Intraoral appliance use in dental practice: An American Dental Association Clinical Evaluators Panel survey

Background: A growing variety of intraoral appliances are being used in dental practice. Insight about the range of applications and practice workflow as well as factors effecting change in practice trends was sought. Methods: A survey was developed to ascertain intraoral appliance use, fabrication methods, staff involvement, and patient experiences in dental practice. The survey was sent to ADA Clinical Evaluators Panel members on July 25, 2022, in Qualtrics and remained open for 2 weeks. After 1 week, those who had not responded yet were sent reminders. Data were analyzed descriptively in SAS Version 9.4. Results: Of the 286 respondents (a 28% response rate), 88% reported providing patients with intraoral appliances apart from providing patients with removable partial dentures. More than one-half of the respondents reported offering bleaching trays (88%), flippers or Essix retainers (83%), splints (81%), athletic mouthguards (72%), orthodontic retainers (60%), fluoride trays (56%), and clear aligners (55%). The biggest changes to practice in the past 5 years with respect to intraoral appliances have been intraoral scanning (56%) and the increase in the variety of intraoral appliances in use. Although 72% reported dental assistants were involved in obtaining impressions and fabricating models for intraoral appliances and 76% reported that laboratory technicians were involved in fabricating intraoral appliances, nearly all (97%) respondents indicated that the dentist was involved in the delivery of appliances to patients. Patient education about the use of their appliances appeared to be delivered using multiple approaches, given that it was reported to occur orally (95%), in print (61%), and visually (42%). That 90% of respondents reported having engaged in continuing education courses about intraoral appliances aligns with these appliances becoming a routine part of dental practice, with both increasing applications and improvements in the relevant technology. Conclusions: Intraoral appliances were found to be used commonly in dental practice, and often multiple members of the dental care team were engaged in the fabrication processes. Practical Implications: There likely will be ongoing interest in relevant learning opportunities about technologic advances as well as the increasingly diverse list of applications for intraoral appliances.