Tech tip: dealing with proclined teeth

In the past we’ve addressed fitting issues resulting from short clinical crowns, but there are other conditions that might affect how securely a patient's aligners sit.

Your patient may have a hard time inserting their aligner properly if they have dramatically proclined teeth flaring out, and after it’s finally been set, the aligner may fit uncomfortably or it may even fall out. We checked in with our Product Quality Director and local tech guru, Sharon Horner, and she made two excellent suggestions. First, she proposes that this problem can be addressed by adding engagers to the first premolars. To request this, select “yes” under the new “Engagers” section of the case submission form. You can specify that the engagers should be placed on the second premolars under “Additional Instructions”.

Sharon also mentioned that dimples placed on the aligner with your Hu-Friedy or Hilliard pliers can give the aligner extra retention and prevent them from slipping or falling off. Just make sure to place the dimples somewhere in the posterior region where they'll be able to properly hug the tooth.

If, at any time after treatment has begun, you discover that engagers are needed, you may request a revision and we’ll be happy to accommodate you!

Tech Tip: A doctor's tip for simplifying extrusions

Extrusions are one of the most difficult movements to achieve with clear aligners. In previous posts, we've discussed a do-it-yourself technique for using a rubber band as an auxiliary. In that technique, you bond a ceramic bracket to the aligner, and a metal bracket to the tooth. You trim the aligner back to make room for the ceramic bracket, and run a 1/4" elastic band between the two brackets to apply force to the tooth.

Dr. Justin Anderson wrote in with a suggestion for improving the technique:

After having trouble getting a bracket to bond to the aligners, I changed to a different method and found better success. Trim back the aligner on the buccal and lingual. (In the original protocol they have you do this just on the lingual). Then bond the porcelain bracket to the tooth on the gingival most aspect of the buccal. Have the patient wear elastics from the bracket on the lingual over the aligner and back to the buccal bracket. This makes the elastics easier to place for the patient and there is less of a chance of de-bonding of brackets.

—Justin Anderson DDS

Thanks for the tip, Dr. Anderson! We're always glad to hear from providers.

We've also heard of doctors cutting two small slits in the aligner on the mesial and distal edges of a tooth and anchoring the elastic band on those slits—another way to avoid bonding the bracket to the aligner.

Whichever technique you use, make sure you trim a little extra so the bracket on the tooth has room to move when it is extruded.

Until next time...

2 things to check at every appointment

As a dental lab, we make aligners according to the prescription we're given. It's up to the patient to wear the aligners 22 hours a day, and it's up to the doctor to prescribe the right treatment and make sure that it's going to plan. Basically, you're James Bond, out in the field, and we're Q, stuck back at the lab, but ready to help however we can.

It's essential for doctors to check their patients' progress throughout treatment. After performing IPR, the treatment plan will usually include Compliance Checkpoints where the doctor can try to floss between specific teeth to confirm that they're moving according to plan. But that's not the only way to confirm a patient's progress. Here are two indicators you should check after every other step:

1. Make sure the teeth match the aligner.

If the aligner is popping up or not seating in an entire area, you can try some of these techniques, such as biting down on Chewies to get it to seat properly. If there's space just around a particular tooth, that's called an incisal gap. Gaps usually occur when a tooth doesn't extrude as planned. (As explained in the case parameters, extrusions are the most difficult type of movement to achieve with clear aligners.) If you see incisal gaps, you can try these techniques, like creating an auxiliary, to apply extra force.

2. Make sure the teeth match the models.

One of the great advantages of ClearCorrect is that we include models for every step. You can compare models to your patient's teeth to evaluate exactly how close they are to the planned treatment. You can also check the treatment plan to see exactly which teeth are supposed to move in each step. (Be sure to match up the step number on the aligner, model, and treatment plan.)

If you check these two things at every appointment, you'll be able to catch any problems that arise early, and you'll stand a much better chance of fixing them easily before they get further off-course. You can always check the Troubleshooting section on the ClearCorrect Wiki for tips, and if you really get stuck, just contact your account rep.

Until next time…

Tech Tip: Reminder - cases close after 1 year of inactivity

We've mentioned this before, but it's worth clarifying: cases don't stay open forever.

After you receive a final scheduled phase (or put a case on hold), you have up to one year to request a revision or final retainer. If we don't hear from you within a year, the case will be automatically closed, and it can't be reopened. Cases are also permanently closed when you request a final retainer.

The cutoff date was originally 180 days after shipping, but we've extended it to a full year to give you extra flexibility.

If your patient requests followup treatment after a case is closed, you can take new photos and impressions (or scans), and submit a new case. The Limited 6 is an ideal, affordable option for simple relapse cases like these.

To learn more about our case closure policies, take a look at sections 3 and 7 of our terms & conditions. Until next time…

Sync your schedule to avoid wasting phases

We try to schedule phases to ship about 12 weeks apart. Each phase includes four steps to be worn for three weeks each, so usually everything works out just fine. Shipping and manufacturing times do change, though, so we do strongly encourage you to wait for a shipping notification before you schedule your patients' fitting appointments.

Sometimes patients' schedules change too. Your patient might go on vacation for a couple of months. Or your patient might have trouble sticking to the 22-week wear schedule, so you have to backtrack a step or two.

If your patient is wearing any steps longer than expected, or taking a break from treatment, it's a really good idea to let your account rep know, so we can reschedule your next phase to be manufactured & shipped right when you need it.

If your schedule gets too far out of sync with ours, phases might start to stack up in your office. If you need to make a reivision, all those unworn phases will be watsted. You might even need to buy more phases to complete the treatment.

For your benefit and ours, please just take a moment to review your cases on ClearComm and see if our schedules are in sync. If we're shipping the next phase while your patient if still wearing step A, let us know. We can adjust our manufacturing schedule to produce aligners more efficiently, and you can leave yourself wiggle room to request revisions without wasting phases.

Refer a friend: it's the easiest $100 you'll ever make

Tell your friends and colleagues to contact us and mention your name. When they submit their first case, you'll get $100 credited to your account. Just remind them of the benefits of ClearCorrect:

  • Up to 40% more affordable than the other guys
  • Made in the USA
  • Excellent customer service
  • Phase-based shipping
  • Leftover phases used to Phase Out unsafe drinking water
  • Flexible treatment options

Address change reminder

It's been over a year now since we moved from our old office on Mitchelldale St. to our current headquarters at 15151 Sommermeyer St. in Houston, but we still get several submissions a week sent to our old address.

If you still have any old shipping labels sitting around your office, please throw them out.

Cases that are shipped to our old office can be delayed by several days or more. Remember, you can submit cases online with free second-day air shipping, and you can always get up-to-date shipping labels from ClearComm or your account rep.

Login improvements

Just a minor announcement this week: we've made some behind-the-scenes improvements to our login process on ClearComm. You can keep using your existing username & password, but now you also have the option to log in using your primary email address as your username:

ClearComm login screen

If you have more than one email address on file with us, you can find out which one can be used to log in on the My Account page.

If you've never used ClearComm, now's a great time to try it out. Give us a call at (888) 331-3323, and we'll be happy to give you or your staff a free walkthrough.

Tech Tip: Track your own unused phases on ClearComm

The first month of our Phase Out project is done, and it's been a big success. You've helped us give more than $10,000 so far—enough to give clean, safe drinking water to more than 500 people for the next 20 years or more.

As we've said before, just the fact that you're doing business with us makes you a part of this movement we're starting to build. But we thought maybe you might want to be able to see a little more about what you personally are doing to help phase out unsafe drinking water.

So now you can see your own contributions on ClearComm. Just click the "Phase Out" button on the right-hand side after you log in, and you'll see right away how many cases you've completed so far, how many leftover phases you had from each, and how much you contributed to Phase Out:

The project just got started a month ago, so you probably don't have tons of cases completed yet. Don't worry. Give it a year, and I bet you'll be floored when you see the difference you've made.

In the meantime, you can always donate and track ClearCorrect's progress at our mycharity: water page.

Phase Out update & limited edition boxes

The response to our Phase Out announcement last week has been really encouraging.

Some doctors have already started suggesting other charities we might want to add to the program. Thanks for all your feedback. We're starting with just charity: water for now, but we'll definitely take your suggestions into consideration as we expand the program in the future.

As you'll see at clearcorrect.com/phaseout, we started with a lump sum donation of $5,000 to make good on our Twitter campaign from last year.

We plan to make our first regular contribution very soon, and follow it up regularly as cases close with leftover phases. As a reminder, we don't close a case and donate the leftover phases until you request a retainer. So please be sure to call your account rep and let us know when your patient is done with treatment.

This is really cool: We've produced a special run of black & yellow aligner boxes, bags, and cases to promote our campaign to phase out unsafe drinking water. The colors were chosen to coordinate with our first partner, charity: water.

Phase Out limited edition packaging

On the bottom of each box, you'll find a brief summary of the Phase Out project. Inside each aligner case (included with Phase Zero), we're inserting cards designed to introduce the campaign to patients.

Hopefully, this campaign will give you an opportunity to explain to your patients how wearing their aligners at least 22 hours every day ensures the best results, which cuts down on the need for midcourse corrections, leaving more leftover phases for Phase Out.

Even if your patients don't end up with leftover phases, they (and you) can always help out by spreading the word or donating directly to charity: water through our mycharity: water profile.