Interview: “We will be able to treat pretty much everything in the future”
Dr Graham Gardner is the first President of the European Aligner Society (EAS), an international organisation established in 2013 that aims to promote education and research in aligner therapy. Trained in South Africa, he has been running his own private practices in the UK since 2008. In an interview with Dental Tribune Online, Gardner shares his ideas and views about the importance of aligners in orthodontics and about the EAS, which he believes will become the society for aligner therapy.
Dental Tribune Online: Dr Gardner, you have been working with aligners for more than a decade now. What convinced you initially of this treatment method and what are the main advantages in your experience?
From the beginning of my career in the early 1990s, a time when ceramic brackets and lingual braces became available, I was certainly aware of the fact that aesthetic appliances were going to be the future of orthodontics.
In 2001, I was fortunate to attend a certification course for Invisalign, which was truly a watershed moment in my orthodontic career because I saw the value and potential of aligner therapy for both dental professionals and patients. In my opinion, aligner therapy opened the door for a huge cohort of patients who would not have considered orthodontic therapy in the past mainly owing to aesthetic concerns. In addition to aesthetic benefits, aligners are far more comfortable than fixed appliances, as they are removable and hence facilitate oral hygiene during therapy. They also move the teeth more gently with less pressure, which is favourable with regard to patient comfort and from a biological perspective too.
Today, I treat over 75 per cent of patients with Invisalign in my practices.
In recent years, clear aligners have become a favourable treatment alternative to fixed appliances, and the global orthodontic supplies market is expected to reach about US$3.9 billion (€3.6 billion) by 2020. In your professional opinion, how will this market develop in the near future?
Over the past decade, aligners have become mainstream orthodontics and I definitely see this trend continuing and expanding. With the technological advancements, including 3-D and CAD/CAM, that allow the clinician to diagnose, plan the treatment and confirm biomechanics in a far more in-depth way than ever before, orthodontics is now catching up with the high-tech world we live in—it is twenty-first-century orthodontics.
When aligners were first introduced to the market, there were some limitations and we could only treat mild malocclusions. However, aligner therapy has come of age and is now a genuine appliance system with which we can treat the majority of malocclusions.
At the moment, however, aligner therapy is still a fairly expensive form of orthodontics. Thus, I hope that improvements in materials and 3-D printing will render manufacture and the product itself more cost-effective. For example, 3-D printers could allow individual practices to print their own aligners in the future.
Overall, with technological advancements and increasing patient acceptance, we will be able to treat pretty much everything in the future in my view.
How have developments in the European and the overseas market differed?
Dentistry as a profession is very conservative and dentists in the US, for example, are perhaps a bit more progressive. However, with regard to aligners, I no longer really see a great difference between Europe and America. The movement is global and I suspect the advancements we are now seeing in Europe will match those in America and Asia, where aligner therapy is also very popular. There are always regional differences, also partly related to legal restrictions, but the trend towards aligner therapy is a global phenomenon.
How does the EAS address the current trends in orthodontics?
Aligner therapy has seen huge advancements over the past decade, with an increasing number of manufacturers offering different systems today. Thus, the main motivation behind the foundation of the EAS was to establish a neutral body—an international society that is independent of any aligner company and open to all dentists using aligners for orthodontic treatment.
The work of the EAS is characterised by three cornerstones. The first is education, namely arranging conferences and regional meetings and introducing clinical online forums, through which members can interact and share experiences and ideas. The second column of the EAS’s philosophy is communication. We aim to be a neutral organisation that patients can turn to for comprehensive information about aligner therapy and that members can consult for guidelines. Research is our third column, which is currently lagging behind. Eventually, we hope to have our own aligner journal or magazine and grant annual awards for excellence in aligner therapy.
With the help of our sponsors, the EAS will grow and become an international umbrella organisation to help promote education and research and development for aligner therapy.
The EAS is a fairly young organisation and hosted its first congress on 13 and 14 February in Vienna. What was the idea behind this event?
The EAS’s primary objective is education because, obviously, education underpins every profession and without it we simply stagnate. Therefore, we decided that our first event should be a congress held in the heart of Europe offering a broad spectrum of informative lectures and a showcase of different systems and products. At the first congress in Vienna, internationally distinguished speakers shared their views and expertise about aligner therapy. Moreover, the event offered manufacturers an independent forum for exhibiting their solutions.
Can dental professionals look forward to another EAS congress next year?
Based on the success of the inaugural event over the past weekend, we definitely want the congress to become a regular event in the calendar. While we are planning to hold the EAS congress every two years, we will be organising smaller regional forums on a continuous basis throughout every year.