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The role of dental hygiene in clear aligner therapy

Nov. 11, 2022
Clear aligners create straight smiles, but more importantly, they help create healthy teeth. Here's how hygienists can make patients' aligner journey as pleasant as possible.

I began my oral care career nearly 15 years ago as an orthodontic dental assistant. Working with patients in that capacity inspired me to become a hygienist, and when I was in school, it clicked: there’s a clear connection between orthodontics and hygiene. Straight, evenly spaced teeth can have an enormous impact on a patient’s oral health, in addition to being a cosmetic improvement.

To that effect, clear aligners have exploded in popularity in recent years, and the demand is only expected to rise.1 As hygienists, we’re at the front lines of patient care. With so many patients interested in improving their smiles, we have a responsibility to ensure patients maintain optimal hygiene before, during, and after their clear aligner journeys. 

Here are three steps to make patients’ experiences with clear aligners as successful as possible.

Educate patients about the hygiene and clear aligner connection

Many people assume straightening teeth is all about cosmetics, but that couldn’t be further from the truth. Misaligned teeth can contribute to a slew of dental hygiene issues. Severely crowded teeth can be difficult to clean; hard-to-reach areas harbor harmful bacteria and biofilm that can lead to cavities and gum disease. On the other hand, excess spacing between teeth can make it easy for food to get stuck in crevices, resulting in the same oral health issues. Finally, a misaligned bite can result in varying pressure on the teeth, which can cause extreme wear, such as teeth that are chipped, cracked, or broken at the gum line and coronal parts of the teeth. 

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We know we need to educate patients about proper hygiene habits, such as regular brushing and daily flossing. But if patients have misaligned teeth, that advice can only go so far. Make sure patients are aware that having their teeth in a healthy position doesn’t equal just a straighter smile—it also equals easier brushing, better flossing, and overall improved hygiene and bite.

Refute misconceptions about clear aligners

Misconceptions about clear aligners abound, which can make patients wary of trying them. Many patients think clear aligners are only for mild cases of crooked teeth, but doctors can treat more moderate and advanced cases with clear aligners due to the improved technology at our disposal. 

Patients may also think clear aligners are not as effective as traditional braces, but we know they work just as well.2,3 Clear aligners aren’t just for adults; children and teenagers can also benefit from them. Unlike braces, clear aligners don’t impose any dietary restrictions since they’re taken out before eating. 

Lastly, patients might think clear aligners are difficult to maintain, but the truth is they require no special effort and are incredibly easy to use. Helping patients overcome misconceptions about clear aligners is an important step in empowering them to improve their oral health.

Guide patients along their clear aligner journeys

Before confirming whether a patient is a candidate for clear aligners, speak with the doctor, because doctors make final treatment decisions. In my practice, the doctor regularly communicates with me about who he is comfortable treating with clear aligners and who he is not. Having conversations like this helps preserve patients’ trust in hygienists by ensuring the entire oral care team is on the same page.

When the doctor has decided that a patient is a candidate for clear aligners, I don’t have to just tell the patient this—I can show them. I use a 3D scanner to show patients any problem areas, which is the perfect opportunity to discuss clear aligners, refute misconceptions, explain patients’ current oral status, and review proper hygiene habits. 

Before, during, and after their clear aligner journeys, hygienists need to be sure patients are brushing and flossing properly, taking out their aligners before eating, and cleaning the aligners before putting them back in their mouth. During care appointments, we need to check for any areas of plaque buildup, which can lead to decalcification, especially around the clear attachments. With the right care and education, every patient can have a clear aligner success story.

Clear aligners are a valuable tool in our toolboxes

It’s important for hygienists to see clear aligners not just as cosmetic treatments, but as valuable oral care tools. We need to look at the overall picture of oral health. Yes, patients will be excited about their improved smile, but we know correcting overcrowding or excessive spacing can improve dental hygiene and decrease the risk for cavities and gum disease. 

At Aspen Dental, we offer Motto clear aligners, which straighten teeth in about six to nine months. After a single in-office visit, patients receive a custom-fitted starter tray designed to whiten teeth and prevent further movement until the first set of custom aligners arrives. Motto clear aligners are made from high-quality, durable material that is nearly invisible, and they’re laser-trimmed for a custom, comfortable fit. Cutting-edge, 3-D precision scanning optimizes the treatment. With Motto, patients have access to in-person, doctor-directed care as well as virtual consultations for half the price of Invisalign. And what’s one of the most important parts? Hygienists are there to support patients every step of the way. 

Remember: clear aligners don’t just create straight teeth; they create healthy teeth.


  1. Wohl D. The future of clear aligners rests on user compliance. September 8, 2022. Accessed October 31, 2022. https://www.dentaleconomics.com/practice/article/14280545/the-future-of-clear-aligners-rests-on-user-compliance
  2. Ke Y, Zhu Y, Zhu M. A comparison of treatment effectiveness between clear aligner and fixed appliance therapies. BMC Oral Health. 2019;19(1):24. doi:10.1186/s12903-018-0695-z
  3. Yassir YA, Nabbat SA, McIntyre GT, Bearn DR. Clinical effectiveness of clear aligner treatment compared to fixed appliance treatment: an overview of systematic re-views. Clin Oral Investig. 2022;26(3):2353-2370 doi:10.1007/s00784-021-04361-1

About the Author

Tobie Shepherd, RDH

Tobie Shepherd, RDH, is with Aspen Dental. She began her oral health career nearly 15 years ago as an orthodontic dental assistant before making the switch to hygiene in 2012. Now, in addition to caring for patients, she is a part of Aspen Dental’s digital health team, training hygienists and other staff on how to have conversations with patients about their smiles.