N L Y A L S O N F E S SI O O R T A L P N E D PUBLISHED IN DUBAI www.dental-tribune.me January-February 2021 | No. 1, Vol. 11 Will COVID-19 push orthodontics further into the digital space? Dental companies are increas- ing their focus on digital treat- ment options Since the SARS-CoV-2 pandemic was declared, the dental companies that supply the industry have in- creased their already strong focus on digital tools. Henry Schein recently launched medpod, a teledentistry clinical decision tool. The company said that the tool will allow dentists to continue to communicate with patients and monitor treatment as the pandemic continues. A spokes- person from Henry Schein con- firmed to DTI that medpod is suit- able for orthodontists. In a recent investor call, Align Tech- nology CEO Joseph Hogan outlined a number of initiatives that the Invis- align manufacturer has put in place to support dentists as they resume the provision of orthodontic care. The company accelerated the devel- opment of virtual tools that were be- ing piloted, such as virtual appoint- ment and care tools for Invisalign. The company has also begun provid- ing relief and deferrals on payments for Invisalign practices, and has in- creased clinical education and train- ing through online platforms. Hogan told listeners in the call, “We honestly feel that, particularly in the orthodontic community, there’ll be a much harder leaning toward a digi- tal kind of environment because of the chance of reinfection rates with COVID-19 and concerns about future shutdowns or slowdowns [...] So we’ll be going to our customers with pro- grammes that really help them to figure out how to convert more and more of their volume to a digital en- vironment.” Align Technology rolled out these tools to the market through its In- visalign mobile and online applica- tions. “Feedback to date has been rel- atively positive, and we believe that doctors will continue using these tools to improve patient experience and increase efficiencies well after COVID-19 restrictions have been lifted,” Hogan said. He asserted that, “together with doctors, we’re going to leverage that power of digital for dentistry and orthodontics more than ever. Doctors are not going back to before”. AD By Jeremy Booth, Dental Tribune In- ternational Digital tools helped orthodontists to continue providing care while their clinics were closed owing to the SARS-CoV-2 pandemic. The leading clear aligner manufacturer says that the new digital tools that it devel- oped for orthodontics in response to the crisis, will continue to be used well after health restrictions are lift- ed. But while these tools have also helped to ease the transition into the resumption of elective care, ortho- dontists admit that chairside consul- tations cannot be replaced. Orthodontic practices in the UK reopened from 8 June 2020, more than two months after the British Orthodontic Society (BOS) advised its members to halt the provision of care owing to the SARS-CoV-2 outbreak. A BOS spokesperson con- firmed to Dental Tribune Interna- tional (DTI) in late May that all or- thodontic care had been suspended during the lockdown across the four home nations. During the lockdown, the BOS stated that most orthodon- tic appliances could be left in situ for some months without detriment if patients followed the usual care in- structions, such as good oral hygiene and the avoidance of sugary and hard or sticky foods that may dam- age them. For the provision of urgent care, the BOS recommended that cases first be triaged by telephone or online video by an orthodontist in order to assess the clinical urgency, but also to minimise the risk of in- fection at emergency care centres. Director for External Relations Dr Peter McCallum told DTI that digital interfaces were being recommended in order to minimise the disruption to treatment for patients wearing fixed appliances. “For our patients, we have given advice on taking pic- tures and videos for their orthodon- tist and provided videos on home repairs,” he said. Orthodontists say that digital tools help, but cannot replace chair time During the lockdown, digital com- munication tools helped to allow follow-up appointments to contin- ue—this was the message from Dr Thiago Gregnanin Pedron, a special- ist in orthodontics in private practice in São Paulo in Brazil. “The challenge, in fact, was minimised, because we usually maintain a contact list of pa- tients at the clinic in a mobile app,” Pedron explained. “Although the clinic was closed from the declara- tion of the pandemic and there was no face-to-face service, online follow- up was carried out and guidance provided on hygiene and the care of orthodontic devices and clarification of possible doubts.” Digital consultations have been a significant help, but Pedron says that they cannot replace chairside con- sultations. “I believe that digital com- munication tools are allies in the control and care of any orthodontic system, but clinical attendance is sovereign in all respects, whether for aligners or fixed orthodontics,” he commented. “I use the self-ligating orthodontics technique, which in addition to the known benefits and advantages, is particularly useful owing to the longer time between orthodontic maintenance sessions, particularly in these current times of isolation.” Dr Anna Hajati, who runs a private orthodontics practice in Stockholm in Sweden, told DTI that keeping in touch with her patients digitally had been better than not at all. “Digital communication tools have been very useful in this crisis to support stranded patients and to keep the number of visits at a low level, and indeed, it is the future. We have been using digital communication for aligner patients as well as for fixed appliance patients. Today, such tools can help occasionally, but cannot re- place a physical check-up,” she said. Sweden did not implement strict lockdown conditions during the crisis, leaving it up to dentists in the country to decide whether to keep their practices open. Social distanc- ing guidelines, however, did result in a drop in patient volumes, and Hajati said that visits to her clinic had de- creased by around 50% in April and May. One of the greatest challenges so far, she admitted, was deciding whether to keep her clinic open. Closing the clinic, she explained, would have helped to protect staff, reduce infec- tions and conserve personal protec- tive equipment. She decided to keep the clinic open, but with increased hygiene routines and clear guide- lines issued to patients. This decision was taken to ensure the survival of the business and the continued pro- vision of care to patients. “My greatest concern and challenge now is the patients that I have in another country and those who live abroad that I could not see,” Hajati said. She believes that the tele-or- thodontics industry will result in changes to the pretreatment process, but she also believes that orthodon- tists are extremely aware of their re- sponsibilities, regardless of the type of appliance that is being used to carry out treatment and the mode of consultation. “Every view or action/ non-action has a responsible dentist behind it, and we want to look our patients in the eyes and say with 100% confidence that ‘this does or doesn’t look fine’. It is about so much more than tooth alignment.”