Phase Out update

Last week, we hit a milestone in our Phase Out project. Since the beginning of the year, we've now donated over 1,000 leftover phases to charity: water. Each phase can bring clean, safe drinking water to one person in a developing country, so that's over 1,000 people whose lives will be improved thanks to your help.

It takes about 18 months to complete a water project, but we'll keep you updated as we go along. Don't forget, you can track how many leftover phases you've contributed on ClearComm, and you can also donate funds directly if you choose.

Tech tip: New & improved treatment plans

In the next couple of weeks, we’re rolling out brand-new, totally redesigned treatment plans. You’re going to love this. The new paperwork adds a ton of new useful information, and really clarifies how phases work. We’ve also managed to cut it down from five pages to a single, Earth-friendly sheet of paper.

Treatment plans: funky & clunky vs. lean & green

Get comfortable, because this tech tip is probably going to be our longest one yet, and you’re going to want to know this stuff.

We’ll start at the top of the treatment plan and work our way down. (Download a sample treatment plan here if you want to follow along.)

Case information

Patient name

Nothing too surprising here. A big readable patient name is followed by the case number, the prescribing doctor, and the date that the current phase was shipped.

(By the way, if your email client usually blocks images, you’ll want to make sure to load them now. Things are about to get very visual.)

Phase graph

Phase graph

The phase graph at the top of each treatment plan gives you a quick overview of the entire case: past, present, and future.

As you know, we make our aligners one phase at a time. A standard phase includes four sets of aligners, and lasts 12 weeks. Each phase is represented as a box on this graph, segmented into four steps. (Phase Zero and the retainer are narrower because they only include one set of aligners.)

Let’s take a closer look at each section of the graph:

Past phases

Past phases

Phases that you’ve already received are represented as gray boxes on the graph.

In this example, a note under phase 3 indicates that it was shipped as a midcourse correction. Don’t worry about the little symbols in phase 1 just yet; we’ll talk about those later.

Current phase

Current phase

The current phase (the one sent with the treatment plan) is filled in green. The phase number above it is big, bold, and also green. In this example, the patient is about to start phase 5, which is also a midcourse correction.

I bet you really want to know about the triangles, square, and X on the first & third step. Just hang tight—it’ll all be clear soon.

Planned phases

Planned phases

The right side of the graph offers a glimpse into the future. Planned phases are represented as green outlines. Here we can see that the final planned phase is phase 6. It’s scheduled to ship around March 28, 2012*, followed by final retainers whenever the doctor requests them (you do request final retainers, don’t you?).

*That asterisk after the shipping date is important. Estimated ship dates are just that—estimates. They change all the time. You really want to wait to schedule appointments until you get an email notifying you that the aligners have shipped. If a patient shows up before the aligners do, no one is happy.

Also remember that this is an estimate of the ship date, not the delivery date.Depending on where you are, UPS Ground delivery can take up to 5 business days. Updated shipping date estimates and tracking numbers are available on ClearComm. Don’t hesitate to use them.

Extra phases

Extra phases

Here’s something you’ve never been able to see before: extra phases. They’re represented by light gray outlines on the graph.

As you know, a certain number of phases are included with each case (3 for Limited, 8 for Full). If a Full case has fewer than 8 phases scheduled, some unused phases are left over. Those extra phases can be used for replacements, midcourse corrections, or refinements. If some phases are still left over when you request the final retainer, they’re donated to the Phase Out program.

These new graphs should help you understand your options. For instance, if you request a midcourse correction, the treatment may use more phases than originally planned. That’s no problem if you have enough unused phases to cover the difference, but if you don’t, you’ll need to pay for the extra phases.

If you request a replacement aligner instead of making one in your office, it will “break” one of your extra phases so it can only be used to make replacements. The shaded boxin the darker gray replacement phase above represents one replacement. The note above the shaded step indicates that it was used to replace step 2A.

Phase-based numbering

Wait a minute. Step 2A?

That’s right, we’re renumbering the aligners to make it more clear which phase they belong to. Instead of steps 13, 14, 15, and 16, you’ll get 4A, 4B, 4C, and 4D.

No more mental calculations; you’ll always dispense A & B at the first appointment, and C & D at the second appointment—even after a midcourse correction.

Appointment instructions

Okay, we’re nearing the home stretch, folks. Remember those funny little symbols on the phase graph? Behold! All will be revealed.

First appointment

The sheet includes separate instructions for the first and second appointment of each phase. You’ll notice that each type of procedure is accompanied by a unique symbol:

  • Compliance Checkpoint A green teardrop represents Compliance Checkpoints.
    • When you see these, check for contact between the teeth with dental floss. If they’re not touching, your patient probably hasn’t been wearing their aligners 22 hours a day, and they might not be ready for the next step.
  • 0.2 mm IPR A red triangle represents IPR.
  • Add engager A blue square represents adding an engager
  • Remove engager A small black X represents removing an engager.
  • Extraction A large gray X represents extraction.

On the phase graph, these symbols indicate which procedures are being performed at each appointment. Now if you need to schedule more time for IPR or engagers, you’ll know in advance.

Tooth charts

On the tooth charts below the instructions, those same symbols give you an at-a-glance overview of where those procedures are being performed. If we know that a tooth is missing, we’ll delete it from the graph. The IPR triangles even change width to indicate whether you’re performing 0.1, 0.2, or 0.3 millimeters of IPR.

There’s a chart for each step, but procedures will never be recommended on step B or D of a phase (because your patient starts those steps at home).

You can also quickly see which teeth are moving in each step—they’re highlighted in green

Tooth charts

The specific movements are listed below each graph:

Tooth movements

Epilogue

Well, I think that about does it. We covered the whole treatment plan, top to bottom. As you can see, there is a lot of information packed onto that one piece of paper. Hopefully, it will seem pretty straightforward when you start to receive the new paperwork in the next few weeks.

If you want to review this tech tip later, it will be available (like all our tips) right here on our blog. Of course, you can also always contact your account rep for assistance or feedback.

I think I'm going to go have a little lie-down. Until next week…

New patient interview

We've told you about a few recent interviews with ClearCorrect providers. Now we're adding patients to the mix. Meet Tom Kretzschmar:

All promo material prices reduced 50% or more

Brochures, posters, banners, and DVD’s can all get your patients asking about ClearCorrect. So now we're making them as affordable as we possibly can:

  • 25-pack of brochures: $5 (formerly $10)
  • Small brochure holder: $5 (formerly $15)
  • Large brochure holder & insert: $10 (formerly $20)
  • Patient DVD: $5 (formerly $10)
  • Standard banner: $60 (formerly $120)
  • Custom banner: $75 (formerly $150)
  • Posters: Free (formerly $10)

You can check them all out on ClearComm or on this updated price list:

ClearCorrect Promotional Materials Price List

Just email or call your account rep at (888) 331-3323 to order. Let us know if you want us to charge your card on file, or use a different payment method.

New free posters

We’ve designed some great new posters for you to hang up around your office.

They're conveniently sized at 18" x 24" to fit standard frames. Best of all, we’re offering them absolutely free to providers. You'll only pay shipping & handling (usually $5.95 per shipment).

First, we have updated versions of our classic posters featuring models Sydney, Savon, and Brianna:

ClearCorrect posters: Sydney, Savon, Brianna

We also have a set of brand-new posters: Case Types (featuring before & after photos, by popular demand), How Does It Work? (a brief introduction to clear aligners), and Simple (an eye-catching minimalist design).

ClearCorrect posters: Case Types, How Does It Work?, Simple

Finally, we have two special posters explaining the Phase Out program. Your patients will feel great knowing that they (and you) are supporting a great cause:

ClearCorrect posters: Phase Out (Kids), Phase Out (Closeup)

As I said before, all of these posters are available now for free. Order one, all eight, or more—we’ll squeeze as many as we can into one poster tube.

Email or call your account rep at (888) 331-3323 to order. (We can charge your account for shipping & handling on request.)

Sneak peek at Zendura® aligner material

ClearCorrect Trimming Kit

Here's something we can whole-heartedly endorse (and get financial compensation for): the ClearCorrect Trimming Kit.

For $90, the kit includes all the supplies you need to make your own replacement aligners in your office: 10 plastic sheets, a steel wheel saw, crown & bridge scissors, and 10 abrasive buff polishers.

Our kits have always included .030" sheets of Biocryl™ plastic. It works great. In fact, it's one of the best materials available for making aligners with a vacuum-former (the most common type of thermoforming machine in dental offices).

We've never talked much about the material we use ourselves here at ClearCorrect, and we've never offered it for sale. This is partly because it wasn't packaged for individual sale, and partly because it requires a more advanced pressure-forming machine such as the BioSTAR, MiniSTAR, Drufomat, or Drufosmart.

Today we can reveal that the material ClearCorrect uses to make our aligners (and retainers) is called Zendura®. It's an advanced polymer that was developed by Bay Materials specifically to balance the properties needed for clear aligners: strength, ductility, chemical resistance, clarity, and stress relaxation resistance. It's significantly more crack-resistant and stain-resistant than traditional PETG-based plastics. We believe that this is the most effective material ever developed for making clear aligners.

We're not offering Zendura for sale just yet, but we do have a limited supply of individually foil-wrapped samples available. If you have a pressure-forming machine, let us know when you order a Trimming Kit, and we'll include a free "sneak-peek" sample of this advanced material while supplies last. We'd love to hear how it works in your office.

You can contact your account rep to order at (888) 331-3323.

Tech tip: Snoring/sleep apnea followup

We've got a little followup this week about appliances for snoring/sleep apnea. First off, a clarification.

Dr. Virginia Hughson-Otte wrote in to say:

"There are NO proven, safe, useful OTC apnea devices. I surely would NEVER recommend to my patients to EVER get an OTC device for sleep apnea."

Last week, when we talked about a sleep apnea appliance that "fits more loosely (like an over-the-counter sport mouthguard)," that was just an analogy to describe the looseness of the fit. Obviously, an actual OTC sport mouthguard shouldn't be used as a sleep apnea appliance. Thanks for pointing out the potential for confusion there, Dr. Hughson-Otte.

aveoTSD

Dr. Hughson-Otte also wrote:

"I'm a fan of the aveoTSD during ClearCorrect therapy... In fact the CPAP machine can actually produce some much anterior pressure you'll end up fighting this with your aligners also and it can prolong TX."

More than one doctor gave us positive feedback about the aveoTSD device. Dr. Marion N. Wilson wrote:

"aveoTSD works great in place of the custom fitted appliances while wearing aligners. It is a good alternative during TX. In fact I use it extensively for my patients who will not use their CPAP machines."

We contacted Glidewell Laboratories, the US distributor of the aveoTSD, to ask them about using the device with clear aligners. Jim Shuck, their VP of Sales & Marketing, responded:

"I personally wear clear retainers myself along with the aveoTSD virtually every night. The intra-oral dimension of the aveoTSD is very thin and since your tongue is held between your upper and lower teeth inside the silicone bulb it is completely comfortable and effectively keeps my airway open so I do not snore."

He also offered a promotional discount for ClearCorrect providers. If you're interested, you can order the aveoTSD here:

$39 off one aveoTSD device for ClearCorrect providers

We should point out that, although clinical trials in other countries have found the aveoTSD effective for mild to moderate obstructive sleep apnea, the FDA has only cleared it for use as an anti-snoring device in the United States.

We have no affiliation with Glidewell Laboratories, and we aren't getting any financial compensation from them. We have not tested the aveoTSD ourselves, so we can't recommend for or against using it. We're just passing along the feedback we've received.

Tech Tip: Sleep apnea appliances & clear aligners

Question:

I have a patient that wears a nighttime appliance for snoring/sleep apnea. What do I have to do to accommodate both clear aligners and the nighttime appliances while they are in treatment? Do the appliance trays provide adequate retention or do you have to make the appliance fit over the clear aligner?

Answer:

As you know, clear aligners should be worn for at least 22 hours per day. If your patient removed the clear aligners each night to wear the sleep apnea appliance, not only would it cut into your patient's wear-time, the appliance could actively work against the aligners, pressuring the teeth back into their original positions.

So, tight-fitting custom sleep apnea appliances probably can't be used during clear aligner treatment.

If you use a loose-fitting sleep apnea appliance, it may be less likely to interfere with the aligners. You could also consider a non-fitted device, such as the aveoTSD or a CPAP machine. If you've found something that works for you, please let us know.

Please note, however, that we have not tested ClearCorrect for use with sleep apnea appliances. We cannot guarantee the safety or efficacy of any sleep apnea device when used with clear aligners.

If your patient just stops wearing a sleep apnea appliance during clear aligner therapy, remember that they'll probably need a new sleep apnea appliance at the end of treatment, to fit the new configuration of their teeth.

Until next time...

Clarification: An earlier version of this post described loose-fitting appliances as “like an over-the-counter sport mouthguard.” We simply meant that the fit of such a device might be similar to an over-the-counter sport mouthguard. We do not recommend using an over-the-counter sport mouthguard to treat snoring or sleep apnea.

Tech tip: Simpler midcourse corrections

We recently updated our midcourse correction form to make it simpler to fill out. Also, as we mentioned a few weeks ago, we'll now accept impressions just for the arch that's giving you trouble, if you prefer.

new Midcourse correction form

Now there are basically just two questions you have to think about:

  • Which steps currently fit your patient's teeth the best?
  • Are you submitting new impressions?

If you submit impressions, we'll use them to revise the next phases. Otherwise, we'll revise the next phases based on the steps and instructions you specify.

As always, we strongly recommend that you try other options, such as backtracking, before resorting to a midcourse correction. If the real problem is patient compliance, midcourse corrections will just waste your time & use up your phases.

("Backtracking" means having your patient go back to the last step that fit well and try again, making sure to wear the aligners at least 22 hours every day. Most of the time, this is all it takes to get a case back on track. If you don't have the old aligners anymore, you can make new ones using the included dental models.)

That's it for this week. I hope 2012 is shaping up to be a great year for you all. Until next time...

2011: Year in review

2011 has been a busy year here at ClearCorrect.

I thought it might be helpful to review some of the stories you might have missed this year. Let's start at the beginning, shall we?

January 2011

February 2011

March 2011

April 2011

May 2011

  • We added snazzy new logos & images for you to download on ClearComm.
  • We countersued Align, asserting that the patents they sued us over (plus a couple others) are invalid, thanks in part to over 70 years worth of undisclosed prior art. (The case is still ongoing, but Align is currently trying to persuade the court to dismiss one of our counterclaims if they promise not to pursue that patent against us anymore).
  • We defined the core values that we hope will set us apart from the competition.
  • Should you do IPR before impressions? Generally, no.

June 2011

July 2011

August 2011

September 2011

October 2011

  • We marked the passing of the innovative, inspring, and incomparable Steve Jobs.
  • Paul Dinh demonstrated how to make your own aligners in a free video.
  • We refreshed our treatment setups and demonstrated how to view them in ascreencast. (We're adding features to our website so quickly, this video is already half-obsolete. We'll try to record a new one soon.)
  • We recorded our first interview with a ClearCorrect provider, Dr. Dale Brant. It came out even better than we expected. (If you're in Texas, and you'd like to be featured in an interview, let us know. Also, the camcorder is still available.)
  • We updated our timeline to include Phase Zero.
  • We announced that, thanks to Phase Zero, we can let doctors judge their own impressions, instead of rejecting them based on arbitrary standards. We also explained how you can use Phase Zero to evaluate the accuracy of our models before you even approve a treatment setup.

November 2011

December 2011

And that pretty much wrapped up the year.

We have some cool stuff in store for 2012, starting with a major announcement next week that we're really, really excited about.

Thank you for all your support. We love you guys.

Happy New Year, everybody!