Spark Aligners and the Rise of Invisible Orthodontics

Alison Werner (00:10)
Hello and welcome to the Orthodontic Products podcast. I’m your host, Alison Werner. On today’s episode, sponsored by Ormco, I’m talking to Dr. Mike DePascale, an orthodontist in private practice at Kozlowski DePascale Orthodontics in Connecticut and key opinion leader for Ormco. We’re going to talk about how aligner treatment continues to advance and become more prolific in orthodontics. And the fact that increased education among patients and consumers has been a catalyst for this rise in invisible orthodontics. Dr. DePascale thanks for joining me.

Mike DePascale (00:40)
Yeah, happy to be here. Thanks for having me.

Alison Werner (00:41)
Great, great. okay, so let’s start by, can you tell me about your practice and how long you have been practicing?

Mike DePascale (00:48)
Sure, yeah, I’ve been practicing. I’ve been here my my whole orthodontic career, so I graduated from University of Maryland in June of 2017 and I came up here to work with Jeff Kozlowski in at that time and I’ve been here ever since then so We’re up in Southeast, Connecticut. We’ve got two locations Both in a similar area is not too far from each other so similar demographic in both places and We do lots of different treatment here. We do a fair amount

Alison Werner (00:52)
well.

Mike DePascale (01:18)
of the practice is phase one. We see lots of adults and part of that I treat. I know we’ll get into this more but pretty much every type of patient with aligners as well.

Alison Werner (01:27)
Okay, well talk to me about what you’re seeing when it comes to demand for aligner treatment among your patients. Are they more informed? How are they talking to you?

Mike DePascale (01:37)
Sure. They are definitely more informed. I think some of this is…

is regional depending on where people are there tends to be greater trends or lesser trends. In my area I think I expected it to be a little bit more pronounced than it has been but I’m for anyone who doesn’t know I’m in small town USA up here in southeast Connecticut so we’re not very close to any major cities I mean Boston and New York are the closest ones but so I think some of that kind of plays into that part of it but they’re absolutely more informed I mean we have people coming in more often

Alison Werner (02:05)
Okay.

Mike DePascale (02:12)
than they ever were, either specifically asking for aligners or mentioning ones that they’ve heard of before. They’ve also at this point, you know, there’s the direct to consumer aspect. So some people have already heard about that or already tried it. We’ve been in a number of those situations as well. And or their general dentist has spoken to them about it. So certainly there is more of an ask for than I think there used to be.

Alison Werner (02:26)
Okay.

Okay, so how does the conversation differ among adult patients seeking treatment for themselves or adolescents and their parents seeking treatment when you’re talking about

Mike DePascale (02:49)
Ha!

That is a great question. I would say on my end, it’s not that different. The biggest things are this. It’s funny because most people, parents are often hesitant about kids and teens with aligners just because of the responsibility involved with it. And I jokingly but seriously say this, kids are often better than adults are. As long as they’re responsible kids, which I always tell parents, you know your kid better than I do. I’ve only known them for the last

10 or 15 minutes or whatever it is. So they work very well in kids. They’re totally fine. It’s just a matter of how responsible are they gonna be because it is a lifestyle change. But I found teenagers, mean, you sometimes boys will be boys, not that it’s only them, but sometimes they’re not great about it. The challenge with adults is many adults are kind of stuck in their ways with, you know, they feel like they’re gonna struggle with.

like the lifestyle change of living with aligners because it is a little bit different all of that being said i think in both sides they’re probably

Alison Werner (03:48)
Mm-hmm.

Mike DePascale (03:57)
over concerned about how well it’s going to go. parents with kids, they’re often nervous about it, but it’s incredibly uncommon that I have a patient that’s really just not wearing them at all and it’s not working. And then again, with adults, often, often they want the aligners but they have a question about how is this going to affect my lifestyle? Because I know I need to be taking these in and out all the time. And then some of that, I think,

has been made much easier with Spark specifically because one of the biggest challenges that people have had in the past is aligners staining. And whether, you know, if somebody wants to drink coffee or something like that, and I do suggest that people only have water with them in. But there’s a number of things that you can get around with that because the aligner is so durable and it doesn’t have any of those issues. I would say it’s those are probably the biggest differences between them. But generally speaking, tends to work very well for

Alison Werner (04:29)
Right.

Okay, so I know you were involved with the pilot testing for Ormco Spark clear aligners, which you just mentioned with that in mind. What is stood out to you about the way aligner technology has evolved in the last few years?

Mike DePascale (05:04)
Sure.

I would say, Ormco’s at the forefront of it in my opinion. I mean, there’s been a number of things amongst other aligner companies that people have done, but as you mentioned, having been with them from the ground up, like literally one of the first offices in the country doing this, I have seen every single thing that has changed through the product over the years. And I think the biggest thing is not, it’s not really just one specific thing that has been done. And I’ve been, not only have I seen all of them, I’ve been a part of developing some

of them. there’s a number that I, you know, there’s a couple things that I could throw out there and say these are some of the really cool things, I think we’ve made to the actual product. But I think more importantly, the bigger thing is how consistent those developments are. Meaning we’re on our 15 plus iteration of the software and new design and along the way over those years there’s been so many different advancements that have been made to the aligner system. I think even if you can

to any other aligner company. They’re in my opinion, consistently making the most advancements to keep making the product better and the software better so that doctors can deliver better treatment. I think that’s the biggest thing.

Alison Werner (06:19)
So how do you think Spark aligners kind of meet this moment when we talk about what patients are looking for now and this concept of invisible orthodontics?

Mike DePascale (06:28)
Yeah, well.

It’s a couple things. I could make that really simple, would say whether it’s kids or adults, mean, the driving factor in wanting to do aligners for most patients is the aesthetics. It’s not usually the, it’s going to be easier for me to brush and floss. I mean, that’s part of it. And I always talk about that, but most of the time it’s the way that they look. And that’s why most people are asking for it. And Spark has absolutely nailed that. I think it’s the most clear one out there. I treated myself with aligners.

and nobody ever knew that I was wearing them. Even when I was in the consulate, it was funny because I’d have adults say something to me like, well, am I gonna be able to wear these during work? Because I talk all the time and I’d be like, I’m wearing them right now while we’re talking about this. So I really think they’ve done a fantastic job of making it something that looks great. And then the second thing that goes right along with that is it has to also work great.

Alison Werner (07:13)
Yeah.

Mike DePascale (07:24)
So we’ve delivered on how it looks, which is the number one thing that patients are looking for with the product. But they’ve also made it as long as things are done well by the doctor, a product that delivers on the service that you want as well. And when I get asked about compliance with aligners, because that’s, you know, elephant in the room, that’s what everybody talks about with people don’t wear them, or I can’t get my patients to wear them, whatever it is. The thing that I always tell people is the most motivating thing in orthodontics or anything in life really

is results, it’s progress. So if you have somebody that’s motivated in the beginning and things are going well because you’ve planned it well and you have a product that delivers on that and they’re progressing, right? So if all the things are going in the right direction, they’re going to be a lot more likely to continue along on that ride with you. So I think they’ve made a great product that looks great and it also works great. And when you combine those things, everything goes smoother.

Alison Werner (08:17)
Okay, well talk to me about how you’re using Spark aligners in your practice. I know you’re treating a range of cases from simple to complex. So can you talk about those cases that stand out in that those ranges?

Mike DePascale (08:29)
Sure, absolutely I can. I mean, if we got into like the details of mechanical stuff, I would say probably the two biggest things that I’ve treated effectively consistently that weren’t really something that I could do before. And I think probably something that a lot of people still aren’t doing are really significant class two. So some of that is a very significant overbite treating that without any appliances, without taking out teeth and without doing surgery. That’s been really effective. And then the total

opposite, someone that has a very severe underbite, correcting that with aligners without taking out teeth, without doing surgery, without doing anything else. I have been able to do that very effectively with just the aligners and elastics and the ways that we’ve developed the product. overarching, would say bigger picture with that, there’s not a lot of situations that…

I look at and I’m like, I don’t think I can do this with aligners. And I think there’s a lot that goes into that. But having the Spark product is a big part of that. And whenever people ask me that, I always tell them, because our practice is very split. We do a lot of braces. And so people often ask me, how do you decide if you’re going to do a aligners or braces or why aren’t you treating everybody with aligners or some version of that? And the answer is, I kind of let the market dictate it. Meaning my goal has always been still

Alison Werner (09:46)
Right. Yeah.

Mike DePascale (09:52)
is I want somebody to be able to come into the office, have a goal, and me be able to get them there as close to the way that they want to do it as possible. And if they want to do it with braces, great, I can do that. If they want to do it with aligners, great, I can do that too. And I think there has been a disconnect on that for a long time that there shouldn’t be anymore where we’ve, I hope, transitioned, I mean I have, and this is where I think we’re going with orthodontics, transitioned from the, well I could do this with braces,

but I don’t think I can do it with aligners too. If you want to get there with aligners, then great, do it. So to give you a more direct answer, it’s very, very rare that someone comes in and I’m like, I don’t know if I can do this with aligners So there’s there’s not much that I’m not treating.

Alison Werner (10:38)
Yeah. Okay. What stands out to you about the Spark treatment planning platform and that experience?

Mike DePascale (10:46)
Sure, I would say the biggest thing is its simplicity. to take a big step back, like with me going from the ground up, I started working with Spark and working with the software and the treatment plan stuff before I had any training in it. It was all brand new to me and I thought that there was a very small learning curve. It wasn’t hard for me to transition into that. And what I mean by simplicity is the design of the software itself. Like when I look at it, it’s very,

digestible, it’s very easy to use, it’s very user friendly. But the flip side of that, this is where I think they’ve balanced it really well, is there’s so much that goes into the back end of making that seem and look simple and if you really want to go like dive in on all the details and the very specific things of each tooth movement and all there’s tons of data behind the scenes that you can get to but it’s not in your face. So I love that. I think there’s a number of other softwares with different companies that

out there that that stuff is all there, but it’s all looking at you all the time. And I think it’s harder for people to process that. So they’ve done a really good job of balancing, like making it user friendly, but also giving you all the information you could possibly want if you want to dive into that. And that’s translated into making treatment planning, I think, much easier.

Alison Werner (12:06)
I’m curious, you mentioned that you started practicing in 2017 and you have been were part of the pilot study with Spark Aligners. I’m just curious, like, how is that experience of, you know, starting your career and then also kind of getting involved in a new aligner system and that development?

Mike DePascale (12:25)
Yeah, awesome. I’ve had such a blast. been a lot of fun. I think I had the benefit of having only been in practice. I was in practice for about two years when I started using Spark, actually a little bit less than that. So probably in fairness, maybe it was a little bit easier for me to transition because I hadn’t been using something else for 20 years. But on the flip side, it was…

in the hands of orthodontists, at least in the United States, because it had been used a lot elsewhere, it was unproven. And, you know, I decided to use it because I saw the aligner, I looked at it, and, you know, we decided it’s something that we thought might work well. And we’ve been working with Ormco for a long time with our other brackets and wires. And that’s been something that we’ve just been treating with for many years. So it was really fun to be able to be like in that beginning process.

and follow to your question earlier, all of the changes that have happened over the years. So to not only see the product get developed, but aligner treatment in general just get elevated over the years. So, I mean, it’s been really fun. I’ve had a lot of fun being along for that ride and then in some ways helping guide it. I’ve been fortunate enough to be part of some of the product development and some of the changes. So I really think we’re just at the beginning of it. It’s been great.

so far but I think there’s a long way to go to make it better.

Alison Werner (13:55)
Great. Well, before I let you go, what are your thoughts about consumers and patients and orthodontic treatment as we look to the future?

Mike DePascale (14:03)
you know, I think it’s going to probably continue the trend. I think the aligner education, for better or worse, you know, I know there’s the direct to consumer thing that.

Awareness of aligner treatment in general, like orthodontic awareness is a good thing. However, it gets out there. I think that’s a good thing for people, but that came with a lot of misinformation through some of those avenues. So I think that amount of information is going to continue as people get more informed and people continue to talk. And I think a bigger thing is, you know, I go back to the results. I think we’re we’re now.

transitioning where there’s getting to be more more doctors out there that can confidently treat more complex things with aligners. So I’m hoping that with, know, consumers are going to see that and there’s going to be more of it, meaning you’re going to have, you know, friends and families that are going to say, you know, go see Dr. Mike or go see whoever. And they’re going be like, well, I don’t know, I don’t want to do braces. I’m 52 years old. And then they’ll say, well, you don’t have to do braces. You can do it this way. And so I expect

that to just continue. I think we’re going to keep going in that direction. I don’t think we’re going to leave braces in the dust. I think that will be there for a while, but I expect as better results go out there and there’s more orthodontists doing it and doing it effectively and doing it with a product that’s again comfortable and it makes the process easy for them. You’re just going to see them continue to ask more for that and we’ll be ready for it.

Alison Werner (15:35)
All right, well, great. you. Thank you so much, Dr. DePascale. It’s been great talking to you.

Mike DePascale (15:41)
Likewise, thank you so much for having me. great to be here.