Dr. Elaine Halley
• Dr. Elaine Halley is an award-winning dentist and Clinical Director of the Pain Free Dental Group in Scotland, with over 30 years of experience. She founded Cherrybank Dental Spa in Perth and is a Digital Smile Design Master and Diamond Invisalign provider.
• Dr. Halley holds a Master’s degree in Restorative and Aesthetic Dentistry from the University of Manchester and is a passionate educator, mentoring dentists and teaching with the Aligner Dental Academy. She has authored numerous articles and the textbook Smile Analysis, and serves on editorial boards for leading UK dental publications.
• A past President of the British Academy of Cosmetic Dentistry, she is also a member of the International College of Dentists.
• In 2019, she launched the UK’s first Seattle Study Club, continuing her commitment to advancing clinical excellence and patient care.
In the ever-evolving landscape of contemporary dentistry, digital technologies have revolutionized various aspects of the field. However, according to Dr. Elaine Halley—a leading practitioner of cosmetic and restorative dentistry based in the UK—advances in diagnosis and treatment planning have not kept pace with these technological innovations. Dr. Halley, a contributor to Align Technology’s Guide to Comprehensive Dentistry, emphasizes the need for integrating digital workflows to enhance patient care. The Guide to Comprehensive Dentistry is a resource that showcases how integrating tooth movement using Invisalign® aligners enhances overall oral health, function, and esthetics.
While many clinicians understand the importance of considering the whole mouth in their diagnosis and treatment planning, the legacy of the ‘single tooth’ approach is still ingrained in some practices. This puts dentists under immense time pressure with little space to consider the bigger picture, she suggests.
“We need to think about the dental examination in a different way, because as soon as you really leverage digital technology, you can start to look at the whole picture,” says Dr. Halley. She explains that in 30 years of practice, the most stressful part of dentistry was believing that everything was well planned, but later realising she’d missed something significant. “Eventually it dawned on me that the reason we miss things is because we’re not taking enough time at the beginning to thoroughly diagnose and consider everything relevant for the needs of the patient, versus what they have asked for.”
“Digital tools mean before you even start touching the patient, you can play out the different clinical scenarios.”
HOW INTRAORAL DIGITAL SCANS ELEVATE THE CONSULTATION
HOW INTRAORAL DIGITAL SCANS ELEVATE THE CONSULTATION
“The big leap forward was when intraoral digital scanners became more accessible: When you have a patient in the chair asking questions, it can be difficult to think through the complexity of their treatment options. Bringing together intraoral scans, digital photography, video, and radiography means you always have your patient ‘in front of you’, but with peace and space to think through their treatment plan. While they are in the chair, you might wonder, ‘Would I do a bridge? Would I do a crown?’ However, thanks to new technologies, you can silence that bit of your mind and focus on asking questions and building a relationship with the patient. That’s real comprehensive dentistry. I couldn’t work without my iTeroTM intraoral digital scanner because my entire workflow starts with scanning each patient.”
Dr. Halley incorporates tools from the Align™ Oral Health Suite in every patient consultation. This ranges from the iTero™ NIRI (near infra-red imaging) technology, which highlights early enamel caries, fracture lines, and calculus, to the Invisalign Smile Architect™ software that allows her to show patients the pros and cons of moving teeth before restoring them.
“Now that we have Invisalign Smile Architect™ as part of the simulation process, we can make Invisalign® treatment planning accessible right from the start. We can visualize what the outcome may be if we move teeth. Similarly, we can assess the implications of not moving the teeth, moving and restoring them, or simply restoring them. Having digital tools means that before you even start touching the patient, you can play out all the different clinical scenarios while also seeing what the completed treatment will look like. This level of digital detail helps patients better understand the benefits of a suggested treatment protocol, and how it will meet their esthetic expectations—but also their functional needs.”
GIVING PATIENTS A SENSE OF CONTROL BUILDS TRUST
GIVING PATIENTS A SENSE OF CONTROL BUILDS TRUST
“Scanning every patient—whether new or existing—allows them to see what’s going on in their mouths. They can discover for themselves how healthy they are, how their esthetics may be compromised, and compare with how they’d like to look. This opens up conversations. When you involve patients in understanding what’s actually happening in their mouths, they feel in control of the decisions and are much more likely to be engaged and to take ownership,” says Dr. Halley.
She cites occasions when patients request a smile design but would rather not move their teeth prior to restoration. “I had one patient recently with a proclined lateral, so their gingival level was higher, and their premolars were tilted in. There was a big step in the gingival level from their canine to their premolars. The patient wanted veneers, but they also had some wear on their anterior teeth, so they were going to need restorations. We weren’t going to be able to carry out just restorative or just ortho.”
“When the patient understood, particularly about widening the buccal corridor, lifting the gingival levels, and tilting the premolars, they went ahead with the full ortho/restorative treatment. This meant fewer veneers because the other teeth were healthy. It was a more complex case, but ultimately meant less restorative work for the patient to maintain.”
Dr. Halley values the ability to repeatedly review and cross-reference digital scans, especially in complex cases. She believes receiving a ClinCheck® plan within 15 minutes is invaluable for keeping everything fresh in her mind. A digital workflow is also useful for less experienced dental associates. For them, a digital workflow that begins with an iTero intraoral scan allows them to slow down and take a little more time at the start.
“This means by the time you begin the actual clinical dentistry, you’re so much more confident because you’ve thought it all through. You know what your treatment sequence is, and you’re not making it up as you go along. That’s also a really important message for burnt-out, overwhelmed dentists: There is a different, more considered way of working.”
Since fully implementing the Align™ Digital Workflow, Dr. Halley says—aside from the return on investment of not having to repeat impressions by ensuring accurately fitting Invisalign aligners—it has also boosted restorative case acceptance. This advanced workflow allows clinicians to discuss prevention strategies with patients, such as applying resin sealants. “You can so clearly show the patient—or the parents of teenagers—any lesions, and clinicians can explain that sealing these lesions reduces the chance of them worsening. This not only improves patient oral health but also provides a direct source of income, justifying the additional investment in the latest NIRI technology.”
ENHANCING THE TEAM’S SENSE OF PROFESSIONALISM
ENHANCING THE TEAM’S SENSE OF PROFESSIONALISM
In addition, Dr. Halley has seen how embracing a digital workflow has transformed her team’s involvement in patient care. “My dental nurses all scan, my hygienists and therapists scan, which has really elevated their sense of professionalism and involvement in the care of our patients, while increasing the variation of their roles*. When I think about what digital has done for us as a practice and as a team, I think it has raised everyone’s enjoyment of the job, because you feel like you’re really enhancing the service by giving patients access to the latest technologies, but at the same time decreasing stress because we’re more systemized and organized. Similarly, there are so many benefits in communicating the ensuing restorative plans with your lab and working collaboratively.”
NOTES
**The role of practice staff varies by country. It is important to check and comply with the specific regulations applicable in your region.