The Clear Aligner Assessment & Fit Notes Template
A clear aligner notes template captures the face-to-face orthodontic assessment and aligner fit — IOTN scoring, BPE and oral health pre-treatment, radiographic assessment with root morphology, treatment plan with attachments and IPR, Montgomery consent including root resorption / relapse / lifetime retention requirement, records taken (photos / scans / radiographs), and aligner fit verification — meeting BOS Professional Standards for Orthodontic Practice (2022) requirements.
BOS has explicitly warned against remote-only clear aligner provision — face-to-face assessment is mandatory. Below is the template UK clinicians paste into their PMS for compliant aligner therapy.
Download the free Clear Aligner Assessment & Fit template — plain text, GDC/FGDP(UK)-aligned.
Why this clear aligner assessment & fit template wins
- Face-to-face clinical assessment documented — BOS-compliance line. Remote-only assessment is explicitly prohibited.
- IOTN scored (DHC + AC) — defines treatment need, defensible for NHS audit if applicable.
- Limitations of aligners discussed explicitly — Montgomery defence against unmet-expectations claims.
- Lifetime retention discussed and accepted — defensible against post-treatment relapse complaints.
- Written consent for elective cosmetic-functional procedures — indemnity-recommended.
Compliance: the medico-legal angle
- BOS Professional Standards for Orthodontic Practice (2022) — face-to-face assessment mandatory.
- BOS position on aligner claims (BDJ 2024) — direct-to-consumer / remote-only aligners not permitted.
- GDC Principle 1 (patient interests) — clinical assessment required before treatment.
- Montgomery — risks of root resorption, relapse, periodontal compromise must be discussed.
- IRMER 2017 — OPG and ceph justification for orthodontic records.
Common mistakes UK dentists make
- Remote-only consultation without face-to-face assessment — BOS breach.
- No IOTN scoring — clinical need undocumented.
- No discussion of lifetime retention — patient blames you for relapse 5 years later.
- No periodontal control before ortho — moving teeth in active periodontitis accelerates bone loss.
- No written consent for cosmetic-functional procedure — indemnity weakness.
Frequently asked questions
Can I provide aligners remotely?
NO — BOS Professional Standards 2022 explicitly require face-to-face clinical assessment before any orthodontic treatment, including aligners. Remote-only providers (mail-order aligners) are non-compliant. Documented in-person examination, periodontal assessment, and consent are mandatory.
What's IOTN and do I need to record it?
Index of Orthodontic Treatment Need — DHC (1-5, scored on worst feature) + AC (1-10, aesthetic photograph match). Defines treatment need objectively. Required for NHS orthodontic justification. Best practice for private aligner cases to document objectively the clinical need.
When is fixed appliances better than aligners?
Complex movements: significant rotations (>25°), large extrusions, severe Class II/III correction, retained extractions cases, severe spacing closure. Aligners excel at: anterior crowding, mild-moderate rotations, simple Class I corrections, post-restorative alignment. Document the choice rationale.
How long does aligner treatment take?
Variable — simple anterior crowding: 4-8 months. Comprehensive cases: 12-24 months including refinements. 30-40% of cases need at least one refinement set. Document realistic estimate at consent.
What about IPR (interproximal reduction)?
Mild enamel reduction (0.1-0.5mm per contact) to create space. Total reduction usually limited to 25-50% of enamel thickness. Document planned IPR sites and amounts at planning, and confirm done at the appropriate aligner stage.
Do I need a retainer for life?
Yes — orthodontic relapse without retention is well-documented. Standard: bonded retainer (canine-canine fixed) + removable retainer (nightly long-term). Discuss at consent BEFORE starting — patient must accept the lifetime commitment.