The future of dentistry in South Africa lies in blending traditional and digital tools. Dentists such as Dr Nicolene Singh are increasingly integrating analogue and digital workflows.
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Singh explains how she runs her practice on a connected model: scanning, planning, designing, communicating and treating as one system.
She says she didn’t set out to build a “digital practice”; she set out to solve a clinical challenge.
“My interest in clear aligner therapy started in 2019. Early on, I still took conventional impressions and fed that analogue starting point into a digital treatment plan,” she says.
“The disconnect was obvious: I was translating between two languages at every step, with each translation costing time and precision.”
Closing gaps
The first real shift came when Singh introduced an intraoral scanner into her workflow, which made the digital approach more central to her practice.
“What surprised me was that the scanner didn’t just replace impressions; it changed how I diagnosed, communicated with patients, and planned,” says the dentist.
“Once I saw that, adding each digital layer became less about buying gadgets and more about closing gaps between steps that were already there.
“Digital dentistry, for me, grew out of orthodontics and then spread through the rest of the practice.”
According to Singh, the backbone of her practice is the iTero Lumina scanner for data capture.
From that scan, the same dataset flows into planning, design, aligner manufacturing, monitoring and patient communication, depending on the case and workflow.
In practice, that means a digital ecosystem for visualising and discussing a patient’s gum health, tooth health, and occlusion.
“It is not the brand names; it’s the architecture,” she says.
“Rather than a scanner here, a design system there and planning software somewhere else, it’s one dataset moving through capture, plan, design, communicate, treat and review.”
Improved patient comfort
She says the switch from a traditional workflow to a fully connected digital one has improved patient comfort with the process compared with conventional impressions.
“With digital visualisation tools, I can show a patient their gum health, tooth condition and occlusion on screen from their scan, rather than relying only on verbal explanation,” she remarks.
“When a patient can also view a simulation of proposed tooth movement or see areas of concern highlighted on their own scan, the conversation can become more collaborative and informed.”
“I am careful to explain that simulations support discussion and informed consent but are not a guarantee of outcome.”
Singh adds that this approach can reduce misunderstandings, rework, and time spent repeating steps, although results and efficiencies vary by patient, clinician and workflow.
For her practice, however, the digital shift has streamlined day-to-day operations.
“In the old workflow, information was captured, then re-captured, then physically transported. Now a scan can be captured once and used as a consistent reference point for downstream steps from that same dataset, subject to clinical verification and case requirements,” says Singh.
Practically, she says, case starts are faster because there’s no waiting on couriered impressions and fewer issues linked to distorted or incomplete physical records.
“It has also changed how my team works. Scanning can be a delegable, teachable skill when training and supervision are in place, so the workflow does not depend on me being involved in every administrative step,” she adds.
This means her “chair time” is focused on clinical decision-making and patient conversation rather than the mechanics of capturing and moving physical records.
Biology still governs result
When different systems connect within a single digital workflow ecosystem, she says she can get a more consistent, longitudinal, objective view of each patient than from disconnected records alone.
“Integration also helps align my orthodontic and restorative planning, because the same digital record can inform both conversations where clinically appropriate,” says the dentist.
“The honest caveat I always give colleagues is that integration can improve inputs, support monitoring, and help sharpen my diagnosis and planning, but it does not replace clinical judgment.
“The biology of the individual patient still governs the result. The system predicts movement; the patient’s tissues deliver it.”
She posits, however, that while digital workflows can help dentists plan more effectively and make better-informed decisions, they do not change the biological realities that ultimately shape the result.
She adds that she’d caution colleagues most about using digital treatment planning to predict outcomes before treatment begins.
“Digital planning gives me a simulation of the intended outcome before I place a single aligner — that is valuable, because it forces me to think through the whole movement sequence in advance rather than reacting appointment by appointment,” she starts.
“But a simulation is a prediction, not a promise. The value of digital planning isn’t that it makes me certain; it’s that it makes me appropriately confident.
“It helps me distinguish what I can predict from what I’m hoping for, and that distinction protects the patient.”
