In the 21st century, orthodontics has evolved into a dynamic field shaped by technological innovation, personalized care, and priorities of aesthetics. As society increasingly values both health and appearance, orthodontics has transformed not just how we straighten teeth, but how we think about dental care as a whole. From the introduction of clear aligners to the integration of artificial intelligence, the 21st century has seen rapid and revolutionary developments in orthodontics. Continuing our exploration of the history of orthodontics on the AlgerBlog, this article details the key milestones and trends that have shaped the practice over the last two and a half decades.
Building on the Contributions of 20th Century Orthodontics
21st-century orthodontics is, in part, defined by the contributions of the previous century. The first few decades of the 2000s have helped build out and popularize breakthroughs of the late 20th century, such as clear aligners and digital orthodontics. (See “The History of Orthodontics Part 4: Orthodontics Over the Turn of the Millennium” for more on this.)
Clear Aligners
While metal braces have remained in widespread use in the 21st century, clear aligner options have grown increasingly more common. Aligner therapy has fundamentally changed the orthodontic experience. Removable, nearly invisible, and generally more comfortable than traditional braces, aligners have become especially popular among adults seeking discreet treatment. While Invisalign led the charge in introducing and popularizing clear aligners starting in the 1990s, competitors, like Spark and ClearCorrect, have since risen up to nuance the field and meet commercial demand. The demand for aesthetic treatment options pushed further innovation. The associated digital workflow—scanning, digital treatment planning, and 3D printing—also streamlined lab processes, allowing for faster turnaround and customization.
Digital Orthodontics
Intraoral Scanners
Like the advancement of clear aligners, the 21st century also pushed digital orthodontics forward. In the early 2000s, orthodontists still relied largely on physical impressions using alginate materials to create dental molds. These traditional methods, while effective, were often uncomfortable and prone to inaccuracies. While intraoral scanners date back to the 1970s, their popularity in orthodontics grew significantly in the 2000s and 2010s. With these handheld devices, clinicians could capture highly detailed 3D images of a patient’s mouth in real-time, eliminating the need for physical impressions and increasing diagnostic precision.
Cone Beam Computed Tomography
Digital imaging technologies, such as Cone Beam Computed Tomography (CBCT), also became more standardized tools for orthodontic diagnosis and treatment planning in the 21st century. CBCT provides 3D visualization of the craniofacial structure, allowing orthodontists to assess bone density, airway space, and root positioning with far greater accuracy than traditional 2D X-rays. These advancements have enabled more precise treatment planning, improved patient safety, and eased the integration of orthodontic treatments with those of other dental specialties like oral surgery or periodontics.
3D Printing and Customized Orthodontic Appliances
The rise of digital orthodontics has dovetailed effectively with 3D printing. Over the last few decades, 3D printing has impacted orthodontic appliance fabrication immensely, allowing for the quick and easy creation of custom retainers, expanders, and surgical guides, which can now be printed in-office or by specialized labs. The convenience of in-house 3D printing has reduced turnaround time and allows for unprecedented customization.
Customized orthodontic appliance systems like Insignia, LightForce, and SureSmile emerged, offering orthodontists tools to design brackets and archwires tailored to individual patients. These systems rely on 3D scans and computer-aided design (CAD) to optimize appliance placement, improving efficiency and outcomes. The result is more predictable tooth movement and often shorter treatment times.
The Social Media Effect on Orthodontics
The rise of social media in the 21st century brought with it a cultural shift in how orthodontics is perceived. Social media platforms like Facebook, Instagram, and TikTok have put image front and center in modern culture, which has sparked a growing emphasis on personal appearance. Orthodontic treatment is no longer seen as merely functional—it’s part of a broader desire for an enhanced, photogenic smile. This cultural evolution has contributed to increased demand for shorter, more discreet treatments. Modern orthodontic patients are comparatively more informed about cosmetic options, tech-savvy, and demand high levels of service. Lucky for them, 21st-century orthodontics has leaned into this beauty culture, utilizing emerging technologies, like remote care and AI tools, to provide patients with increased convenience, comfort, and unparalleled treatment options.
The COVID Pandemic and Orthodontic Remote Care
The Impact of COVID on Orthodontics
The COVID pandemic that hit a global tipping point in 2020 impacted orthodontics as it did nearly every industry at the time. Widespread lockdowns severely restricted patient mobility, forcing orthodontists to adapt their practices to meet the swiftly changing times. One elegant solution was the quick adoption of remote patient care, or “teleorthodontics.” Video conferencing software, such as Zoom ( first released for public use in 2013), was dramatically refined to meet the meteoric rise in demand in 2020.
Remote Care Becomes Common Practice
The impact Zoom had on keeping the world connected while individuals remained quarantined at a distance cannot be overstated, and it became one of the essential ways orthodontists oversaw the treatment of patients. Additionally, digital monitoring and app-based progress tracking assisted in this effort, allowing patients access to the orthodontic care they required with a reduced need for travel. Remote care was so successful during the pandemic that it has remained a core offering by many orthodontic offices, even as the world has returned to a state of regular mobility. The convenience and efficiency of a hybrid care model—blending in-person and remote treatment—appears to be the preferred option for many patients.
Artificial Intelligence in Orthodontics
Like many industries, orthodontics has started to apply Artificial Intelligence (AI) as a practical tool. Significant advancements in AI in the 2020s have increased the power and diversity of AI systems. Today, orthodontists use AI-powered software applications to assist with diagnostics, treatment planning, and outcome prediction. Tools like DentalMonitoring and Invisalign’s ClinCheck software integrate machine learning algorithms to analyze tooth movement and provide real-time feedback to both patients and clinicians.
These technologies have allowed for more personalized treatment plans, both during in-person visits and remotely. AI is quickly becoming a key component of remote monitoring, enabling orthodontists to track progress with unprecedented accuracy and intervene earlier if treatment deviates from a predicted plan. Leaning into the popular service of telehealth orthodontic care, companies have introduced remote patient management platforms, allowing orthodontists to track treatment without frequent in-office visits.
Conclusion
The history of orthodontics in the 21st century has seen technologies of the 20th century grow to new heights in our current millennium. Clear aligners and digital technologies have shaped orthodontics into the modern practice we see today, while emerging tools, like telehealth remote care and AI continue to shape orthodontics for the future. As we move further into the century, continued integration of digital tools, global collaboration, and evolving patient expectations will further form the future of orthodontics in ways that were unimaginable just a few decades ago. As that future comes to be, we will continue to track the progression of orthodontics here on the AlgerBlog.
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