly weigh-ins. Why? Because it works. Customers reach their weight loss goals more frequently and faster when objective weight assessments are done on a weekly basis. It is the same in orthodontics. Patients wear their aligners more consistently and change to the next set of aligners on a more consistent cadence when they know that someone is watching. Virtual treatment monitoring compels patients to be a more active participant in their treatment and take greater responsibility for their actions.

3. Easier communication

Another concern that I hear from doctors regarding virtual treatment monitoring is that patients will somehow feel left out of the loop if they do not come in for regular office visits. On the contrary, virtual treatment monitoring provides the patient with direct messaging capabilities using their smartphones and allows patients to feel connected to the office 24 hours a day, 365 days per year. When patients begin treatment, we emphasize the importance of using the direct messaging feature stating, “If you have any questions or concerns, feel free to reach out to us on your app at any time.” Patients love the convenience of not having to make a phone call, being placed on hold, or leaving a voicemail. It strengthens the partnership between the patient and doctor with the use of technology.

4. Greater customer service

Doctors say to me all the time that their patients love coming to the office for appointments. While it is true that your patients do love you and your staff, I can assure you that they do not love the appointment. Whether it is adult patients or parents of children who are your patients, they perceive the office visit as something they need to do rather than want to do. There is no question that they want an attractive smile and healthy bite, but they want it in a way that does not interfere with work, school, and leisure activities. We are dealing with the Amazon generation, folks. They expect food delivery, limousine services, grocery shopping, etc, all delivered to their doorstep with the touch of a button on their smartphones. Integrating virtual treatment monitoring into your routine clear aligner practice workflows speaks the language of Generations Z and Alpha and provides them with connectivity and customer service in a way to which they are accustomed.

With remote weekly virtual check-ins, tracking and compliance issues can be identified early and remedied much sooner, which leads to shorter treatment times, fewer additional aligner orders, and greater profitability.

5. Early detection of tracking and compliance issues

These days it is common for orthodontists to see their clear aligner patients every 10 to 12 weeks in the office. But what happens when a tooth is not tracking, or the patient hasn’t been wearing their aligners as directed? Three months down the line, treatment may be sufficiently off the rails to require a new scan and an additional aligner order. This inefficiency costs time and money and can be frustrating for both doctor as well as patient. With remote weekly virtual check-ins, tracking and compliance issues can be identified early and remedied much sooner. Overall, this leads to shorter treatment times, fewer additional aligner orders and greater profitability.

6. Closer hygiene monitoring

Thankfully, I see significantly less decay and gingival inflammation in my clear aligner patients compared to my fixed appliance patients. Nevertheless, it is still important to keep a watchful eye on oral hygiene during clear aligner treatment. The image quality using virtual treatment monitoring is excellent and allows us to identify those problem patients and take corrective actions sooner. Automated messages can be sent to the patient reminding them to brush and floss as directed, and face to face meetings, whether virtual or in person, may be scheduled to reinforce good oral hygiene techniques and keep patients and parents apprised of their treatment.

The remote monitoring image quality allows Glaser to closely track hygiene between in-person visits, while automated messages allow him to communicate with the patient if there is an issue. 

7. Fewer in-office appointments for the practice.

From a practice efficiency perspective, there is no question that virtual treatment monitoring significantly reduces the number of in-office appointments. This efficiency in turn leads to fewer patient appointments during the day, easier scheduling, shorter work hours, and fewer days worked per year in my practice, all while maintaining good monthly production. The lighter appointment schedule makes it easier to fit new patient exams into the day as well as patients demanding to be squeezed in. I see zero negatives to a lighter daily patient load for any practice if monthly exams and start goals are being met.

8. Fewer in-office appointments for the patients and/or parents.

From the patient’s perspective, it is a huge win if they can get the smile that they want with less intrusion into their daily activities. My treatment coordinator messages this to every new patient at the new patient exam, saying, “We know how busy it is for people these days and we can provide you with great treatment, but only need to see you in the office two to three times per year.” After 7 years I have never had a patient complain or push back on that messaging.

9. Fewer out-transfers

What do you do when a patient in fixed appliances moves to another city? For my practice this typically means transferring the case to another doctor in their new city. On the other hand, when patients are in clear aligner treatment and have virtual treatment monitoring, most of the time I can remain the treating doctor. While I may need to ask a favor from a colleague to take a scan or remove some attachments, most of the time I can complete that patient’s treatment and save the time, frustration, and expense of transferring.

10. Cast a wider net

As I have discussed, one of the cool things about virtual treatment monitoring is the ability to treat patients with fewer in office appointments. One final advantage: You can use this messaging to attract patients to your practice from a wider geographic area. They may not want to drive 45 minutes or more for monthly appointments but making that trek just a few times per year is much more acceptable. As a result, I have widened the geographic area that I market to, and now treat patients from zip codes that I never saw before.

The advantages to using virtual treatment monitoring are wide-ranging. In 2024 and beyond, patients expect their orthodontic treatment to be delivered in an efficient and convenient way. At the same time, digital technologies can make the office run more efficiently and with less stress. 

What’s not to like?

Barry Glaser, DMD, is a pioneer in Invisalign treatment for children and teens. His dynamic speaking style has made him a sought-after speaker worldwide and he has presented over 400 lectures and seminars on five continents. He has authored numerous articles on clear aligner treatment, and he is the author of the best-selling book, The Insider’s Guide to Invisalign Treatment. He is an Invisalign Diamond Plus Provider and has been an Align Faculty member for over 10 years.