Tech Tip: Evaluating a treatment setup

Tech Tip: Evaluating a treatment setup

Making sure that the treatment setup reflects the treatment goals for you and your patient is probably the most important part of the case submission and approval process. It’s essential that you know what to look for and the best way to communicate these needs to your technician. Here are our suggestions or “how to” for evaluating a treatment setup.

Evaluating a treatment setup

  • Begin with the end in mind – make sure you’re focused on the treatment goals for your patient when evaluating the treatment setup.
  • As you go through the treatment setup, make notes of any items to adjust (if necessary)
  • Confirm the software has accurately related the models and bite registration:New Treatment Setup 5-1.png
    • Put the timeline of the treatment setup in the starting position and tilt the model up to check for gaps between the upper and lower incisors—comparing this view to the patient’s photographs and records can reveal any improper bite registration for the model.
  • From the front view, check the midline relationship.
  • Using the right and left views, check the accuracy of the:
    • Overjet
    • Overbite
    • Canine relationship
    • Molar relationship
  • Use the occlusal views to confirm that the impressions or intraoral scans accurately captured the shape of the teeth.
  • If you’re satisfied with the starting model, carefully review the subsequent steps to verify that the planned tooth movements are safe and effective.
  • Verify that any recommended IPR and engagers are sufficient to achieve your goals.
  • If you requested overcorrection or a digitial power chain, verify that you are satisfied with these. 
  • Note the number of required aligners and wear schedule.
  • New Treatment Setup 8.pngWhen you’re finished reviewing the setup, click EVALUATE. There are 4 options to choose from:
    • Approve the setup and select a price option for the case, which will kick off production
    • Decline the setup and ask for adjustments
    • Decline the setup and submit new impressions or scans
    • Decline the setup and cancel the case 

We hope this information proves helpful when reviewing your patient's treatment setups.  

ClearCorrect e-courses

                       
                       

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Getting Started: 
Clear Aligner Basics

New to clear aligners? Start here. This course will provide you with the skills and confidence you'll need to begin treating patients with ClearCorrect.

Topics include:

  • Clear Aligner/Orthodontics basics
  • How to select & submit cases for treatment
  • How to manage a case
    • Engagers – best practices
    • IPR – best practices
    • Checkups & revisions
  • How to finish a case
    • Identifying problem issues prior to the last aligner
    • Retainers & retention

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Practice Enhancement 
With Clear Aligners

Learn how you can take your practice to the next level with a ton of useful marketing and managing insights accrued over decades of first-hand experience.

Topics include:

  • How to use clear aligners to enhance your practice success
  • How to set up your team for success
  • External and internal marketing
  • How to establish the clear aligner experience in your practice

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Beyond Aligner Basics: 
For the Experienced Provider

If you've got a good amount of experience with clear aligners, but you're looking to do more complex cases, we highly recommend this course.

Topics include:

  • Mastering troubleshooting techniques
  • How and when to use auxiliaries for clear aligners

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Questions? Call your sales rep at 
(888) 331-3323.

About the presenter

Dr. Ken Fischer has been practicing as an orthodontic specialist in Southern California since 1975. He is a former president of the California Association of Orthodontists and a former council chair for the AAO. Dr. Fischer embraced clear aligner treatment in 2000 and has treated a broad spectrum of malocclusions in over 1200 patients. He served on the Invisalign Clinical Advisory Board for 13 years, but now serves ClearCorrect as its Clinical Advisor. He is the author of a number of published articles, a mentor, domestic and international lecturer, and consultant for clear aligner orthodontic corrections.

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ClearCorrect is designated as an Approved PACE Program Provider by the Academy of General Dentistry. The formal continuing dental education programs of this program provider are accepted by AGD for Fellowship, Mastership and membership maintenance credit. Approval does not imply acceptance by a state or provincial board of dentistry or AGD endorsement. The current term of approval extends from 4/1/2015 to 3/31/2019. Provider ID 304173.

 

Tech Tip: More on non-compliant patients

This week we have some additional education and tips on non-compliant patients.

If you break down the subject of non-compliant patients a bit further, you can see there are two main types:

  • The deliberately non-compliant patient
  • The inadvertant non-compliant patient

With clear aligners the deliberately non-complaint patient may be less common. But differentiating the two may help you to understand them better. Here are some tips on this which don't promise to resolve the issue, but may help us to better motivate the non-compliant patients.

Is there an underlying reason for the non-compliance?

  • Lack of education on the basics, importance of and reasons behind the specific instructions
  • The aligners are uncomfortable, embarrasing, interfering with work or life conditions 
  • Patient is forgetful

Understanding the specific issue for that patient can help you both to come up with workable solutions. 

Education

Education is KEY to compliance and the importance of it should not be underestimated. A thorough education from the start should help to deter non-compliance. A fair percentage of your patients are non-compliant whether you are aware of this or not. We covered some tools and resources for this in our tip last week, specifically:

Having the patient repeat your instructions back to you can help to ensure that they have been accurately understood. 

Involve the patient in every step

  • Involving the patient from the initial consult, to records, to appointments and retention with details of the procedures and a timeline can help to enlist cooperation. 
  • Set goals that patients understand (the setup is a good visualization of the final goals) and establish mini-goals along the way (for example, we have finished closing spaces, we are now half done, we are in the finishing steps, etc)

Communicate and support

  • Be honest when non-compliance is suspected and remind patients without scolding them. For example "I'd like to see you finished by ___ date, can we work together to make this happen?"
  • Encourage patients and share your enthusiasm with their treatment—e.g., "Your teeth are moving like that of a teenager. Keep up the good work!” 
  • Let them know you care. Listen to patients. Sometimes they have life events or situations where aligner wear may not be the highest priority. Let them know you are there for them no matter what and you will bend over backwards to help them achieve their goal of a beautiful smile. 

Documentation

All documentation is important as is true in most industries. For non-compliant patients it is especially good practice to document throughout treatment, as you may need this later.

Key notes for documentation:

  • Missed appointments
  • Patient comes to appointment without their aligners on or with them
  • Mysteriously "clean" aligners (2 or 3 weeks of wear on an aligner will show)
  • Aligners are still tight after 2-3 weeks of wear (should be loose, easy to insert and remove)

For further information on non-compliant patients, visit our help center here

Until next time...

Flex & Unlimited now available

As previously announced, we are releasing our new Flex & Unlimited pricing options today to all US providers (with the exception of certain dental groups).

Here's what to expect.

When you submit a case, you won't be asked to choose a "case type." Instead, there's a new option to recommend or limit the number of steps:

Duration: Recommend or Limited to 12 steps

  • If you leave this on Recommend, we'll show you how many steps we need to try to reach your prescribed goals on the treatment setup. (This is kind of like the old "Recommend a case type" option.)
  • If you choose Limit, you can restrict the duration of the treatment. (This is kind of like the old "Limited 6" and "Limited 12" options, except you can choose any number you want.) This is just an upper limit—we won't be moving teeth slower or faster to hit a particular number. If it takes fewer steps than your limit to reach your prescribed goals, we'll use fewer. If it takes more, you might not reach all of your prescribed goals.

Submitting a case is still free.

When you get your treatment setup, you'll see how many steps are planned. If everything looks good, click Approve. That's when you'll be presented with a choice between Flex or Unlimited pricing options:

Approving treatment setup

Any case can be treated as Flex or Unlimited, regardless of duration. You'll see the exact duration and cost of both options. If you're not sure which one to choose, here are some points to consider:

  • If you want the safest, most predictable option, you can't go wrong with Unlimited. Your costs will be covered for the next five years, no matter what happens. Remember, this now includes up to two sets of retainers every six months.
  • If you want the most affordable upfront cost, that's going to be Flex for all but the longest dual-arch cases. Flex is also a good option if you and your patient are prepared to deal with any additional costs that may come up during treatment.
  • If you want to optimize your overall cost over the entire treatment period, it's a little less clear-cut. With Flex, additional aligners (such as revisions, replacements, and retainers) are priced at the same rate as aligners for new cases. You'll also need a new treatment setup for any revisions. This can vary a lot from doctor to doctor and from patient to patient. Some people don't need anything but what's shown in the initial setup; others start over almost from scratch multiple times. Once these additional costs are factored in, Unlimited can end up being the more affordable option over time for many cases.

There are no strict guidelines, but here are some rules of thumb for the types of treatment that might be best suited for each treatment option:

Flex

  • Minor anterior movements
  • Minor crowding or spacing
  • Relapses from previous orthodontic treatment
  • Minor movements in a single arch
  • Combination treatment (transitioning between traditional orthodontics and clear aligners)

Unlimited

  • Moderate to severe crowding or spacing
  • Midline misalignment
  • Overjet and overbite
  • Open bites
  • Class II and Class III bite relationships
  • Non-compliant patients
  • Patients with potential interruptions, such as military service, pregnancy, weddings, and frequent travel
  • Patients desiring retention with clear aligners after treatment

If you still have questions, we've got answers:

Tech Tip: Tracking Guides

If you've been practicing clear aligner therapy for any length of time, you've likely discovered that some teeth prefer to stay where they are. When you run into this, various factors may be involved, such as an older patient, unusually-shaped teeth, or just a tooth that needs a little more pressure.

We have put together some helpful guides for you on a couple of the more common issues. These guides walk you through checking the various potential factors that may get that tooth moving along as originally planned. You can view both guides here:

troubleshooting_rotationsIncisal_Gaps

Until next time...

Our Tradeshow Calendar for 2015

We’re attending more trade shows than ever this year, including a few international shows for the first time ever!

Check out our schedule below and if we’re going to be in your area, come by and see us. Bring your doctor friends to our booth, once they register and submit a case, you'll both get $100 off your next case.

Chicago Midwinter - Chicago, IL
February 26th-28th, 2015
Booth # 3846

Pacific Dental Conference (PDC) - Vancouver, Canada
March 5th-7th, 2015
Booth # 1354

CEREC Seminar (Ortho and Aesthetic Techniques) - Scottsdale, AZ
March 7th-8th, 2015
Booth # TBD

36th Annual Australian Dental Congress - Brisbane, Australia
March 25th-29th, 2015
Booth # 490

Hinman - Atlanta, GA
March 26th-28th, 2015
Booth # 440

Townie Meeting - Las Vegas, NV
April 15th-18th, 2015
Booth # 200

California Dental Association (CDA) - Anaheim, CA
April 30th- May 2nd, 2015
Booth # 477

Ontario Dental Association (ODA) - Toronto, Canada
May 7th-9th, 2015
Booth # 947

American Association of Orthodontics (AAO) - San Francisco, CA
May 15th-19th, 2015
Booth # 545

CEREC seminar (Updates in CEREC Technology) - Scottsdale, AZ
May 16th-17th, 2015
Booth # TBD

Texas Academy of General Dentistry (AGD) - Austin, TX
June 5th-6th, 2015
Booth # 18 

Florida National Dental Convention (FNDC) - Kissimmee, FL
June 11th-13th, 2015
Booth # 1022

California Dental Association (CDA) - San Francisco, CA
August 20th-22nd, 2015
Booth # 1442

Canadian Dental Association (CDA) - St. Johns, NL
August 27th-29th, 2015
Booth # 94

Northeastern Society of Orthodontics (NESO) - Providence, RI
September 10th-13th, 2015
Booth # TBD

CEREC 30th - Las Vegas, NV
September 17th-19th, 2015
Booth # TBD

Canadian Association of Orthodontists - Victoria, British Columbia
September 17th-19th, 2015
Booth # 28

Southern Association of Orthodontists - Orlando, FL
October 1st-3rd, 2015
Booth # 706

CEREC seminar (ortho & esthetic techniques) - Scottsdale, AZ
October 22nd-23rd, 2015
Booth # TBD

Rocky Mountain Society of Orthodontics (RMSO) - Scottsdale, AZ
October 30th-November 1st, 2015
Booth # TBD

American Dental Associated (ADA) - Washington, D.C.
November 5th-7th, 2015
Booth # 1048

CEREC seminar (Updates in Cerec Technology) - Scottsdale, AZ
November 6th-7th, 2015  
Booth # TBD

Greater New York Dental Meeting (GNYDM) - New York, NY
November 27th-December 12th, 2015
Booth # 4016 

Tech Tip: Tips on submitting a case

Submitting a new case? Here are a few tips:

If you have any other questions about submitting a case, give your account rep a call.

Until next time...

Update: As of March 15, 2016, bite registrations are no longer required in submitting a case to ClearCorrect, and you can watch an updated video on case submission here.

2014: Year in Review

First of all, happy New Year!

We've got plenty of exciting plans for 2015, but we thought it might be helfpul to take a moment first to review some of the improvements we made in 2014 (just in case you missed them).

  • We improved our packaging and paperwork, switching to smaller boxes with included labels for easier filing.
  • We upgraded our treatment setups to increase the quality and usability of this treatment planning tool. Here is a quick summary of the new features:

Color gums & teeth

Models for every step of treatment

3D representations of IPR & engagers

Tooth charts & instructions for every step

Missing teeth & placed engagers on chart

Treatment animation

Embedded link to ClearComm

Better Mac support

Improved interface 

We'll have plenty more to announce soon. Until then, we hope you have a great start to your new year!

Tech Tip: Trimming questions

1. Why do your aligners overlap the gumline?

As we announced in September, we now trim our aligners with a smooth contour, overlapping the attached gingiva. We made this change based on clinical research which demonstrated big improvements to retention using this technique.

New trimming protocol

2. Can I make custom trimming requests?

Unfortunately, we are not able to accept custom trimming requests. We trim all aligners using the same standard protocol. If you want to customize your aligners, you can do so fairly easily in your office with a buffing wheel (like the ones available in our online store).

3. What should I look for if my patient complains of sore gums?

ClearCorrect aligners go through a multi-stage polishing process, so actual rough or sharp edges should be quite rare.

It is fairly common, however, to experience some discomfort for the first few days wearing an aligner. This often indicates that the soft tissue is getting used to having foreign material present in the mouth. Changes to the mucosa eventually fade away when the patient stops wearing aligners.

If the gums are being impinged, one possibility is that the gingiva were not captured accurately in the impression. We prefer 4-5 millimeters of gum to be included. Incomplete impressions will affect our production models.

Frenum_pullYou may also want to look for frenum pulls. These can be difficult to detect because the aligner may feel comfortable at first, but as the patient speaks and moves around, the frenum becomes irritated and ulcerated. Unfortunately this dynamic movement is not captured in the impression. Clear photographs can help to identify these. Gingival frenum pulls are rare, but when they occur, they are typically found in the maxillary premolar and midline areas. If this proves to be a problem, you may want to trim the aligner shorter in the affected areas.

Need a little support?

spidermanClearCorrect is continuing to grow while our commitment to our providers remains the same. To better serve you, we've established a support team that's here to offer help when you need it.

The role of support is to answer your calls and emails in regard to ongoing cases. A support representative can help you with many issues, including:

…and more. Consider us your friendly neighborhood Spider-Man.

Our support reps are here to answer your emails and calls from 7am – 7pm Central at (888) 331-3323 or support@clearcorrect.com.

Until next time...