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News / February 25, 2021

Improving oral health through tooth alignment

by Anna Middleton

Improving oral health through tooth alignmentAlign Technology launches free dental hygienist training programme.

Are you a dental hygienist or therapist looking to get more involved in improving oral health through tooth alignment?

Align Technology has launched a training programme. It is designed to show dental hygienists and therapists the pivotal new role they can play within a multidisciplinary, digitally-focused practice.

The four-part series is delivered on a dedicated Invisalign webpage. It’s free for dental hygienists and therapists keen to learn how their expanded scope of practice makes them the ideal partner for dentists offering the Invisalign treatment.

Four-part programme

An initial pilot for the programme proved extremely popular amongst the 150 hygienists and therapists who participated. It has now been made available nationwide across the UK and Eire.

The agenda for the four-part online programme runs as follows:

  1. An educational session about how the Invisalign system fits into the hygienist/dentist interface and practice workflow; how to identify the patients who could most benefit from tooth alignment to improve their oral health; and how to introduce the Invisalign concept during the hygiene consultation
  2. How to effectively communicate with patients during the hygiene consultation 
  3. The relationship between oral health and straight teeth
  4. How to implement a digital workflow between practitioner and hygienist in the practice: how to diagnose and scan with the Itero intraoral scanner.

Part three of the programme is presented by Anna Middleton. Anna was the highest ranked dental hygienist in the 2020 Dentistry Top 50 –coming in at number nine. She is best known to her 11.6k Instagram followers as @Londonhygienist.

Here, Anna explains more about the new training programme and the role she plays in upskilling her peers.

In Anna’s words

This is an online programme, especially developed for dental hygienists and therapists. It gives them an insight into how Align Technology offers a solution to aid patients in their treatment choices.

I will be discussing both how I use digital scanning to have open conversations with patients about their dentition, and how I use it in my Itero workflow as an aid to the other clinicians in practice.

More and more hygienists and therapists are looking for ways to help their patients achieve high levels of good oral health. Also, building further skills by offering additional services, which can create a unique and positive patient journey.

They are also keen to undertake such additional roles to help their practices to continue their growth.

Pilot sessions

In the pilot sessions of the programme, delegates were keen to learn more about how they could incorporate digital scanning into their scope of practice. They were also keen to develop ways to initiate conversations with patients about teeth straightening, and why these conversations are so important. I was able to share some of the dialogue I use and discuss the steps I take with my patients.

With this orthodontic programme, there a real scope of opportunities for these dental professionals. I always say: ‘Teamwork makes the dream work’. Often, when I see a patient under direct access, they may not have visited a dental practice for some time. It is during this time I can discuss not only their oral health but also their dental health. I use scanning of my patients as a digital record. We all know the saying ‘a picture is worth a thousand words’… it couldn’t be truer.  The scans allow me to show patients all the areas in their mouth in detail. I can then use it to discuss any concerns they may have – and discuss potential solutions.

Hygienists and therapists

Hygienists and therapists play an important role in any dental practice. The start of any smile makeover journey will begin with a session with me, and the dentists I work with. I always stress the importance of good oral hygiene and health in order to achieve results. This will also preserve their treatment for long after completion.

Many of my patients who had difficulty maintaining their oral hygiene due to crowding have now said how much better their mouths feel and how much easier it is to clean. Those who had more frequent visits in a year are now on six to 12 month recalls.

I have had conversations with some hygienists and therapists who would like to use their expanded scope of practice more. I believe there is plenty of work to go round and often all it takes is to have a few open discussions with the team and implement a new workflow.

The dentists I work with have special interests in aesthetic and restorative dentistry. By sending elements of work to me means they can focus on the areas they best enjoy. This in turn is also a better use of their time.

Making the assessment

I see the Invisalign programme helping hygienists and therapists to help their patients, as we know misalignment of teeth can be a contributing factor to poor oral hygiene and tooth wear.

While Invisalign treatment may not be suitable for all patients – it is the dentist or specialist orthodontist who makes the assessment and decides if the patient is a suitable candidate for a clear aligner treatment – it is a discreet and affordable solution, and one that some patients might not even be aware of. I still have patients who think that ‘braces’ means ‘metal train tracks’ so by being able to scan patients for Invisalign treatment means that you can offer options to your patients.

Complete game changer

The programme will also show hygienists and therapists other benefits of scanning, as it records restorations and calculus. I use digital scanning for all my impressions now. I had a patient who desperately wanted whitening but could not tolerate alginate impressions, I used the Itero scanner to scan their teeth to produce their whitening trays – this was a complete game changer for them.

The Itero digital workflow between me and the dentists I work with has made things really simple. I have longer appointments for all new patients, which allows plenty of time to scan and then discuss treatment options with the patient. Then, if there is anything they would like to discuss further, I book them in with the dentist.

Because they have already had a scan, they can then continue the conversations – it is like passing the baton seamlessly. We are also now slowly scanning all existing patients so we have baseline digital recordings.

It is easy to assume that patients are happy with their smile, but that can change over time. I have found that the technology fascinates patients. Then they tell me about what they see and what they do not like. This is the best way to initiate conversation about what we can do to help. 

Hygienists and therapists are in a prime position to carry out scans. Utilising those in your team who are happy and want to take on extra duties will reveal an improvement in workflow and time management. Your revenue will also increase, which I am sure any dentist would welcome.

Working in tandem

Anna Middleton works with Dr Rhona Eskander, who added: ‘I think this hygienist programme is such a good idea because ultimately the success of the Invisalign workflow depends on teamwork.

‘The hygienist tends to have a very good relationship with patients. So, educating them that aligning the teeth has a massive benefit on oral hygiene is a huge help. Patients are more likely to understand about teeth straightening options because the hygienist had already highlighted the benefits. 

‘Anna sees patients herself as a result of direct access and often I get referrals for aligning their teeth. In my experience, the hygienist convinces the patient to have treatment before you have even seen them. Ultimately, because the hygienist has already had that discussion with the patient, they can see more patients.

‘Dentists should get on board with this Align hygienist programme. Particularly if their staff are already talking to their patients about the Invisalign treatment. With so many more hygiene than dental appointments, it makes sense to involve their hygienists. It is something that really should not be missed.’

Access to the training programme is via the Invisalign portal. To register, the dental hygienist or therapist needs to log on in collaboration with the Invisalign provider in the practice where they work using their IDS number.


This article first appeared in Irish Dentistry magazine. You can read the latest issue here.