A thorough review of your patient’s progress at each appointment can help you catch and address treatment issues early on, such as non-compliance or difficult movements not occuring as planned. By keeping an eye out for red flags, you may be able to avoid revisions, keep treatment on track, and get better results faster.
Here's a checklist of things to look for at each appointment:
- Confirm that patient is wearing the correct set of aligners.
- Visually confirm that the aligners fit completely without no incisal gaps or other spaces between the teeth and the aligner. If there is an incisal gap after the aligner has been worn for the recommended time, that may be a sign of incomplete movements. Check out this article for some solutions.
- Verify that your patient can remove the aligners without difficulty. If the aligners are still tight, the patient may need to wear them for another week or two.
- Examine the condition of the aligners. If they still look pristine, that may indicate that the patient hasn't been wearing them regularly. If you suspect non-compliance, address it with your patient.
- Verify that the teeth are moving as planned by comparing the dentition to the current step on the treatment setup.
- Use floss to confirm loose interproximal contacts between all teeth, especially if Compliance Checkpoints are indicated on the treatment plan. Address any tight contacts found.
- Confirm that any engagers are still present and in good condition.
- Confirm that the next scheduled set aligners fits well.
- Refer to the treatment plan paperwork or treatment setup and perform any scheduled procedures, such as performing IPR and placing or removing engagers.
- Try the aligners on again and check for blanching of the gingiva near the trimline. Blanching can occasionally be seen around gingival frenum, but could also be caused by distortions in the original impression. Often these are minor and any discomfort can be addressed by trimming the aligners back slightly with scissors.
- Some clinicians may find it helpful to run a finger along the edge of the aligner to check for sharp edges or areas where it has lifted away from the gingiva.
- Confirm the wear schedule and document the dates when the patient should change aligners and return for a followup appointment.
What are some of the key indicators that a patient is ready to move to the next aligner?
- Full and complete fit of current aligners
- Patient able to easily remove and place current set of aligners
- Loose contacts and spaces closed at Compliance Checkpoints
- Planned tooth movements have occurred
A printable version of this checklist is available on our Help Center.