Tech Tip: Best practices for treatment setups

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We've put together a summary of best practices for reviewing and approving a treatment setup. This guide covers recommendations on what you can verify, review and communicate as well as treatment adjustment options.

1. Compare to patient photos to confirm that the software has accurately captured the:

  • Articulation of the models and bite registration
  • Midline relationship
  • Overjet 
  • Overbite
  • Canine and molar relationships
  • Shape of teeth 

2. Carefully review the subsequent steps to verify the planned tooth movements are safe and effective.

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3. Verify that any recommended IPR and engagers are sufficient to achieve your goals.

Here are some adjustments you can make, depending on the patient age, dentition and  ease or complexity of treatment:

  • You can slow down difficult movements to help roots stay upright and translate
  • You can adjust the wear schedule to 1, 2 or 3 weeks (1 week wear schedules are often done in combination with accelerated tooth movement technologies)
  • You can adjust your engager preferences
    • Remove or reduce engagers
    • Request vertical or horizontal engagers
    • Specify when to place or remove engagers
    • Add engagers to increase aligner retention (short clinical crowns)
  • You can adjust your IPR preferences
    • Schedule IPR for specific stages
    • Adjust the scheduled amount between 0.1 and 0.3 mm.

You can let the technician know if you are:

  1. Extracting a tooth
  2. Using class II correction techniques
  3. Using any other auxiliaries, such as:
    • Buttons and elastics for extrusions and/or rotations
    • Class II correctors (such as TAD's, Forsus, coils/springs, etc).

Note: If you find yourself frequently requesting standard changes to treatment setups (for example, "add overcorrection" or "end with a digital powerchain"), the best place to do that is on your case submission form. 

When you are done evaluating a treatment setup, you have four options:

  1. Approve the setup, select a price option and start the case
  2. Decline the setup and ask for changes
  3. Decline the setup and submit new impressions or intraoral scans
  4. Decline the setup and cancel the case

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If you want to make an adjustment, 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. 

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If you are inclined to show the patient the treatment setup, you can show them in your office or use the "share link" option to copy the URL and send it to them. 

Tech Tip: Checklist for clear aligner success

In recent surveys, you've said that you want help getting patients in the door.

In response, we've collected the best advice from top providers, account reps and support staff and created this checklistto guide you step-by-step all the way from registering as a brand new provider to promoting your practice. 

Here's an outline of the steps covered in this checklist:

  1. Register as a provider
  2. Prepare your practice
  3. Treat your first patient
  4. Prioritize aligners in your practice
  5. Assign team responsibilities
  6. Market your services to the public

If you're brand-new to ClearCorrect, just start at the beginning and work your way down. If you've already treated a few cases, you may be able to skip ahead. Don't be overwhelmed! You can do this. Just take it one step at a time. Wherever you're at in the process, we hope that this guide helps you take your practice to the next level. 

A PDF version of this checklist is available here.

1. Register as a provider

  • Register at clearcorrect.com/doctors.
  • Log in to the doctor’s portal at dr.clearcorrect.com and familiarize yourself.
  • Watch the Basics of ClearCorrect playlist on YouTube.
  • Visit our Help Center at support.clearcorrect.com and take a look around. This should be your first stop whenever you have questions.
  • Get acquainted with your account rep. Tell your receptionist to expect a call from a ClearCorrect representative within a day or two of registration. You can also call us at the phone number listed in the sidebar of the doctor's portal. 

2. Prepare your practice

  • Gather supplies. You’ll need a way to take and upload high-quality photos.
    • Digital camera or smartphone
    To capture your patients’ dentition, you’ll also need an intraoral scanner or:
    • PVS impression material
    • Plastic impression trays
    We don’t accept alginate impressions, stone models, or metal impression trays.
  • Prepare to place engagers. You might not need this immediately, but as you move into more complex cases, you’ll probably need to place engagers. You can get supplies from store.clearcorrect.com or another vendor. See How to Place Engagers.
  • Prepare to perform IPR. You’ll also probably eventually need supplies for IPR, available from store.clearcorrect.com and other vendors. See How to Perform IPR.
  • Set pricing. Typical patient costs for aligner treatment range from $1,500 to $8,000, depending on the complexity of treatment and what the market will bear. Be sure to allow yourself a sustainable proft margin. Choosing Unlimited treatment keeps costs predictable. Choosing Flex can save money upfront, but allow headroom to accommodate revisions, replacements, and retainers—or prepare your patient for possible future costs.
  • Register for an e-course or live workshop at store.clearcorrect.com. This isn’t required, but we highly recommend it. ClearCorrect offers CE credit for a range of courses on topics related to clear aligners. These courses answer many of the most common questions that our support staff receives. Your staff can take any e-course you take at no additional cost, and they can accompany you to live workshops at a reduced rate.

3. Treat your first patient

  • Start with a simple case. Look for a minor issue that can be corrected in less than a dozen steps, without major crowding that might require interproximal reduction (IPR) or difficult movements that might require engagers. Anterior teeth are easier to correct than posterior teeth, and tipping is easier than extrusion or rotation. You may find it convenient to start with a staff member, a family member, or even yourself.
  • Get informed consent. Every patient should read and sign an informed consent form. Make sure they understand these key points:
    • You, the doctor, are responsible for their care.
    • ClearCorrect manufactures aligners based on your prescription.
    • Patients should contact you if they have any questions or concerns.
    • Any orthodontic treatment carries some risks.
    • No one can guarantee a successful outcome.
    • Aligners need to be worn consistently—22 hours a day, every day.
    • Most people will need retainers after completing treatment.
    • There may be additional costs for revisions, replacements, or retainers.
  • Take photos and impressions or scans. See How to Take Photos & X-Rays and How to Take One-Step Impressions.
  • Submit your prescription. See How to Submit a Case.
  • Review & approve the treatment setup. See Treatment Setups.
  • Teach your patient how to wear & care for their aligners. Instructions are printed on the back of each aligner bag. It is absolutely essential for your patient to understand the importance of wearing aligners consistently. This is the single most important factor in treatment success.
  • Give your patient two sets of aligners and check their progress at each appointment. See Checkups & Revisions.
  • Follow up with retainers after treatment. See Retention.
  • Don’t be afraid to ask for help. From the doctor’s portal (dr.clearcorrect.com) or the Help Center (support.clearcorrect.com.), click the green Help button in the lower-right corner to chat with a support rep. You can also call us or email support@clearcorrect.com. Be prepared with your office email or phone number, and (if applicable) the case number. 

4. Prioritize aligners in your practice

Unfortunately, you probably can’t just sit back and wait for patients to walk in to your practice asking for clear aligners. That might happen occasionally, but most people don’t consider correcting malocclusion until the benefits are presented to them. Here are some of the actions that set successful practices apart:

  • Ask every patient whether they’re happy with their smile. Give every new patient a smile survey with questions like:
    • How would you rate your smile from 1 to 10?
    • What would you change about your teeth?
    • Does it feel like your teeth fit together properly when you bite down?
  • Talk to every patient about clear aligners, regardless of what they come in for. Even if a patient isn’t a good candidate, they may know someone else who is. If they are a good candidate, include aligners in their treatment plan and make sure they have a copy when they leave.
  • Play videos for patients in the waiting and exam rooms to introduce them to the benefits of orthodontics and how clear aligners work. There’s even a waiting room video playlist that can be played on a loop.
  • Tell patients about the benefits of correcting malocclusion. We offer a chart of conditions & benefits that you may want to laminate and keep on hand.
  • Put out promotional materials. Make sure ClearCorrect is visible in every part of your practice. You can order promotional materials from your rep or store.clearcorrect.com.
    • Display brochures in your waiting room and exam rooms
    • Hang posters throughout the office
    • Attach a window cling by your front door
    • Stock your front desk with ClearCorrect pens
    • Teach patients about aligners with a fiipbook and before & after photos
    • Let patients get hands-on with a typodont and sample aligners
  • Update your website. Add information about ClearCorrect to your practice’s website. You can find logos, images, and sample copy at support.clearcorrect.com.
  • Set achievable treatment goals. Start simple and work your way up to treating more difficult malocclusion as you gain experience and confidence with aligners. Even minor anterior corrections can make a big difference in a patient’s self-confidence.

5. Assign team responsibilities

  • Get the whole team on board. Make sure every member of your staff understands their role in the successful implementation of clear aligner treatment. Everyone should be prepared to promote clear aligners to any patient that could benefit from them.
  • Educate your staff. Every staff member should understand the basics of clear aligners and where to get help. They can:
  • Conduct regular staff meetings to review the effectiveness of each individual, and the successful growth of the practice thanks to clear aligners.
  • Distribute laminated cards to your staff outlining roles and responsibilities.

Here are some examples of specific duties you might assign to staff members:

  • Receptionists are usually the first people to welcome new patients, so they must be prepared to discuss clear aligners. They can:
    • Promote your practice as a provider of clear aligners
    • Identify potential clear aligner patients
    • Get patients to fill out a new patient survey/questionnaire
    • Note any interested patients watching videos in waiting room
  • Dental hygienists are in a unique position to identify potential clear aligner patients and initiate a conversation about clear aligners before turning things over to the doctor. A hygienist that's educated thoroughly on the numerous benefits of orthodontics can do a lot of the sales work. They can:
    • Identify conditions that may benefit from orthodontic correction
    • Identify symptoms of occlusal disease
    • Educate patients about how correcting malocclusion can improve oral health
  • Dental assistants play a key role in patient education and promotion of aligners because of their direct, frequent contact with patients. They can:
    • Identify potential patients by asking if there’s anything that they want to change about their smile
    • Perform an initial workup:
      • Confirm that the Informed Consent Agreement has been signed
      • Take impressions/scans
      • Take photos
      • Conduct a chairside examination
      • Fill out an online prescription or pre-submission worksheet
    • Educate the patient about clear aligners:
      • How to wear aligners
      • The importance of following the wear schedule
      • How to clean and care for aligners
      • What to expect regarding engagers and IPR
    • Assist with checkup appointments:
      • Retrieve the next set of aligners for distribution
      • Review the treatment plan
      • Determine whether engager or IPR procedures are scheduled, and if so, ready the required materials and inform the doctor
      • Ask the patient whether they are wearing their aligners 22 hours a day, and whether they are they experiencing any discomfort
      • Document the treatment notes and progress
    • Encourage existing patients to tell their friends about ClearCorrect
    • Enroll in continuing education for clear aligner treatment
  • Treatment coordinators (or office managers) can have an important role in getting new clear aligner patients. In many practices, the treatment coordinator discusses pricing and financing with patients. A treatment coordinator that is comfortable discussing these topics can really help to seal the deal. They can:
    • Discuss clear aligners with patients to identify prospects for the doctor
    • Show patients their treatment plans when needed
    • Discuss insurance, pricing, payment, and financing options
    • Inform patient of their responsibilities with regards to payments, appointments, etc.
    • Follow up with potential patients that were interested in clear aligner treatment
  • Clear aligner manager is not a necessary role for every practice, but some practices find it helpful to dedicate a team member specifically to managing the clear aligner workflow. This could mean additional responsibilities for an existing employee, or a dedicated staff member in a high-volume practice. They can:
    • Work with the doctor to submit clear aligner prescriptions online
    • Alert the doctor when treatment setups are available for review
    • Store and organize boxes of aligners
    • Schedule patients for the delivery of their aligners
    • Order and track revisions
    • Order retainers and replacements
    • Organize marketing and promotion of clear aligners
    • Coordinate with a ClearCorrect representative to get promotional materials and resolve support issues
    • Act as a team leader in motivating other staff members (and the doctor) to make the practice a community leader in clear aligners
    • Work with the practice’s financial manager to administer the costs and fees related to clear aligner treatment
    • Coordinate with the finance company to verify qualified patients and promote to them

6. Market your services to the public

  • Create an on-hold message promoting clear aligners.
  • Send postcards and emails to current and potential patients announcing that you offer ClearCorrect, and promoting specials.
  • Run promotions such as:
    • Free whitening with clear aligner treatment
    • Free initial consultation and treatment setup
    • Free starter kit items (OAP cleaner, Outie tool, Chewies, aligner case)
    • Discounts on aligners or retainers
  • Generate good word of mouth. Hold a staff meeting to get everyone on board identifying actions to create positive referrals.
  • Print referral cards. These can offer services such as free x-rays, exam, and a consultation, and should be distributed to every patient that comes into your office. Be sure to mention the typical cost of these services, to increase the perceived value of the offer.
  • Send bouquets of flowers, cookies, or balloons to patients starting treatment. These can include referral cards along with gifts such as a branded mug, toothbrush, or gift card. Send to the patient’s place of work to create buzz with their co-workers.
  • Always have a staff member in treatment. It’s a great conversation starter, and they’ll be able to speak from personal experience.
  • Make sure your website is up to date and optimized for search engines. You can also invest in paid search results and email marketing. S3SB offers discounted website design and internet marketing services to ClearCorrect providers.
  • Manage your presence on social media. Stay in touch with patients and prospects on Facebook, Twitter, and Instagram, and keep up your reputation on review sites like Yelp, HealthGrades, RealSelf, and Google My Business.
  • Send monthly newsletters promoting current specials and services.
  • Establish a practice mission statement and regular goals.
  • Consider traditional advertising like TV, newspaper, radio, and billboards if they fit your budget and location.
  • Conduct “Lunch and Learn” sessions with other interested professionals.
  • Speak about clear aligners at community meetings, school programs, and other events.
  • Ask your patient financing service to conduct a “soft hit” to identify pre-qualified prospects in your patient database, and target them in your marketing. (If your service doesn’t offer this, consider beWell patient financing, who also offers free registration to ClearCorrect providers with the promo code CCFREE.)
  • Schedule a “ClearCorrect Day” promoting clear aligners and offering discounts for anyone who signs up that day.
  • Hold contests and giveaways to gather leads for potential patients.
  • Give back to the community. Select a cause that will position you better with your targeted audience.

Tech Tip: Predictability of tooth movements

Due to variations between teeth, some are more amenable to certain types of orthodontic tooth movements with clear aligners than others. Here are some rough guidelines to help you choose cases and calibrate expectations.

Basic movements

Clear aligners are particularly-well suited for facial/lingual movements. They excel when there's a broad surface to apply force to, and adjacent retentive surfaces to anchor against.

Moderate movements

  • Distal/mesial movements - if there is inadequate tooth contact with the aligner with the portion of the clinical crown to "push" the tooth in the desired direction, consider adding an engager for additional surface area
  • Most rotations/rotations of lower premolars - ensure there is adequate space to rotate the tooth and consider the position of the tooth root as it is easier to rotate a tooth that is normally inclined. For example, a tooth that is mesially tipped should be uprighted first before attempts to correct its rotation. Conically-shaped teeth, such as mandibular premolars, offer little natural morphology for an aligner to "grip" onto. These teeth commonly require engagers to provide for added morphology.
  • Torquing - evaluate the crown morphology, particularly length of the clinical crowns as these are more easily torqued. Short clinical crowns and lack of defined crown morphology (e.g. bulbous shaped crowns) may be assisted with engagers

More challenging movements

These tooth movements require added attention to details such as the crown morphology, position of the tooth root, available space/arch length to perform the movement and can be assisted with engagers and/or auxiliaries such as buttons and elastics.

  • Extrusions - most effective with single rooted teeth that have a straight root. Also consider the crown morphology and interproximal areas. Triangular shaped tooth crowns and or interproximal areas that allow for the aligner to engage more of the crown may be extruded without engagers. Short clinical crowns, lack of defined crown morphology and multi-root teeth more commonly require engagers
  • Intrusions - consider the morphology and retentiveness of the adjacent anchor teeth. If they do not provide sufficient natural undercut, engagers are often used. ClearCorrect's extended trimline design often provides sufficient retention for intrusion of single rooted teeth without the need for engagers. Intrusion of multi-rooted teeth is extremely rare as this is a very difficult movement and will require engagers on adjacent teeth to assist. 

 For further education on difficult movements and auxiliaries, check out our advanced e-course.

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. 

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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.

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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. 

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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...