Clear Aligner Treatment in Denmark – A Questionnaire Survey among Citizens and Dental Practitioners in Denmark

Authors

  • Clara Rasborg Hartogsohn Orthodontics, Section for Oral Health, Society and Technology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark https://orcid.org/0009-0008-2977-1040
  • Kasper Rosing Community Dentistry, Section for Oral Health, Society and Technology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark https://orcid.org/0000-0002-0024-6436
  • Liselotte Sonnesen Orthodontics, Section for Oral Health, Society and Technology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark https://orcid.org/0000-0003-0320-8096

DOI:

https://doi.org/10.2340/aos.v85.45996

Keywords:

Orthodontics, clear aligner treatment, malocclusion

Abstract

Objectives: This study investigates clear aligner treatment (CAT) of adult patients in private dental practice and aims to identify: 1) The awareness of and knowledge about CAT among citizens, 2) how citizens who have received CAT experience the treatment and 3) how general dentists and orthodontists assess CAT.

Materials and methods: The study was based on an observational cross-sectional questionnaire investigation. Two separate online questionnaires were sent out to all private dental clinics in Denmark and to a group of 2000 citizens aged ≥18 years.

Results: 217 citizens and 200 practitioners were included in the analysis. The citizens’ awareness of CAT was poor in general, and younger citizens were more aware of CAT. The citizens most often became aware of CAT through their own dentist or through friends and family. The citizens were in general satisfied with their treatments.The practitioners always/often informed about all parameters possible. The most frequent indication for CAT was cosmetics. The orthodontists more often included a lateral cephalogram in the diagnostics before CAT and more often made changes and more comprehensive changes to the digital treatment plan. The orthodontists were less satisfied with CAT compared to the general dentists.

Conclusions: This study has provided valuable knowledge on the awareness and satisfaction of CAT among the citizens and indicated how practitioners assess CAT of adult patients in private dental practice in Denmark.

Downloads

Download data is not yet available.

References

Johal A, Bondemark L. Clear aligner orthodontic treatment: Angle Societyof Europe consensus viewpoint. J Orthod 2021; 48: 300–304. DOI: https://doi.org/10.1177/14653125211006423

Indenrigs- og Sundhedsministeriet. Bekendtgørelse om tandpleje, https://www.retsinformation.dk/eli/lta/2022/959 (2022, accessed 17 April 2024).

Kristensen K, Henrikson T. Tandregulering med alignere. Tandlaegebladet 2022; 126: 718–729.

Saccomanno S, Saran S, Laganà D, et al. Motivation, Perception, and Behavior of the Adult Orthodontic Patient: A Survey Analysis. Biomed Res Int; 2022. Epub ahead of print 2022. DOI: https://doi.org/10.1155/2022/2754051

Tamer I, Öztas E, Marsan G. Orthodontic treatment with clear aligners andthe scientific reality behind their marketing: A literature review. Turkish Journal of Orthodontics 2019; 32: 241–246. DOI: https://doi.org/10.5152/TurkJOrthod.2019.18083

Ben Gassem AA. Does Clear Aligner Treatment Result in Different PatientPerceptions of Treatment Process and Outcomes Compared toConventional/Traditional Fixed Appliance Treatment: A Literature Review. EuropeanJournal of Dentistry 2022; 16: 274–285. DOI: https://doi.org/10.1055/s-0041-1739441

Alansari RA. Youth perception of different orthodontic appliances. Patient Prefer Adherence 2020; 14: 1011–1019. DOI: https://doi.org/10.2147/PPA.S257814

Linjawi AI, Alsadat MA, Othman MA, et al. Awareness, perception andreadiness regarding clear aligner therapy among orthodontists and other dental specialists. J Biol Regul Homeost Agents 2020; 34: 1061–1066. DOI: https://doi.org/10.23812/20-155-L-15

Baxmann M, Timm LH, Schwendicke F. Who Seeks Clear Aligner Therapy? A European Cross-National Real-World Data Analysis. 13. Epub ahead of print 1 January 2023. DOI: https://doi.org/10.3390/life13010065

Liao T-H, Fang JC-C, Wang I-K, et al. Characteristics and Dental Indices of Orthodontic Patients Using Aligners or Brackets. Int J Environ Res Public Health; 19. Epub ahead of print 27 May 2022. DOI: https://doi.org/10.3390/ijerph19116569

d’Apuzzo F, Perillo L, Carrico CK, et al. Clear aligner treatment: differentperspectives between orthodontists and general dentists. Prog Orthod 2019; 20: 10. DOI: https://doi.org/10.1186/s40510-019-0263-3

Flores-Mir C, Brandelli J, Pacheco-Pereira C. Patient satisfaction andquality of life status after 2 treatment modalities: Invisalign and conventional fixed appliances. American Journal of Orthodontics and Dentofacial Orthopedics 2018; 154:639–644. DOI: https://doi.org/10.1016/j.ajodo.2018.01.013

Pacheco-Pereira C, Brandelli J, Flores-Mir C. Patient satisfaction andquality of life changes after Invisalign treatment. American Journal of Orthodontics and Dentofacial Orthopedics 2018; 153: 834–841. DOI: https://doi.org/10.1016/j.ajodo.2017.10.023

Gao Y, Sun X, Yan X, et al. Orthodontic Practitioners’ Knowledge andEducation Demand on Clear Aligner Therapy. Int Dent J. Epub ahead of print 2023.

Galluccio G. Is the use of clear aligners a real critical change in oral healthprevention and treatment? Clinica Terapeutica 2021; 172: 113–115.

Yassir YA, Nabbat SA, McIntyre GT, et al. Clinical effectiveness of clearaligner treatment compared to fixed appliance treatment: an overview of systematic reviews. Clinical Oral Investigations 2022; 26: 2353–2370. DOI: https://doi.org/10.1007/s00784-021-04361-1

Chong H, Peh J, Weir T, et al. Patient experiences with clear aligners: a scoping review. Eur J Orthod; 47. Epub ahead of print 8 April 2025. DOI: https://doi.org/10.1093/ejo/cjaf017

Mentz R, Juul A, Sonnesen L. Diagnostik forud for ortodontisk behandling hos voksne. Tandlaegebladet 2022; 126: 710–716.

Indenrigs- og Sundhedsministeriet. Sundhedsloven, https://www.retsinformation.dk/eli/lta/2022/210#id807d9f2b-84c9-45de-b5ddd59b2713b4b8 (2022, accessed 5 December 2023).

Alwafi A, Bichu YM, Avanessian A, et al. Overview of systematic reviewsand meta-analyses assessing the predictability and clinical effectiveness of clear aligner therapy. Dentistry Review 2023; 3: 100074. DOI: https://doi.org/10.1016/j.dentre.2023.100074

World Health Organization. Constitution, https://www.who.int/about/accountability/governance/constitution (accessed 15 April2024).

Sheiham A, Maizels JE, Cushing AM. The concept of need in dental care. IntDent J 1982; 32: 265–70.

Steinbach R, Kwiatkowska R. Concepts of Need and Social Justice, https://www.healthknowledge.org.uk/public-health-textbook/medical-sociologypolicy-economics/4c-equality-equity-policy/concepts-need-sjustice (2016, accessed 5 December 2023).

Meade MJ, Weir T. A survey of orthodontic clear aligner practices among orthodontists. American Journal of Orthodontics and Dentofacial Orthopedics 2022;162: e302–e311. DOI: https://doi.org/10.1016/j.ajodo.2022.08.018

Alajmi S, Shaban A, Al-Azemi R. Comparison of Short-Term Oral Impacts Experienced by Patients Treated with Invisalign or Conventional Fixed Orthodontic Appliances. Medical Principles and Practice 2020; 29: 382–388. DOI: https://doi.org/10.1159/000505459

Meier B, Wiemer KB, Miethke RR. Invisalign® - Ein Patientenprofil.Auswertung einer prospektiven Befragung. Journal of Orofacial Orthopedics 2003; 64:352–358. DOI: https://doi.org/10.1007/s00056-003-0301-z

Mironica A, Popescu CA, George D, et al. Social Media Influence on Body Image and Cosmetic Surgery Considerations: A Systematic Review. Cureus 2024; 16:e65626. DOI: https://doi.org/10.7759/cureus.65626

Abbasi MS, Lal A, Das G, et al. Impact of Social Media on Aesthetic Dentistry: General Practitioners’ Perspectives. Healthcare (Switzerland); 10. Epub ahead of print 1 October 2022. DOI: https://doi.org/10.3390/healthcare10102055

Meade MJ, Meade EA, Dreyer CW. Orthodontic clear aligners and TikTok videos: A content, reliability and quality analysis. Int Orthod; 20. Epub ahead of print 1 September 2022. DOI: https://doi.org/10.1016/j.ortho.2022.100663

Sycińska-Dziarnowska M, Szyszka-Sommerfeld L, Woźniak K, et al. Predicting Interest in Orthodontic Aligners: A Google Trends Data Analysis. Int J Environ Res Public Health; 19. Epub ahead of print 1 March 2022. DOI: https://doi.org/10.3390/ijerph19053105

Meira TM, Prestes J, Gasparello GG, et al. The effects of images posted to social media by orthodontists on public perception of professional credibility and willingness to become a client. Prog Orthod; 22. Epub ahead of print 1 December 2021. DOI: https://doi.org/10.1186/s40510-021-00353-9

Ferlias N, Smith K, Straarup A, et al. Quality assessment of online information on orthodontic Web sites in the United States. American Journal of Orthodontics and Dentofacial Orthopedics 2023; 163: 843–850. DOI: https://doi.org/10.1016/j.ajodo.2022.09.012

Brown M, Wiltshire W, Henrique de Sa Leitao Pinheiro F, et al. Adult patient preference for an orthodontic care provider in Canada. American Journal of Orthodontics and Dentofacial Orthopedics 2022; 162: 477-482.e5. DOI: https://doi.org/10.1016/j.ajodo.2021.04.035

Gower T, Pham J, Jouriles EN, et al. Cognitive biases in perceptions of posttraumatic growth: A systematic review and meta-analysis. Clin Psychol Rev 2022; 94: 102159. DOI: https://doi.org/10.1016/j.cpr.2022.102159

Alfawal AMH, Burhan AS, Mahmoud G, et al. The impact of non-extraction orthodontic treatment on oral health-related quality of life: clear aligners versus fixed appliances-a randomized controlled trial. Eur J Orthod 2022; 44: 595–602. DOI: https://doi.org/10.1093/ejo/cjac012

Catalogue of Bias Collaboration, Spencer E, Brassey J, et al. Recall Bias. Catalogue of Bias, https://catalogofbias.org/biases/recall-bias/ (2017, accessed 10 November 2025).

Meade MJ, Dreyer CW. Web-based information on orthodontic clear aligners: a qualitative and readability assessment. Aust Dent J 2020; 65: 225–232. DOI: https://doi.org/10.1111/adj.12776

Abu-Arqub S, Ahmida A, Da Cunha Godoy L, et al. Insight into clear aligner therapy protocols and preferences among members of the American Association of Orthodontists in the United States and Canada. Angle Orthod 2023; 93: 417–426. DOI: https://doi.org/10.2319/101022-694.1

Lam J, Freer E, Miles P. Comparative assessment of treatment efficiency and patient experience between Dental Monitoring and conventional monitoring of clear aligner therapy: A single-center randomized controlled trial. American Journal of Orthodontics and Dentofacial Orthopedics 2023; 163: 456–464. DOI: https://doi.org/10.1016/j.ajodo.2022.12.004

Oliveira P, Bugaighis I, Nunes Costa H, et al. Perception of Need for Further Refinement in a Clear Aligner Treatment among Orthodontists, Dentists and Laypeople: A Retrospective Study. Int J Environ Res Public Health; 19. Epub ahead of print 1 December 2022. DOI: https://doi.org/10.3390/ijerph192315498

Heath EM, English JD, Johnson CD, et al. Perceptions of orthodontic case complexity among orthodontists, general practitioners, orthodontic residents, and dental students. American Journal of Orthodontics and Dentofacial Orthopedics 2017; 151: 335–341. DOI: https://doi.org/10.1016/j.ajodo.2016.06.045

Christensen GJ. Orthodontics and the general practitioner. J Am Dent Assoc 2002; 133: 369–71. DOI: https://doi.org/10.14219/jada.archive.2002.0178

Best AD, Shroff B, Carrico CK, et al. Treatment management between orthodontists and general practitioners performing clear aligner therapy. Angle Orthodontist 2017; 87: 432–439. DOI: https://doi.org/10.2319/062616-500.1

Doyal L, Gough I. A Theory of Human Need. 1st ed. MACMILLAN, 1991. DOI: https://doi.org/10.1007/978-1-349-21500-3_1

Hussain SR, Jiang SS, Bosio JA. Generational perspectives of orthodontists in the U.S. and Canada: A survey study. American Journal of Orthodontics and Dentofacial Orthopedics 2022; 162: 824–838. DOI: https://doi.org/10.1016/j.ajodo.2021.07.020

Pae E-K, McKenna GA, Sheehan TJ, et al. Role of lateral cephalograms in assessing severity and difficulty of orthodontic cases. American Journal of Orthodontics and Dentofacial Orthopedics 2001; 120: 254–262. DOI: https://doi.org/10.1067/mod.2001.116825

Meade MJ, Weir T. Treatment planning protocols with the Invisalign appliance: an exploratory survey. Angle Orthod 2023; 93: 501–506. DOI: https://doi.org/10.2319/111422-783.1

Hartogsohn CR, Sonnesen L. Clear Aligner Treatment: Indications, Advantages, and Adverse Effects—A Systematic Review. Dent J (Basel) 2025; 13: 40. DOI: https://doi.org/10.3390/dj13010040

Alhafi ZM, Hajeer MY, Alam MK, et al. Quality and stability of orthodontic treatment outcomes with clear aligners versus fixed appliances: a systematic review and meta-analysis. Eur J Orthod; 47. Epub ahead of print 16 October 2025. DOI: https://doi.org/10.1093/ejo/cjaf091

Vicéns J, Russo A. Comparative use of invisalign® by orthodontists and general practitioners. Angle Orthodontist 2010; 80: 425–434. DOI: https://doi.org/10.2319/052309-292.1

Catalogue of Bias Collaboration, Turk A, Heneghan C, et al. Non-response bias. Catalogue of Bias, https://catalogofbias.org/biases/non-response-bias/ (2019, accessed 20 February 2026).

Catalogue of Bias Collaboration, Nunan D, Bankhead C, et al. Selection bias. Catalogue of Bias, https://catalogofbias.org/biases/selection-bias/ (2017, accessed 20 February 2026).

Jones TL, Baxter MAJ, Khanduja V. A quick guide to survey research. Ann R Coll Surg Engl 2013; 95: 5–7. DOI: https://doi.org/10.1308/003588413X13511609956372

Downloads

Published

2026-05-11