Maximizing Patient Care and Practice Growth with ClearCorrect Aligners

Alison Werner:

Hello, I’m Alison Werner, Chief Editor of Orthodontic Products, and this is the Orthodontic Products Podcast on the Medcor Podcast Network. For this episode, sponsored by ClearCorrect, I’m joined by Dr. Daniel Berant to talk about how orthodontics fits into the bigger paradigm of overall health, how digital technology and aligners have come together, and how the two in tandem can help with practice growth. We also talk about Clear Correct, the aligner brand he has chosen to work with in his practice.

Now first, an introduction. Dr. Berant is a dual certified specialist in orthodontics and periodontics in private practice in New York City. Dr. Berant attended the University of British Columbia for dental school. And after three years practicing as a general dentist went on to complete his residency at the University of Pennsylvania in the university’s highly competitive Periodontics Orthodontics program. Dr. Berant, thanks for joining me.

Dr. Daniel Berant:

It’s such a pleasure to be here, Alison. Thank you for having me.

Alison Werner:

Great. So as I mentioned in my introduction, you are a double certified specialist in orthodontics and periodontics. Why did you decide on this pairing and how has it served you as an orthodontist?

Dr. Daniel Berant:

So after working for three years as a general dentist, I realized there’s certain shortcomings and questions that I constantly had. They centered upon growth and development and saving teeth. How come some patients who were regularly seeing by the dentist all of a sudden had severe periodontal disease and had to lose a tooth? I was blessed to have amazing mentors in my formative years and even currently that sort of opened my eyes to what’s possible, and I heard about this program at the University of Pennsylvania that offers the combination of periodontics and orthodontics.

And so as an orthodontist, really you have to understand how do we move teeth and that’s through the tissue, through the bone, through the gums, and that’s the specialty of periodontics. Whenever we’re doing movements, we want to be cognizant of that. We want to make sure that we’re moving teeth in a healthy manner and setting up our patients for a lifetime of success by placing the teeth in a healthy, stable position that ultimately also looks aesthetically pleasing to help our patients with their confidence and their overall life.

Alison Werner:

Well, you practice at Smile Design Manhattan, a multi-specialty practice focused on cosmetic dentistry and founded by Dr. Lee Gous. Tell me about the practice and what makes it unique. Why was it right for you?

Dr. Daniel Berant:

So what Dr. Lee Gous created was this environment where general dentist specialists can all work together to serve our patients in the best possible manner through interdisciplinary care. I think that’s very important to discuss the impact that being able to communicate directly with your colleagues while the patient is in front of you. It’s a different mode of treatment. In the past, it used to be a general dentist would refer out and then you would have letters corresponding. Nowadays, the one that I find is the most rewarding is to be able to sit with the patient, with the other doctors looking at the case and seeing how we can work as a team and have that approach to the patient’s overall care.

Alison Werner:

So how would you describe the patients coming to you for orthodontic treatment in this practice? What are they looking for?

Dr. Daniel Berant:

So in this particular practice, we do have a pediatric dentist that sees some kids. We do see a few adolescent patients. But mostly in this practice is adult patients that have had some level of orthodontic treatment in the past. They forgot or they lost their retainer. They’ve had relapse. And then others that finally are taking that leap of faith and wanting to correct a bite that they’ve never been confident in. When we’re doing cosmetic cases, there’s a certain level of corrections we can do through cutting the teeth and making crowns and veneers. However, there’s a limitation to that. And also when we practice minimally invasive dentistry, which is the respect for a patient’s own tissue for their teeth, their gums, their bone, when you have that philosophy of minimally invasive dentistry, you really want to take as little tooth structure as possible. If a patient is going through veneers, sometimes just by aligning the teeth and placing the natural teeth in the proper position, that satisfies beyond satisfies, it makes a patient’s very happy to see a beautiful smile because the teeth are in their natural place. And with the addition of a whitening and a cleaning that can sometimes prevent them from having to remove a lot of their tooth structure in order to get that beautiful, white healthy smile.

Alison Werner:

So in your practice, what would you say is the breakdown between aligners and braces? Or are you an all aligner practice?

Dr. Daniel Berant:

So I would say we’re a predominantly aligner practice. It’s about 70/30, I would say, with the majority of adult patients opting for the clear aligners. A lot of the patients that would opt for braces are the ones that … aligners, this is the fun fact here, aligners don’t move your teeth unless you wear them. And so if patients don’t wear their aligners, those teeth aren’t going to move regardless how beautifully we treat and plan it, how amazing the product is. And so for those patients, which is about maybe 10 to 20% in the adult population, we’ll opt for the traditional braces, ceramic braces and whatnot.

With the aligners, again, we find there’s several benefits, one being the health of the tissue. So it’s a lot easier to keep your teeth clean when you’re in aligners because you take them off, you brush, floss like you normally do. Aesthetically, they’re easier to wear because people aren’t as aware that you’re going through orthodontic treatment. And then finally, there’s less impact on your life. You can eat whatever you want. You always see these Instagram videos with can you eat chewy foods, crunchy? So there’s none of those limitations with the aligners, and so those are three of the major advantages.

Alison Werner:

Yeah, okay. So when it comes to aligners in your practice, you’ve chosen to work with Clear Correct. Why was this brand right for you?

Dr. Daniel Berant:

So Clear Correct, which is a subsidiary of Straumann Group, is really one of the leading aligner companies in the marketplace. There’s several, incredible aligner companies out there. The thing that intrigues me about Clear Correct when we started with them is their story, how they started. It was one dentist who wanted to provide their patients with aligners. And so eventually kind of like these feel good stories started in his garage and then built into this larger corporation, finally was bought out by Straumann. So with my two specialties with implants, regenerative whole idea of saving teeth, which Straumann is really world-class in globally, it’s so exciting that they’ve taken on this company called Clear Correct that’s specializing in aligner therapy. And so working with them allows me to wear both hats simultaneously.

Alison Werner:

Okay. So what has your experience clinically been with Clear Correct aligners? What have you found?

Dr. Daniel Berant:

So with Clear Correct aligners, I found that patients are very happy with the fit of it in terms of the comfort. With the plastic itself it’s very transparent, so people don’t really see at all when their patients are wearing it. And I really like the fit as it goes throughout treatment. Some of the big things that can stop treatment is when the aligners stop fitting properly. We call it losing tracking. And then you have to do refinement scans. So the patients have to come in, they have to get a new scan, then they have to wait another several weeks depending to get their new aligners. And so I find that with Clear Correct aligners, there’s less and less of that occurring with our patients, so they’re being able to finish on time if not early.

Alison Werner:

That’s always good. You mentioned the transparency of the aligner material from the aesthetic point, but is there anything else about the aligner material that kind of stands out to you?

Dr. Daniel Berant:

The aligner material itself, I always tell patients, tell colleagues when it comes to aligners, it’s really like a paintbrush for an artist. And so it’s more important who’s controlling the paintbrush than the plastic itself. The nice thing about Straumann is their huge R and D department is constantly trying to find ways to improve the durability, improve the efficacy of each movement. And so what I’ve noticed from when we started with Clear Correct till now, the aligners themselves don’t stain. They also are, as I was saying, very comfortable for the patient with their design, the way they’re cut. And so I always rely on my patients giving me the feedback of what’s comfortable, what do they like. That’s what I’d say is my favorite parts about Clear Correct aligners.

Alison Werner:

Great. Well when we talk about aligners, the digital technology surrounding it is just as important as the plastic. What has your experience been with the Clear Correct treatment planning software?

Dr. Daniel Berant:

The same thing as with the aligners. It’s evolving to the point that the Clear Correct team really listens to the doctors. And when we ask them for something, I’m so impressed with how quickly they’re able to turn around that around. So when we ask like, “Hey, can I get more freedom to be able to move a tooth,” not to be too scientific like [inaudible 00:08:38] , things like that, they’ve created the capabilities within their software to provide the dentist that freedom. Usually what would happen is there’s a huge turnaround time, you’d have to type it all out. And so now with the software team that they have in place, we have a lot of freedom in terms of placing the attachments where we want them, how we want them, placing cutouts if we want to use traditional orthodontic mechanics with rubber bands or elastics. And so there’s very responsive individuals working on the other side that are truly listening to the doctor’s requests.

Alison Werner:

That’s always good. It’s clear how digital technology can benefit treatment planning. But can you talk to me about how digital technology and aligners have helped you with practice growth?

Dr. Daniel Berant:

So one of the major things that might prevent a patient from undergoing treatment is the lack of certainty of what to expect, also the lack of awareness of what’s possible. And so we often find patients that will say to us, “I didn’t even know you guys could do that.” Before with orthodontics traditional embraces, you’re really taking a leap of faith in your orthodontist being like, “Oh, no, no, I can align it. The teeth are going to be straight. And no, they’ll hold the cast of the perfect dentition.” But not everyone’s teeth look the same, so there’s a bit of a disconnect there.

What digital technology has really allowed us to do is when we scan our patients, and this is a video scan, it’s non-radiation, we are able to provide our patients with a live present view of their teeth. And then with a click of a button, you’re able to see, oh, the teeth can become like this, and so they’re able to see that. As the technology continues to advance, we’re going to be able to literally take a photo of our patients so they see their face with their smile wherever malocclusion they have. And then with the click of a button, they’ll see their face with the new smile that’s what we aim to provide our patients. And so the big thing is not telling patients what they need, it’s showing them what’s possible. And when you click that button and they see it for themselves, there is no selling involved. It’s, “Doc, how can we do that? When can I start?” And so you’re able to provide that treatment that benefits the patient’s overall health, wellness, and aesthetics without having to try to convince in any way, shape or form.

Alison Werner:

Yeah, exactly. Well now in terms, going back to Clear Correct, in terms of ordering aligners and treatment planning, what has stood out to you about the support services Clear Correct offers you throughout your cases?

Dr. Daniel Berant:

I would say the instant responsiveness of the team that works for Clear Correct. I know from my staff, whenever they have a question that they’ll message Matt or Amy or someone that is part of our team, and I’m always impressed, no matter literally 24/7, someone is responding to us we’ll get back to you within 24 hours, and then the solution is always corrected or whatever help we need is immediately addressed. And so that’s what’s really stood out. It’s all about the people that you surround yourself with. And any company that you align yourself with, no pun intended, really becomes a team member of the overall practice. And so you just want to choose carefully and make sure that you have people that support you and your patient care.

Alison Werner:

Well you just talked about how when you’re choosing a company or a brand, make sure that they’re going to work with you and care about what you’re doing. What does go into your decision making when deciding on an aligner brand? What were you thinking when you were looking at Clear Correct?

Dr. Daniel Berant:

Most first and foremost, does the product work? You need to make sure that it’s tested and you see the results of the treatment that you want to render. Once you have that established, then you want to look at the people that are affiliated with the organization and how they support you beyond just the product at hand. The thing that really impressed me with Clear Correct is the way they helped us incorporate three shape scanning, the way they help teach our team, our assistant, our hygienists, how involved they are in promoting health for our patients, and also the added value of bringing the Straumann Group and the implant regenerative, surgical side. And so when you’re working in this multidisciplinary practice where you offer all the services to your patients to be able to have one home base with one company that’s able to service all of those and you have an incredible experience every single time, it just fuels the desire to continue with that brand.

So if I were to give advice on how to choose a product, I would definitely recommend talking to some key opinion leaders, so doctors who have tested the product, and then also seeing who the individuals in the area are that are able to help them.

Alison Werner:

Okay. Well, I want to switch gears a bit before we finish up. In recent years, there’s, because you are a periodontist, in recent years there has been an increased awareness about the role of oral health plays in overall health. As a periodontist and orthodontist, how does orthodontics fit into overall oral health?

Dr. Daniel Berant:

That’s a beautiful question. I think orthodontics plays such a pivotal role in overall health because it really sets the state for our kids, for adolescent patients for the rest of their life. When we’re able to place those teeth into a healthy position, one that respects their way they bite and the way they function and their specific, the gum, how thick it is, how thin it is, and more so now in the adolescent population, we’re diagnosing sleep apnea, constricted airways, and seeing the enormous impact that has on our patients’ wellbeing. So when we’re able to use our orthodontic knowledge to expand the upper arch, to create room for the tongue, to help facilitate the growth, forward movement of the lower jaw so patients can breathe better, and working with our medical colleagues, diagnosing in enlarged tonsils or adenoids, really working with a patient’s overall health mentality first.

I wrote this article how I see orthodontics, there’s been this paradigm shift from just dental related, meaning I need the teeth and I need this tooth relating to this tooth and that location from the inside, and then forgetting about the outside. So it went from inside out. We’re really starting from the outside in. We’re looking at the patient’s proportions. We’re looking at how their profile is, how their lower jaw fits. We’re asking the questions about sleep, and we’re asking the questions about breathing.

And also, I have to share this story with you, Alison, because it happened a few months ago, and it really ties in this whole multidisciplinary situation. So I had a female patient who was referred to me by one of our general doctors to address her lower recession and thin gums and sensitivity that she was experiencing. As she was being seated in my chair, the dentist says, “Oh, do you mind talking to her daughter grinds her teeth at night,” clenches grinds. Her daughter is like six years old. And so I told her, I’m like, “Well, that’s not normal. That’s not normal for a kid to be doing that. There’s something wrong there that we should look into. Can you bring her in?” And so just think about the multidisciplinary aspect. She would’ve been referred to me just for her gums, but because we’re all in the same area, she could bring up her daughter’s concerns. So she brought her daughter. Her daughter has worn down her entire dentition, grind down her primary teeth. And so I discussed with her, I’m like, “Does she have issues paying attention in school?” She goes, “Yeah, her teachers think she has ADHD. They want to put her on Ridalyn.” And I’m like, “Does she get sleepy during the day?” She’s like, ‘As soon as she gets in the car, she falls asleep.” And this we didn’t talk to about later, but she was very small, petite for her age.

And so I told her, I’m like, “Look, there’s something wrong here. Something needs to be addressed. I think there’s could be concern about her airways.” She went to see an ENT. They diagnosed her with enlarged tonsils. They removed them. And a few months ago, this is when she came to me and she said, “You saved my daughter’s life.” And anytime someone says that to, you know, get the chills, you get the warm fuzzy feelings. And I go, “What do you mean?” She goes, “They removed the tonsils. And for the first time in my life, I heard my daughter say, ‘Mommy, I’m hungry.’ She got an appetite. First time in her life, she’s paying attention in school where the teacher’s like, ‘Oh no, she’s doing great.'” And she goes, “Now, when we take road trips, she’s no longer falling asleep in the car.” And so all of a sudden at the age of six and seven, you’ve completely transformed this girl’s life. And so it all comes from the diagnosing of where are her teeth, where is her jaw, what’s going on beyond just the mouth itself. And so that’s how I feel like orthodontics really plays a pivotal role in the overall health patient.

Alison Werner:

Absolutely. Well, thank you so much for sharing that story and for just sharing your experience in your practice. It’s been a pleasure talking to you today.

Dr. Daniel Berant:

It’s been my pleasure. Thank you so much for having me.

Alison Werner:

And to our audience, thanks for taking the time to listen. Don’t forget to subscribe to the Medcor Podcast Network to get the latest episodes of the Orthodontic Products Podcast. And be sure to visit orthodonticproductsonline.com for the latest orthodontic industry news. Until next time, take care.