I got the chance to talk to Amos Dudley, the man who has received a great deal of national media attention for fabricating his own clear aligners, and found his insight interesting and valuable. See for yourself and be sure to check out his blog at amosdudley.com.

OrthoPundit: Amos, you’ve gotten a lot of press of late. It stands to reason because you’re obviously awesome. My question is, what did the reporters want to know and what were some of the most interesting questions to you? Are there any questions that you think they should have asked?

Amos: The message with much of the news coverage was limited to how I saved money, which honestly is a little disappointing. For me, this project was more about applying multiple technologies in a way that would challenge assumptions about what’s possible for a layperson, and less about cost. I was also routinely asked about whether I planned to start a business creating cheap invisible aligners for people. It was obvious early on that this wouldn’t be a good idea. For one thing, I had a very simple relapsed-braces case – I don’t have the knowledge to go beyond what I did. Beyond that, there would be huge liability issues, and major logistic challenges to treating people remotely, especially since I wouldn’t have x-rays, much less the training to interpret them. There are also already companies competing with Invisalign in this space, like SmileDirectClub, who have a several year operational head-start. And finally, I’m a designer and a hacker, not an orthodontist – those are my passions, and I’m sticking to them.

OrthoPundit: What did you find most difficult about producing aligners for yourself?

Amos: The most challenging part was finding the resources to do sufficient research to the point where I was confident that it might work. The actual manufacture of the aligners was quite easy, given the correct tools.

OrthoPundit: What surprised you the most about the process?

Amos: That I was able to go from a mold to a vacuum formed aligner without too much accumulated error. I was worried that inaccuracies along the chain would result in a retainer that simply didn’t fit at all, but this turned out not to be true. The first aligner snapped into place very nicely.

OrthoPundit: Do you think this kind of thing is repeatable by those without your resources or brainpower?

Amos: Certainly not without the resources. High-resolution desktop 3D printing and scanning aren’t nearly accurate enough at the consumer level yet. That kind of accuracy is definitely available at a slightly higher cost though (the Form 2 printer being a good example), one which is out of reach for the average person but well within the reach of your average orthodontist’s office.

OrthoPundit: Do you foresee a day where every church group, civic group and large company has printing capabilities as a benefit for their members and employees? How does this change the world? What will it mean to orthodontists? Is it possible that orthodontists could become like radiologists and do their work remotely? Is it possible that orthodontists will no longer be necessary once the algorithms are good enough?

Amos: I think this could be accomplished today, if someone wanted to invest in developing software intelligent enough to plan tooth movement given a large set of constraints and variables. I don’t see it being a good idea unless a human verifies the results somewhere along the chain, and is involved in checking the progress of the procedure, and making course corrections. The actual manufacture of the aligner isn’t the major expense anymore, but there’s still a lot of value in the analytical eye of a professional.

OrthoPundit: I’ve said for years now that one day there will be an automated photo-booth type stall in the local mall with a CBCT and a 3D printer. The patient would put their credit card in, fill out medical history, get a scan and the first set of trays would pop out of the machine and the rest would be mailed to them. What do you think about that scenario?

Amos: For something as important as the health of the teeth, putting complete faith in a machine seems too risky at this stage. I think it would be plausible, so long as there’s a human involved to verify the plan – at least until machine learning and AI become stronger.

OrthoPundit: Just as an aside, do you know the difference between an orthodontist and a general dentist?

Amos: Orthodontists specialize in the alignment of teeth, while dentists deal with general oral health. I had braces when I was a teenager, so I’ve always known the difference.