Tech Tip: How to avoid a case revision

As we've mentioned in previous tech tips, you can avoid unproductive case revisions by checking for tight contacts on a regular basis. Teeth can't move when they're jammed up against other teeth. By reducing the enamel a bit at the point of contact, you can free up space for teeth to move. 

Here's a real-life scenario from a recent case:

A provider checks his patient's treatment plan, and sees that tooth #24 is scheduled to rotate distally during step 7A and 7B. He places engagers on the tooth, as recommended.

When the patient comes in for the next appointment, he sees that the tooth has not rotated as planned, and the engager does not align with the engager void in step 7C. Tight contacts have prevented tooth #24 from rotating.

If you are in a similar situation, you can take the following steps to solve it before resorting to a lengthy case revision:

Reference Links:

Do you have your own ideas for avoiding a case revision, or have experience troubleshooting? Drop us a line in the comment section below, and we'll share your experience in a future tech tip!

Happy Birthday to ClearCorrect!

Six years ago, we began making clear aligners for Dr. Willis Pumphrey and about 400 of his patients in Texas. Today, we have grown significantly to provide a comprehensive clear aligner treatment system for thousands of dentists and tens of thousands of patients nationwide.

We have had an incredible journey thus far, and we want to thank you for your loyalty and support over these years. We couldn't have done it without you!

To commemorate our sixth anniversary, we created this short video to reflect on our past and give a glimpse of what's to come. Our future is bright, and we are excited to share it with you. 

We wish you all the best over the holiday season!

Tech Tip: Using IPR to avoid case revisions

We see a lot of case revisions submitted when unpredictable tooth movements (such as extrusions and rotations) just aren't happening. Teeth need space to complete any type of movement, and when they don't have enough, it can cause tracking or fitting issues. These "heavy" or "tight" contacts are common and can appear at any time in treatment, due to the nature of teeth and the patient's physiology.

Even if you follow the treatment plan to a T, and the patient is completely compliant, you may still need to perform IPR. This, my friends, is the nature of clear aligners.

Sending in a case revision before troubleshooting can waste money, chair time, and planned phases. You can avoid submitting an unnecessary case revision by using these IPR techniques:

  • Always check for tight contacts before submitting a case revision. You can easily alleviate tight contacts by hand stripping, as demonstrated in our IPR tutorial video.
  • Take IPR into your own hands! The recommended amounts of IPR in the treatment setup and treatment plan are for guidance only. You are the doctor, and are the one ultimately treating the patient. Small amounts of unscheduled IPR can get treatment back on track much quicker than submitting a lengthy case revision.
  • Use your good sense -- don't perform IPR in a spot where there's already space, even if it's recommended on the treatment plan. Too late? Don't worry, it's an easy fix. At the end of treatment, the spaces caused by excessive IPR can be closed with a digital power chain in a refinement.
  • If you still have questions, we have wiki articles dedicated to performing IPR and troubleshooting other related issues. Or, contact your account rep; they will help you review your patient's treatment and decide what to do next.

Tech Tip: Why do engagers fall off?


An engager fell off the tooth when my patient removed their aligners. What should I do?


The root cause of a loose engager is that something is preventing the bonding agent from bonding the engager to the tooth's surface. When this happens, the composite material cannot fully adhere to the tooth, and the engager will fall off. 

The most frequent causes of this issue are:

  • The petroleum jelly used on the engager template may have smeared on the tooth surface.
  • Plaque on the tooth may be preventing the acid etch from working.
  • The tooth was a restoration, and the etch was not effective on the restoration's surface.
  • The compressed air used to dry off the tooth during engager placement could have been contaminated with oil.

To solve this issue, follow these helpful tips from our chief technical officer, Paul Dihn:

  • If you notice that petroleum jelly transfered from the engager template to the etching surface of the tooth, use the previous step that best fit the patient as an engager template without using petroleum jelly. (If you cannot use the previous aligner as a template, try lifting the original template off of the tooth during insertion.)
  • If there is plaque on the tooth, micro-etch (sandblast) the surface of the tooth, and then re-install the engager using our instructions, listed in ClearComm.
  • If you are placing an engager on a restoration, use a special etch from your dental supplier that is formulated to work with the restored surface. (Note: this may not always work.)
  • Contaminated compressed air is an issue with the system, and can be hard to correct. If you suspect that your compressed air may be contaminated with oil, try drying the tooth with a low-heat blow dryer that can be purchased from your dental supplier.

Tech Tip: How to work with teeth-grinding


My patient habitually grinds their teeth. Can I still treat them with ClearCorrect?


Habitual tooth-grinding can make clear aligner therapy difficult -- unless you are willing to work around it. The main problem with this issue is that the constant grinding of the teeth wears down the aligners to the point that the material loses its retentiveness. Therefore, the patient may wear the aligner out before it has a chance to move the teeth adequately during that step of treatment.

However, if you are willing to be flexible and manage the patient's treatment more closely, you can work around the grinding. Because we give you models of each step of treatment, you can easily create as many replacements for each aligner as is needed. (We carry Zendura aligner plastic for replacements in our Online Store.)

We suggest that you determine how long it takes your patient to wear down one set of aligners, then adjust their aligner wear schedule accordingly. Then, craft replacement aligners of each step in order to actively progress through treatment. For example, if your patient grinds down an aligner in two weeks, have your patient switch out the original aligner with a replacement after one-and-a-half weeks. With that replacement, they will be able to complete that step with a fresh, retentive aligner and start the next step on track with treatment.

Before and after photos

Dr. Mason Jones recently sent us these photos of his patient's succesful progress through treatment, along with a testimonial. Check it out!


"Connie's treatment couldn't have been any smoother. After discussing her concerns and what she hoped we could achieve, we took some photos, made some impressions and got started. I had originally projected 24 months for her to wear the aligners, but in reality, her teeth moved much quicker than we expected...16 months! Connie was thrilled. And, with tears in her eyes, she told us how much her life was changed by the orthodontic treatment. Seeing her so happy with her new smile has been one of the best feelings ever."

Thanks, Dr. Jones! To submit before and after photos of your patient's treatment results, contact us at

Tech Tip: Marketing tips from ClearCorrect providers

We asked some of our high-submitting providers to share their tips and experience with promoting their practice as a ClearCorrect provider, which are now available on the Wiki. Here are a few of their responses:

Promote everywhere

"We promote ClearCorrect on everything we do: our web page, door hangers, posters in the office -- even our business cards. Current upgrades to the ClearCorrect system are prominently mentioned in staff meetings. Our hygienist is on the alert to mention ClearCorrect to likely patient candidates."

Talk about ClearCorrect to every patient

"After each exam, my hygienist and I ask patients if they know about ClearCorrect. If they don't, we explain it to them and show them the clear aligners. We explain the patients how it works and how they can benefit from it."

Build a strategic pricing model

"The main thing we do in our practice to promote ClearCorrect is to charge the same amount for either treatment (i.e. the same cost for aligner therapy or fixed appliances). A lot of times, patients are quoted a higher fee for aligners versus fixed appliances, so they are more likely to start treatment with us because of our pricing model."

Be confident

"I think it's really just a matter of confidence. If you confidently tell the patient that you have a solution for their smile that doesn't involve 'shots', 'drilling', and is a fraction of the cost of veneers, it's usually a done deal. I am careful not to pressure anyone -- it's just presented as an idea. But I can't believe how many people have come back to me at a later time, after not being interested, and have decided to move ahead with treatment."

View these tips and more on the ClearCorrect Wiki.

Do you have any marketing tips to share, or photos of your strategies at work? Share them in the comments below!

Tech Tip: Putting a case on hold

One of the greatest advantages to ClearCorrect's phase-based system is that you have the freedom and flexibility to start, pause, and adjust treatment according to the needs of your patient's case. Over the next few weeks, we will share tips on how to use our system to your advantage and get the most out of treatment.

Placing a case on hold with ClearCorrect is simple. If your patient goes on vacation or falls behind in treatment, you can place your case on hold to prevent the next scheduled phase of treatment from being shipped out to you. This way, you can receive the correct phase of treatment only when you need it.

Unlike Professor X, we don't have the ability to read minds. Letting us know when to hold your case is key to preventing wasted time, resources, and unused phases.

Here are some important points to consider about holding a case:

  • Contact your account rep to place the case on hold. Your rep will be able to hold production on the next scheduled phase until you and your patient are ready to resume treatment.
  • Sync your schedule with ours. As our Timeline shows, we try to ship a phase every 12 weeks. If your patient gets too far off schedule, you might start stacking up phases before you need them. If you decide you need a revision, those phases will be wasted, and you might need to buy more in order to finish treatment. To avoid this situation, place your cases on hold as soon as you anticipate a delay in treatment.
  • When you're ready, just ask your account rep to take your case off hold. A new phase will ship approximately 15 business days after you resume the case. Please keep this estimate in mind as you schedule further appointments with your patients. As always, you will receive an email notification when that next phase ships.

For more helpful tips and resources for effectively managing your cases, please visit the Managing a case section on the Wiki.

Tech Tip: Informed Consent & Agreement

We provide the Informed Consent & Agreement document so you can inform your patients of potential risks associated with clear aligner therapy, and set their expectations appropriately. The final section is a legal agreement between you and your patient, establishing that your patient consents to receive treatment and understands the risks involved.

We encourage you to review the information on this form with your patients and sign it together. Though we don't require a copy of this form for our records, we strongly recommend that you keep it with your patient's records for future reference.

The agreement prepares patients for many issues that can arise during treatment, including:

  • Treatment time may exceed your initial estimates.
  • In some cases, additional dental procedures may be necessary to complete treatment.
  • There may be additional costs associated with extended treatment.
  • Wearing the aligners may temporarily affect the patient's speech and/or increase the salivation or dryness of the mouth.
  • Engagers or IPR may be required during treatment.
  • Non-compliance may result in a relapse of final treatment results.

We strongly recommend that you go over this agreement with each of your ClearCorrect patients before treatment, and during treatment if any questions arise. Call your account representative at (888) 331-3323 if you or your patients have any questions about this document.

Tech Tip: Short clinical crowns

Recently, we've been focusing our tech tips on troubleshooting tips to help you manage your cases when issues arise. One issue that may affect ill-fitting aligners is short clinical crowns. Because the clinical crown is so short, there are fewer retention points on which the aligners can apply pressure. When there aren't many retention points on the tooth, the aligner won't be able to fully seat over the tooth, or will "pop off".

A helpful way to prevent problems in treatment relating to short clinical crowns is to indicate any short clinical crowns and request engagers on the first or second premolars under the "Additional Instructions" section of your case submission form. Please specify to place those engagers during step 1A, and we will accommodate your request.

Letting us know about short clinical crowns when submitting a case prevents fitting problems. Check for short clinical crowns whenever you evaluate your patient (especially if Phase Zero doesn't fit). This way, you can request engagers right away and get your patient into successful treatment.