Tech Tip: Patient FAQ's

Patients have questions and it’s nice to have the answers for them. We’ve provided some of the more common questions asked about clear aligners so you and your staff are prepared.

What should I expect during treatment?

While wearing clear aligners is generally not painful, there will be brief periods, days not weeks, when the new aligners may cause the teeth to be uncomfortable.

Expect people to glance at your teeth and ask, “What do you have on your teeth?”

Your ‘bite’ will feel different from time to time while the teeth are in transition.

You may have a lisp at first while becoming accustomed to talking with the aligner on. 

You may have engagers ("buttons") a small bump on the aligner, assisting the aligner to move the tooth. 

Will the aligners hurt? How comfortable are the aligners?

It’s fairly common to experience some tenderness or sensitivity for the first few days of wearing a new aligner. However, the more you wear the aligner the more comfortable they become. Sores and irritation are possible but really don’t occur that often.

The aligners can also sometimes temporarily affect your speech. But most people adapt quickly to wearing the aligners and it is rare that your speech would be impaired for an extended period of time. You may also experience a temporary increase in salivation or dryness of the mouth.

ClearCorrect aligners are among the most comfortable in the industry. Similar to braces, if aligners change too abruptly between steps, they can cause unnecessary discomfort. ClearCorrect aligners employ a unique system which balances your comfort and treatment time.

Are the aligners hard to keep clean? How do I clean them?

No. The aligners are fairly simple to keep clean, however, tooth decay, periodontal disease, decalcification (permanent markings on the teeth) or inflammation of the gums may occur if proper oral hygiene and preventative maintenance are not maintained.

Most aligners can be cleaned with a toothbrush and cool water. A non-abrasive toothpaste is also recommended. Cleaning instructions are on every bag of new aligners.

I’ve seen people with bumps on their aligners – what are they?

Depending on your treatment, it may be necessary to temporarily affix engagers (those bumps) to your teeth. They’re made of tooth-colored composite material and are there to assist with difficult tooth movements. When you’re not wearing your aligners they can feel awkward in your mouth, but don’t worry they’re easy to remove and are only used when absolutely necessary.

How long will I be in treatment?

That depends entirely on the treatment goals you set with your doctor and the amount of correction that needs to be achieved. Treatment time can at times exceed estimates. Poor compliance, missing appointments, excessive bone growth, poor oral hygiene and broken appliances can make treatment time longer, increase costs and affect the quality of your results.

Treatment time can also vary considerably depending on an individual's health and physiology. Much of orthodontic tooth movement relies on metabolism and bone remodeling. Further, the rate of tooth movement is not always linear and also depends on the type of movement being performed. For these reasons, treatment times are estimates based on the doctor's clinical examination findings and experience.

What is the daily wear schedule?

It's recommended that you wear the aligners 22 hours a day. They should be removed for meals only, brushing and flossing before re-inserting the aligner. If not worn for up to 22 hours a day, the corrective process can be halted and within a few hours begin to reverse. It can then take several days for this process to start up again. Wearing your aligners 22 hours a day is key to achieving your treatment goals.  

How long should I wear an aligner before going to the next one? 

The wear schedule is determined by the doctor taking into account the individual's malocclusion, health history, treatment setup and goals. It commonly ranges between 1 and 3 weeks and may not always be the same increment of time during the entire treatment. Compliance with wearing the aligner and type of tooth movement being performed are central factors in determining aligner changes.

What will happen when I’m done with treatment?

While the treatment aligners will have a determined period of wear based upon the treatment goals, the retainers may have to be worn for an extended period of time based upon the condition of the treatment result. The doctor will recommend a retainer wear schedule for you based on your dentition and what correction was done. 

What are the clear aligners made of?

ClearCorrect aligners are made from a plastic which has been specially formulated for ClearCorrect. It is a polyurethane resin that has been crafted and tested extensively to make it a superior plastic for clear aligners: it leads the class in stress retention, crack & impact resistance, clarity, and stain resistance. And, of course, it has been thoroughly tested for biocompatibility. 

Do the aligners contain BPA or phthalates?

No. ClearCorrect aligners are made without BPA or phthalates, and have been approved by the FDA.

I’m pregnant/nursing, can I do clear aligner treatment?

ClearCorrect aligners are free from harmful chemicals and do not pose a significant risk to your health. However, it’s up to you and your doctor to determine if treatment is safe for you.

Until next time...

Tech Tip: Waiting room playlist

If you're looking for something to educate and enlighten patients on clear aligners, we've put this series of videos together just for you. It has been designed to play and loop in your waiting room or you can pick and choose any of the videos to play for patients in the dental chair. 

If you have a prospective patient in front of you, we recommend showing them How clear aligners work and Why you should care about orthodontics?.

This playlist includes:

  • Patient reviews
  • Before and afters
  • How clear aligners work
  • Why should you care about orthodontics 

You can find this playlist on our Youtube channel or you can find it in the practice building section of our help center. To get started, simply click on the image below. 

waiting room playlist.jpg

 

 
 

Tech Tip: Marketing your practice online

Figuring out how to market your practice online can be overwhelming. Here's a summary of how online marketing and a personalized website can increase the number of patients coming through your doors:

S3SB Website.png Website design and maintenance. Your website is your online calling card and most potential patients will judge you completely based on how your website resonates with them personally. Building or updating your website so it is professional, up-to-date and draws customers in is key for obtaining new patients.
S3SB SEO.png Search engine optimization is the process of maximizing the # of visitors to a particular website by ensuring that it appears high on the list of results returned by a search engine. Ranking high in the results is what SEO is all about. Google is the biggest and most popular search engine in today's world, with more than 75% of all internet searches being done through Google. If your website isn't showing up on the first page of a Google search, you're missing out on potential patients.
S3SB Paid Search.png Paid search advertising or pay-per-click means you advertise by paying the search engine you're using (i.e. Google) each time your ad is clicked on. Paid search makes your website visible to people searching for your services even if your ranking is low. With paid search you can create and run Google Ads that target the right location and potential patients. You can also run specific campaigns on procedures such as "ClearCorrect" or "clear braces" or other dental services.
S3SB Social Media.png Social media marketing is the process of gaining traffic or attention through social media sites. The most commonly used social media sites are Facebook, Instagram and Twitter. A higher number of social media followers tends to improve trust, recognition and credibility to potential patients. The most significant benefit is it's humanization element; becoming more humanized is important because people like doing business with other people; not with companies or businesses.

Because we know the struggle is real when it comes to getting more patients in your door, we've recently partnered with S3SB, a prestigious Los Angeles web design and marketing agency, to provide online marketing and practice-building services customized for ClearCorrect providers.

S3 Element-1.jpg 

S3SB offers a full suite of services, including:

  • 20% off a full website design for ClearCorrect providers
  • Updates to existing pages
  • Search engine optimization
  • Paid search ads
  • Reputation management
  • Social media
  • Lead tracking
  • Email marketing
  • Monthly metrics

 

You can call (855) 674-S3SB or click below to receive a free marketing evaluation performed by actual marketing experts, not a computer program.

Request a free marketing evaluation

 

P.S. You know what goes great with a redesigned website? Our Practice Success workshops, where you can learn more marketing tools and tips for building your practice from orthodontic specialist Duane Grummons. Check out our upcoming sessions in Orlando and Chicago. Or you can check out our Practice Enhancement e-course, coming soon!

Tech Tip: Talking to your technician

Depending on your dental school and sometimes from one instructor to another, dental terms and their meanings can vary slightly. This can spell disaster when it comes to prescriptions and moving teeth. 

If you are asking the technician to "tip" a tooth and this means something different between the two of you, you may not get the movement you wanted.

For this reason, we've put together a list of definitions you can refer to when speaking to our technicians. This glossary covers all movements, directions, tooth charts and more. Here are some examples:

You can access the full glossary here

Until next time...

Tech Tip: Auxiliaries and tooth movements

In the majority of cases the aligner itself will do most (if not all) of the work to accomplish the patients treatment goals. However, sometimes auxiliaries are needed.

The term “auxiliaries” as used in orthodontic treatment with clear aligners refers to an entity or item that may be used in conjunction with clear aligners to enhance the movement of, or effect a change in, the teeth or skeletal components.

Some of the more common auxiliaries used in clear aligner treatment are:

1. Bonded brackets or buttons with elastics for:buttons, brackets, elastics.jpg

2. Limited braces

  • Closing anterior and posterior open bites
  • Pre-aligner treatment in the late mixed dentition

3. Expanders for:

  • Skeletal expansion
  • Dental expansion greater than 3-4mms

4. Dimples made with pliers for:

  • Improving retention of the aligner
  • “Nudging” a tooth (rotations, tipping, torqueing)

5. Pontics when teeth are missing for:

  • Esthetics
  • To maintain space pre-restoration

6. Class II correctors and Molar distalizers

7. Temporary anchorage device (TADs)

Where a movement is not being achieved as desired or planned with the aligner alone, auxiliaries can help to effect the desired movement.

Auxiliaries can assist with the following movements:

  • Tipping

  • Torqueing

  • Rotations

  • Extrusions

Until next time...

Tech Tip: Editing your prescription instructions

Occasionally a doctor will call in and ask for a change to be made to a prescription form, a treatment setup or a revision request. 

While support is happy to answer any questions you have about this, there are legal liabilities to us verbally receiving these instructions and forwarding them to the technician. Meaning that we will be required to ask you to log into the doctor's portal and request these instructions directly. 

If you have a treatment setup pending approval, you can update your prescription by declining the treatment setup and communicating the new information to the technician in your notes. If you’ve already approved the treatment setup, you may need to request a revision and make your changes there.

If your treatment setup is not available yet, (it was recently submitted or declined), feel free to contact support for assistance. 

disapproving-setup.png

You will receive an email notification once your new treatment setup is ready to be viewed, either right away, at the end of the day, or at the end of the week, depending on how often you've asked to receive notifications.

Tech Tip: Finishing a case

Doctors often request a revision for some final touch-ups to hone in on the treatment goals. For instance, you might want to request some additional aligners to close a gap or complete a rotation, moving the teeth into their final position.

Determining if treatment is finished to your standards and your patient’s satisfaction once the last aligner has been worn gives you both the opportunity to take advantage of all options for correcting any undesirable issues.

Sometimes, your perception of a nicely finished case is different from the patient’s. When you give the patient an opportunity to express their satisfaction of the treatment result before announcing that treatment is finished, your patient will feel like you care about how they feel about their result.

Identifying potential issues prior to the last aligner

Here are some potential issues and the steps you can take to address them:

1. Residual spaces

residual spacing.jpg

What to do:

  • Review the treatment setup to confirm that there should be no spaces remaining
  • Order a case revision to close the spaces
  • Request a ‘digital power chain’ in a case revision to ensure the remaining spaces are closed (ClearCorrect can adjust the 3D model to lingualize all the spaced teeth by about 0.2 mm, pulling the teeth closer together the same way a power chain does)

2. Incomplete rotations

Patients are most aware of “imperfections” with the upper and lower incisors.

What to do:

  • Continue with the last aligner for an additional couple of weeks – you may want to consider using the ‘dimples’ technique to complete the rotation
  • You can fabricate an in-office reset aligner to complete the rotation or request a remake of this last step
  • Order a revision to complete the rotation

Remember – there must be adequate space to rotate into (see image below) 

3. Teeth are not aligning as expected

In the example below, there’s not enough space to align the upper left central incisor.

 incomplete rotations 2.jpg

A situation like the above requires a revision to provide more expansion or proclination to open sufficient space to optimize the alignment of those incisors; there is too much crowding for IPR.

What to do:

  • Order a case revision to get the remaining alignment needed

4. Irregular or uneven incisal edges and marginal ridges

uneven incisal edges.jpg

What to do:

  • In many cases of mild incisor edge irregularities, conservative enamoplasty to smooth the incisal edges slightly will significantly improve the appearance of the whole smile line and impress the patient with how much better their teeth look.
  • In situations of moderate to severe incisal edge or occlusal wear, restorative dentistry could be of great benefit to provide a better esthetic result

5. Occlusion not fully interdigitated or idealized

class 1.png

Not every case will end up with an idealized, fully interdigitated Class I occlusion like the example above, and not every case needs to. It's up to you and your patient to decide what goals you're happy with. If you are aiming for absolute perfection, it's probably going to take some fine-tuning to get there.

What to do:

  • Order a case revision to achieve the full interdigitation desired

6. Posterior openbite due to intruded posterior teeth.

This is thought to be caused by extreme masseter activity when wearing aligners and is the most commonly proposed etiology, which is an intuitive explanation, but not proven by clinical research.

posterior open bite.jpgposterior open bite after.jpg

What to do:

7. Black triangles

Black triangles can happen with any method of alignment, including traditional braces. This is a natural consequence of alignment correction, so it can't always be avoided.

Black Triangle.jpg

What to do:

  • Alert the patient pre-treatment of the potential if it exists
  • Re-contour (IPR) wide incisal edges
  • Emphasize with patient the importance of an optimum oral hygiene regimen

And thats it for now. Until next time...

Tech Tip: Adjusting a Treatment Setup

treatmant setup.pngWhen you evaluate a treatment setup, sometimes you might want to make some adjustments before you click approve and order your aligners.

For example, if you forgot to mention something on the case submission form, this is your chance to let the technician know.

Or, maybe your prescription was complete, but you want to adjust the position or movements of the teeth once you see them in the setup.

Here are a few examples of adjustments you might want to make:

difficult movement.jpgYou can slow down difficult movements.

Moving less per step can help roots stay upright and translate, rather than lagging behind and tipping. (Of course, the tradeoff is more steps and longer treatment time, so this is where Unlimited pricing really shines.) Our default movement protocol is 0.3 mm per step.

You can adjust the wear schedule to 1, 2, or 3 weeks.

You can choose your wear schedule when you submit the case, but you may want to change this once you see how the teeth are staged. Our technicians can adjust this in the treatment setup, or you can ask our support team to make this change once treatment has started. (This is less important for Flex treatment, but it can affect when Unlimited phases ship, and when legacy cases close.)

You can let us know that you'll be extracting a tooth if you find that you need to create more space than IPR and expansion can handle.

(Remember to translate the teeth slowly to avoid tipping.) You can also request vertical engagers on either side of the extraction site to help keep the roots parallel.

You can tell us about Class II correction techniques that you intend to use, such as:

  • Molar distal rotationclass II.jpg
  • Molar distalization
  • Using elastics with buttons bonded to the aligners (not preferred, but can be done)
  • Using elastics with buttons bonded to the cuspids and molars by manually modifying the aligners

The technician does not need to know exactly when or how you're modifying the aligners, but you should tell the tech that you plan to use elastics so we can properly adjust the angulation of the upper and lower incisors. We don't simulate the effect of elastics, so the setup may not accurately represent all of the Class II correction that you hope to acheive.

You can tell us about any other auxiliaries that you intend to use, such as:

You can adjust your engager preferences.

For example, you can:

  • Remove or reduce engagers (current research indicates that we may not need as many engagers as traditionally thought).
  • Request vertical or horizontal engagers.
  • Specify when to place or remove engagers.
  • Add engagers as anchorage for intrusion and extrusion.
  • Add engagers to increase aligner retention with short clinical crowns.

You can also adjust your IPR preferences.

For example, you can:

  • Schedule IPR for specific stages.
  • Adjust the scheduled amount per appointment between 0.1 to 0.3 mm. Consider the full arch when deciding how much IPR is needed.

If you want to make an adjustment to a treatment setup,click DISAPPROVE and let us know what you want to do. Our technicians will do their best to make any changes you request and upload a new version for your approval within a few days.

You will receive an email notification after your new treatment setup is ready to be viewed, (either right away, at the end of the day, or at the end of the week, depending on how often you've elected to receive notifications).

We hope this helps you tailor each prescription to your patient's needs.

Until next time…

Tech Tip: Impression Materials

When submitting a case with physical impressions, we only accept PVS impressions on disposable trays. For more information on best practices with taking impressions, see the full article here

Per our terms and conditions, alginate impressions, stone models, and metal impression trays will be rejected. These and all other submitted materials become the property of ClearCorrect and will not be returned.

To clarify the reasons for this:

  • Alginate dries out and the material itself can shrink or expand depending on environmental factors. This can make the aligner too big or too small, depending on any changes.
  • Stone models don’t always survive the shipping process. We usually see some sort of chipping, especially along the cusps/incisal edges. Sometimes this can be a whole tooth, but most of the time it will be something minor that’s hard to detect but can still cause fitting issues.
  • Additionally, with stone models, we can’t control the quality of the stone model. The impression can be perfect, but if the pour-up is bad the scan will be compromised. Things like air bubbles can be filled in, but it leaves us guessing at what the shape of the tooth is actually like.
  • Metal trays cannot be run through our scanner, requiring a pour up process which, as mentioned above, is prone to error. 

We hope this helps to clarify why these materials will be rejected. If you have any further questions, feel free to check out the articles relating to this in our help center.

You may also contact our support team at support@clearcorrect.com or at 888-331-3323. 

Tech Tip: Ankylosed teeth

When attempting to move teeth around, you may find yourself dealing with an "ankylosed tooth".

An ankylosed tooth means the root of a tooth is permanently connected to the jaw. It cannot move because the tooth no longer has the protective periodontal ligament around it. The root of the tooth will then become permanently attached to the jaw bone.

Image result for ankylosed teeth

An ankylosed tooth looks exactly like a regular tooth, except that sometimes it may be higher or lower in the gum line. A tooth can become ankylosed while it is still growing out of the gums. When that happens, the tooth is usually shorter due to its growth having been halted mid process.

Medically, it is not known exactly what causes a periodontal ligament to dissolve from around a tooth’s root and cause ankylosis—but something happens that damages the ligament. One of the suspected causes is dental trauma, particularly occlusal trauma.

ankylosed tooth.jpg

There are usually no symptoms or pain with a tooth becoming ankylosed and it is often discovered when examining a patient’s mouth, taking x-rays or when trying to use braces. The only way to handle an ankylosed tooth is to leave it where it is or remove it surgically.

A patient can still get clear aligners if they have an ankylosed tooth. Just keep in mind that clear aligners will only move teeth that are not ankylosed. If a doctor suspects an ankylosed tooth, they can tap on the teeth with a dental mirror. The ankylosed tooth will have more of a solid sound when tapped compared to the dull, cushioned sound of other teeth. It can then be confirmed with X-rays.