Tech Tip: Gaps between aligners & teeth

Intrusions and extrusions are some of the most unpredictable movements to achieve with aligners. Often everything goes as hoped, but other times, those teeth will just stubbornly stay put, causing small gaps between those teeth and the aligner.

Example of gap between tooth and clear aligner

Doctors have several options for dealing with this situation. Here are some of the solutions we've encountered:

  1. Leave it alone. If that particular movement isn't essential to the appearance or function of the teeth, you might just decide it's not worth complicating the treatment to deal with it. (You might need to remove the engager from that tooth if it gets in the way.)
  2. Wait it out. If you have unused phases remaining, you can just stay on schedule until the final step, then target those stubborn teeth by themselves with a refinement.
  3. Bring out the band. Extrusions are particularly difficult for aligners; there's just not much leverage to work with. You can apply some extra force by improvising an auxiliary with some brackets and an elastic band, as shown in this how-to. This is often surprisingly effective.
  4. Let Chewie be your co-pilot. One of the best tools for helping with intrusions are Chewies. Patients love these things. Chewing on those for a few times each day can really help to seat the aligners, relieve pressure, and help to intrude the teeth.

How to submit a case in 2½ minutes

Why you should submit online

  1. It’s faster.
  2. It’s more accurate.
  3. You get 2nd-day air shipping for free.
  4. You can track your case right away on ClearComm.
  5. You can quickly add & update payment methods.

If you haven’t tried it yet, give it a shot: dr.clearcorrect.com.

Play around with it as much as you like--you won’t be charged anything until you click “Finish” on the final step. You can go to your Cases page to cancel or resume any incomplete submissions.

We’ve made online submission as close as possible to completing the paper form, so don't be scared to try it. Here's a quick video we threw together to show how fast & easy it can be, even when you include both photos & x-rays:

New phase-based numbering

Aligner bag

As previously announced, we’re sending new redesigned single-page treatment plans with each phase of aligners, starting today. This is a great time to review our previous tech tip explaining the many improvements that you’ll see on the new paperwork.

One of the changes we briefly mentioned was our switch to phase-based numbering for each step. We’re making that change today as well. We didn’t go into too much detail last time, so let’s take a look at how that works now.

The basic idea is very simple. Each phase you receive already has a number. You start with Phase Zero, move on to phase 1, then phase 2, and so on. That’s not changing.

Now each step will have a number based on the phase it came in: phase 1 will include steps 1A, 1B, 1C, and 1D, phase 2 will include steps 2A, 2B, 2C, and 2D, and so on.

IPR, engagers, and Compliance Checkpoints will always be scheduled for your appointments on steps A & C of each phase. If you submit a midcourse correction while your patient is wearing phase 3, you’ll get revised models starting with step 4A.

We’re making this change for existing cases as well as new ones, so we’ve prepared this conversion chart to help you understand the changes:

Step number conversion chart

It’s really not as complicated as it looks: whenever you get a phase, you start on step A and continue through step D. That’s it.

You might also notice that we’ve added a unique QR code to each bag. It doesn’t do much yet, but we do have plans for it in the future. Oh yes, big plans. Secret plans.

Until next time...

Free two-day shipping for all new online case submissions

We improved our shipping label tracking last week, and as a side effect, a lot of folks realized that they’ve been getting something for free that they were really supposed to be paying for. Hey, we’re cool like that. Unfortunately, all good loopholes must come to an end.

As explained in our terms & conditions and our product list, the following shipping charges are included in your up-front costs:

  • one shipment to us to submit impressions for a new case
  • shipments to you for all included phases (including Phase Zero & retainers)

These shipping costs are not included in the lab fee:

  • additional shipments to us (such as new impressions for midcourse corrections)
  • shipments to you of replacement aligners
  • a one-time surcharge for shipments to Alaska, Hawaii, and offshore territories

This isn’t a new policy—we just haven’t been enforcing it very strictly. Now that we’re tracking what each shipping label is for, people can no longer print unlimited shipping labels for free. The days of walking into clubs and “making it rain” with UPS Ground shipping labels are over. (We’re looking at you, Dr. Harold “Mad Grillz” MacPhearson of Omaha, Nebraska.)

However, there is some sugar sprinkled on this donut of disappointment, and boy is it sweet:

First of all, we’re upgrading all new online case submissions to 2nd-day air shipping at no extra charge. (If you’re close to our headquarters in Houston, your impressions might still be sent via Ground if the estimated delivery time is the same or quicker.) For folks who are further away, this will shave days off your turnaround time. Just submit a case on ClearComm, and an upgraded shipping label will be generated automatically. (This change doesn’t affect aligners, which are still shipped via UPS Ground.)

Secondly, if you’re not comfortable submitting online yet, you can still get free Ground shipping labels for handwritten case submissions. Just call or email your account rep, and we’ll email or fax you a label, just like old times.

If you need shipping labels to send us anything else, print your own labels on ClearComm and take advantage of our lower shipping rates and tracking on ClearComm.

On a related note, we have heard that some doctors have had trouble uploading photos when submitting online. While we improve the photo uploading page, we’re temporarily allowing doctors to skip that step and include photos in the submission box if they have problems. If you can upload your photos, please do—it’s quicker and more accurate than matching up physical prints.

Finally, this should probably go without saying, but don’t use shipping labels more than once. If you print multiple copies of a shipping label and use them to ship multiple packages, UPS will get all confused, and there’s no telling what will happen to your valuable submission. If you need to reprint a label for legitimate reasons, it is possible. Go to the Shipments page on ClearComm, show your shipments “to ClearCorrect”, and click “Details” next to the label you want to reprint. A pop-up window will appear with tracking information and an option “View/Print Label”.

Shipping changes

We’re making a few minor changes to ClearComm that you should keep an eye out for.

Until now, we’ve stored information about doctors’ offices separately from contact information, shipping addresses, and billing addresses. Adding or updating an address requires us to re-enter the same data in several different places. As you might imagine, this can sometimes lead to confusion and mistakes.

To reduce the possibility of mix-ups, we’re cutting our shipping options down to just one address for each of your offices. We already have this information, but we mostly use it for the Find a Doctor section of our website. When you submit a case online, you’ll simply assign it to one of your offices, and we’ll ship it there, instead of asking you to choose a shipping address and phone number every time you submit a case. If you only practice from one location, you don’t have to choose at all.

Shipping labels screenshot

We want to make sure we get this right, so we’re making this transition gradually. This change will only apply to new case submissions-your cases already in progress will be unaffected.

When you submit a case online, a shipping label will automatically be generated for you at no cost. If you need to create a shipping label for some other purpose (for instance, to send us impressions for a midcourse correction), you can still do so on our Shipping Labels page. You’ll select the office you’re shipping from and (if applicable) the case you’re shipping records for, and your credit card will be charged for each label that you create. Later, you’ll be able to track each shipment by case number.

Questions

What if the office I want to ship to isn’t listed on ClearComm?

If you want to add, update, or combine office information, ask your account rep to do it for you. You can have multiple offices, and you can share an office with other providers. You will be able to manage this information yourself in a future update to ClearComm.

Can I ship to my house instead of my office?

No. To avoid shipping surcharges and to prevent fraud, new cases can only be shipped to dental offices, not residences or P.O. boxes.

Does this affect my billing information?

No. Your billing address is linked to your credit card or checking account on file, and will not be affected by this transition.

Why can’t I get unlimited free shipping labels?

As specified in our terms & conditions, shipping costs for your initial case submission and all phases are included in your lab fee. (Providers outside of the continental U.S. pay an additional $150 per case.) Additional shipping costs—for instance, for submitting revised impressions—are your responsibility.

Until next time…

Zendura available at 25% off for ClearCorrect providers

Do you have a pressure-forming machine like a BioSTAR, MiniSTAR, Drufomat, or Drufosmart?

Would you like to make aligners in your own office with the same industry-leading aligner material that ClearCorrect uses?

You're in luck. Zendura is now available for purchase from your account rep.

This is the finest material you can buy for making clear aligners. The best doesn't come cheap: Zendura costs $4 per sheet direct from the manufacturer. However, we've negotiated a discount exclusively for ClearCorrect providers. When you order material through us, you'll get 25% off.

Most doctors aren't ready for this industrial-strength material—for them, we still offer standard orthodontic plastic. However, if you're one of the elite few with serious pressure-forming equipment, and you'll settle for nothing less than the best, email or call your account rep to order Zendura. You'll be one of the first doctors in the world with the capability to create factory-quality aligners & retainers in your own office.

Over $25,000 raised for charity: water

A quick update on our Phase Out project—since January, you’ve helped us raise over $25,000 to bring clean, safe drinking water to people in developing countries. The folks at charity: water recently wrote us to say:

We continue to be blown away by your team’s passion for the cause and your amazing dedication to making a huge change in the world through your efforts!! Thank you!

We are so grateful to all the ClearCorrect patients and providers who have made this possible by wearing their aligners regularly and completing treatment with leftover phases. Don’t forget, you can track your own phases on ClearComm. Together, we’re making a difference.

Tech Tip: What to expect when you submit a case

Since we introduced Phase Zero in September, we’ve cut our typical Phase Zero production time down to 5 business days or less. A couple of weeks ago, we made some more improvements to sync up the deliveries of Phase Zero and the treatment setup. So we’ve updated our timeline to reflect these changes. This document is the best explanation of what to expect when you submit a case.

To give you a more realistic estimate, we’re now counting shipping time to & from your office and allowing a couple of days for your Phase Zero / treatment setup evaluation. If everything goes smoothly, you can probably expect to get Phase Zero about two weeks after shipping your case submission, and Phase 1 about two and a half weeks after approving the treatment setup. Pay close attention to the red notes on the timeline: they’ll help you avoid case delays.

Remember, Phase Zero is based directly on scans of your impressions. We can't correct impression mistakes or verify that the models match your patient's teeth. That’s your job. When you make sure that Phase Zero fits on your patient's teeth, you're not just getting them started faster; you’re also physically confirming the accuracy of the 3D models used for the treatment setup. That's why it’s important to call your patient in for a Phase Zero fitting appointment before approving the setup.

This sample timeline is based on typical UPS Ground shipping times for the Southern/Central United States. Delivery times can vary significantly depending on your distance from our headquarters in Houston. Adjust your estimates accordingly:

UPS Ground shipping times to 77041

UPS Ground shipping times from 77041

Tech Tip: 5 midcourse correction myths

There are a lot of misconceptions out there about refinements & midcourse corrections. Here are some of the most common misunderstandings:

Myth #1: You can get unlimited midcourse corrections & refinements for free.

False. It is true that we don't charge a fee for refinements or midcourse corrections. However, you're still only entitled to receive the number of phases included with your case (3 for Limited, 8 for Full). If you use more than that, you'll have to pay for the extra phases. You're also responsible for the cost of shipping new impressions to us.

Myth #2: You should request a midcourse correction every time an aligner doesn't fit.

False. Most of the time, if the teeth aren't on track, it's because the patient hasn't been wearing the aligners regularly. The aligners really need to be worn 22 hours a day, every day, for best results. If your patient isn't doing that, then requesting a midcourse correction is a complete waste of time. 

Remember what a midcourse correction is: we simply make a new phase starting from the current position of the patient's teeth. You can accomplish the same thing without wasting a phase by simply backtracking to the last step that fit and reinforcing the wear schedule. For extra strength, you can make fresh aligners using the included dental models. Of course, use your professional judgement, too. If there's a difficult extrusion or intrusion that's not happening, a bracket & auxiliary technique will often be more effective than a midcourse correction.

Myth #3: You'll get a Phase Zero and treatment setup after a midcourse correction.

False. As the name implies, Phase Zero is only sent at the beginning of treatment. A midcourse correction does not change the ultimate goal for the case, so we don't generate a new setup for your approval.

Myth #4: Your patient should stop wearing aligners while waiting for a midcourse correction.

Myth #5: Your patient should keep advancing to new steps while waiting for a midcourse correction.

False and false. When you submit a midcourse correction form, we'll ask "Which steps currently fit your patient's teeth best?" Those are the aligners your patient should keep wearing to retain the position of their teeth. When you get the revised phase, give the first included step to your patient and discard any unused steps from the previous phase.

As always, if you have any questions, just ask your account rep.

Small Business Today radio interview

Our CEO, Jarrett Pumphrey, and Anthony Penketh (our Chief Marketing Officer) were interviewed yesterday by John Cruise for the Small Business Today radio show.

It was a great interview, and a lot of fun. If you'd like to learn a little more about us, check it out: