StraightSmile Solutions®
Leaving a Class 3 Patient with Anterior Contacts and Just Straighten the Teeth? Risks and Liability
Orthodontic treatment aims to improve the function and aesthetics of a patient’s smile by correcting malocclusions and aligning the teeth. Sometimes, a patient may present with a Class 3 malocclusion, commonly known as an underbite, where the lower teeth protrude beyond the upper teeth. While straightening the teeth may seem like a straightforward solution, orthodontists must consider the overall occlusal harmony and skeletal relationships to ensure optimal treatment outcomes and mitigate potential risks and liabilities.
A Class 3 malocclusion goes beyond simple tooth misalignment and often involves skeletal discrepancies, meaning the upper and lower jaws do not properly align. Therefore, solely straightening the teeth without addressing the underlying skeletal issues can result in suboptimal results and potential long-term complications. The teeth may be forced into an artificially ideal alignment in such cases, but the fundamental skeletal disharmony must be addressed.
Leaving a Class 3 patient with anterior contacts can lead to several risks and complications. First and foremost, occlusal instability may arise, as the patient’s bite may not function properly due to the mismatch between the upper and lower jaws. This can lead to difficulties in chewing, speaking, and even breathing. Additionally, the excessive strain on the front teeth can lead to tooth wear, chipping, or root resorption over time.
From a liability perspective, orthodontists have a duty of care to their patients and must provide treatment that adheres to the standard of care within the profession. Failing to address the skeletal component of a Class 3 malocclusion and solely focusing on tooth alignment may be considered a deviation from the accepted practice norms. If a patient experiences adverse effects or unsatisfactory results due to this approach, the orthodontist could face legal ramifications and potential malpractice claims.
To mitigate these risks and liabilities, orthodontists must thoroughly examine and diagnose Class 3 patients. This may involve radiographic imaging, dental impressions, and comprehensive treatment planning. Orthodontic treatment for Class 3 malocclusions often requires a multidisciplinary approach involving collaboration with oral and maxillofacial surgeons or other specialists to address the underlying skeletal issues and achieve optimal functional and aesthetic outcomes.
Conclusion
Dr. Amanda from StraightSmile Solutions emphasizes the importance of consulting the dental practice act of your state or country to understand the rules. She recommends this best approach in compromised cases due to past experiences and potential legal repercussions. Dr. Amanda warns that even with signed consent forms, patients may still complain and cause financial and legal troubles. Class 3 patients with severe bite issues are particularly risky, and she refuses to straighten teeth without addressing the bite. Dr. Amanda suggests contacting liability insurance for guidance and potentially creating a specialized document. Only proceed with proper legal protection.
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Jun 8th, 2023
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Taking Compromised Class III And Underbite Patients – Is It Worth It?
Taking Compromised Class III And Underbite Patients – Is It Worth It?
Have you ever wondered, is it worth taking on compromised orthodontic class III or underbite patients? If this is a question you’ve been feeling unsure about, there are a few key things you could consider to inform your decision.
Should You Take a Compromised Orthodontic Class III Case?
Taking on a compromised orthodontic class III case can be tricky, and it’s incredibly important to recognize when you have a compromised case to help inform your decision.
Crucially, before you even consider taking on a compromised case, make sure you’ve started by getting a compromise release form. Indeed, you won’t be able to get these difficult cases perfect with an orthodontic treatment plan alone.
As such, you will need to get coverage from your insurance provider for this sort of scenario and make sure you’ve outlined all of the risks, benefits, and alternatives of the compromised treatment plan in writing, and get this read and signed by your patient to cover your team.
Patients need to understand all of the limitations of a compromised case before getting started, as failing to do so can result in patients demanding a refund (or worse). Don’t take the risk. If you’re unsure, it’s better not to take on compromised cases where you can’t deliver perfect results.
If You Decide to Take The Case
If you decide to take the compromised case on, it’s important to stick to standards of care at every stage and ensure you’ve outlined everything the patient will need to know. Notably, it’s worth considering here that compromised cases should only be done in adults, ideally, once they have stopped growing; children will often be able to get better results with a proper treatment plan since they are still growing.
Compromised cases must always have a CEPH done. This is crucial to ensure you know what you’re dealing with clearly and help inform your treatment plan development.
If you are at all unsure about whether to go ahead with a compromised treatment plan, get professional support from a licensed orthodontist first. It’s not worth the risk.
Find Professional Support For Your Case
If you need professional support for your orthodontic class III case, we here at Straight Smile Solutions can help. After all, we understand that there are many different cases and scenarios, and there’s no simple solution to every case. Nonetheless, you can take steps to inform your decision – so if you need guidance with your particular case, don’t hesitate to book a consultation with our friendly experts!
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Jun 7th, 2023
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Are Black Triangles Bad?
Have you ever wondered whether black triangles are bad in orthodontics cases? If this is something you have been wondering about, our experts can help, and we’ve outlined some key things you need to know about black triangles in orthodontics and whether you need a treatment plan to address them.
What is a Black Triangle?
A black triangle is a relatively common condition that typically occurs with aging. These happen when gaps appear in the gum line, creating the look of a dark black triangle between the teeth. However, while some people may experience these issues, they’re generally not a major problem.
What Causes Black Triangles?
Black triangles are commonly a result of aging. However, they can also be caused by genetics, and many people whose family members have experienced this condition may find they eventually experience the same in themselves, as they age.
Are They Bad?
While it’s easy to assume that black triangles must be a problem, this isn’t wholly the case. In fact, they often don’t need a treatment plan since it’s easier to clean in between black triangles – however, every patient is unique, so make sure to discuss this with them if they’re at all concerned about it. IPR can be used to reduce the appearance of these if needed, though.
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Jun 7th, 2023
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Tags: black triangle, IPR
StraightSmile Solutions Now Offers Direct Access Support on Spark Clear Aligners
StraightSmile Solutions is excited to announce that we now offer support with Spark Clear Aligners. While StraightSmile Solutions is not affiliated with Spark or Ormco, we wanted to offer access to support in order to help providers use aligner systems that we’ve seen good outcomes with.
In this article, we will cover why we chose to offer support for Spark Clear Aligners and how we plan to help providers gain results for their patients.
StraightSmile Solutions Now Offers Direct Access Support on Spark Clear Aligners Treatment Plans
We chose to offer direct access support for Spark because we recommend them. There are a lot of clear aligner brands on the market that don’t deliver outcomes for patients, and at StraightSmile Solutions, we are focused on successfully providing treatment to patients. We’ve found through our research and work with working orthodontists that Spark has good outcomes for their patients, and we want to help providers use Spark in their practice.
There are a few other brands that we work with and that we also recommend. When we compared the outcomes from Spark and the other benefits of the aligner company, we felt confident adding it to our short list of aligner brands that we recommend working with. The others are Invisalign, ClearCorrect, and Global.
Just because we recommend something doesn’t mean it’s always perfect. For full transparency, we don’t love that Spark is a software-based service. But apart from this downside, we love the results providers get, their plans, and the fact that the company does not restrict the number of aligners you request. It’s important to us to specialize in working with aligner brands that we believe in, and we hope to help more providers learn about and successfully use Spark Clear Aligners for their patients.
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Jun 7th, 2023
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When Do You Use a Lower RPE / Expander?
When Do You Use a Lower RPE / Expander?
In orthodontics, a lower removable palatal expander (RPE) is commonly used to correct dental and skeletal issues in growing children. The RPE device applies gentle pressure to the palate and teeth, gradually expanding the upper jaw to create space for proper tooth alignment and improve overall facial symmetry. However, there are instances where a lower RPE or expander with a lower resistance to force is recommended.
When determining the appropriate resistance level, one crucial factor is the child’s dental development stage. A lower RPE with reduced resistance may be used during the early mixed dentition phase, which occurs between the ages of six to nine. At this stage, the primary goal is to guide the growth and development of the jaw while creating sufficient space for the permanent teeth to erupt properly. The orthodontist can gradually encourage jaw expansion without excessive force using a lower RPE or expander.
Children with certain skeletal discrepancies or craniofacial conditions may also benefit from a lower RPE or expander. For instance, in cases of maxillary constriction, where the upper jaw is narrower than ideal, a lower RPE can be used to widen the palate and promote better teeth alignment gently. Similarly, children with cleft palate or other congenital abnormalities may require a lower resistance expander to accommodate their specific needs.
It’s important to note that a qualified orthodontist should make the decision to use a lower RPE or expander after a thorough examination and evaluation of the child’s individual needs. Before recommending the appropriate treatment approach, the orthodontist will consider factors such as the child’s age, dental development, skeletal structure, and existing conditions.
Conclusion
Dr. Amanda from Straight Smile Solutions discusses the topic of expansion in orthodontics, specifically focusing on the use of upper and lower expanders in growing children. Dr. Amanda advises against expanding in adults due to risks and suggests oral surgery instead. However, she recommends using both upper and lower expanders in children with crowding or impactions. The turns and treatment approach frequency may vary, and retention is crucial after expansion. Dr. Amanda stresses the importance of early intervention for proper jaw growth and addressing behavioral issues related to sleep and airway problems. She recommends using eruptive guidance appliances for teeth alignment and bite improvement. Dr. Amanda also highlights the impact of diet and lifestyle on jaw development and recommends exploring resources like the book “Breath” by James Nestor for further information. Her approach aims to expand the arches and promote healthy jaw development in children, considering the effects of modern lifestyles.
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Jun 7th, 2023
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How IPR Works for Additional Aligners with Invisalign
How IPR Works for Additional Aligners with Invisalign
Have you ever wondered about how IPR works for additional aligners (AKA refinements)? If this is something you have been unsure about, don’t panic; our friendly team here at Straight Smile Solutions are on hand to help you learn more about how IPR works to refine additional aligners with Invisalign.
What is IPR?
IPR stands for interproximal reduction. This technique removes a small amount of enamel from the edges of the teeth, thereby allowing slightly more room to correct crowding and the like.
There are several possible applications for IPR with Invisalign. However, before taking on your first case, it’s worth checking how additional aligners actually work in these scenarios.
How IPRs Work for Additional Aligners with Invisalign
When you head to your patient’s ClinCheck history, you’ll be able to view data regarding whether you did IPR for a patient and if you should do more work or not. This question will be asked by the Invisalign team when you submit a request for additional aligners (refinements).
Remember: in many cases, you will need to ask Invisalign directly for a very specific case, such as if you want no more than a certain amount of cumulative IPR or if you’re trying to do posterior work instead. If you’ve already considered redistributing, though, or if you think that doing additional aligners is going to be ineffective for the patient, you could consider elastics.
Final Thoughts
If you have been wondering about how IPR works with Invisalign and how additional refinement aligners are available, today’s guide should have helped. However, don’t be afraid to get in touch with our experts for further guidance on your unique cases, or check out our YouTube channel for more specific examples.
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Jun 6th, 2023
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Tags: Invisalign, IPR, refinement
Why Cloud Storage of Final Models is Important for All Ortho Cases
Maintaining cloud storage of final orthodontic records for braces, aligners, and Invisalign is standard practice amongst orthodontists. However, this practice has yet to become popular among general and pediatric dentists who provide orthodontic services to their clients.
In this article, we’ll discuss why cloud storage has become common practice for orthodontists and why those who don’t currently implement this strategy should consider doing so.
The first reason why cloud storage of final models is the standard of care for final records mandated by your area. Before the creation of digital study models, orthodontists used to keep physical final models for seven years after treatment or seven years after the patient turned 18. Even if your state does not mandate that you hold onto final models for a set period after treatment, there are other reasons why you should.
One of these reasons is risk management. Final models can help you significantly in the event of a complaint to a dental board or an insurance company. Not having these final study models in the event of a complaint can hurt you, especially if mandated by standard of care. Final models will help you to defend yourself against a complaint by ensuring that you have evidence of how the case looked at completion.
Additionally, these final models can help you to continue making money from these clients while having a high standard of care. The final models can be used to assist clients in the event of a lost retainer. While it isn’t perfect, final models can be used to make retainers from clients with braces or aligners, which you can charge for. You can also make bleaching trays and night guards from these final study models, which allow you to continue a good standard of care with your patients.
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Jun 2nd, 2023
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Invisalign Moderate: How to Choose Cases
Have you ever considered using Invisalign moderate on a case? As part of your dentist consultation, it’s important to check the features of your chosen package to see whether you’re taking the right approach for a particular client. Fortunately, we’ve outlined some key things you should know for your case selection on which type of Invisalign (or aligner) product you should use.
When to Use Invisalign Moderate
There are a handful of scenarios in which you may want to use Invisalign moderate, but these will be few and far between for most dentist portfolios and consultations.
Before taking on any case, try to work out how many aligners your patient should need. To add a little flexibility, double this number – and that’s the number of aligners you’ll want to count on to reduce your risk of revisions. If the number is below twenty, you may be able to try a moderate Invisalign plan. However, if the result is higher than this, there’s a good chance that Invisalign doesn’t fit for your patient’s needs.
Moderate for Invisalign should always be for very simple cases, usually once all of the teeth are fully in and erupted already. And don’t forget: moderate cases only include around two years of cover, which can mean patients who relapse aren’t covered.
Choose Comprehensive for the Best Invisalign Before and After
If you have been struggling to work out which option to use, we here at Straight Smile Solutions generally recommend going for the fully comprehensive Invisalign portfolio package rather than opting for moderate. This approach provides a much lower-pressure solution, giving patients less discomfort and more reliable results overall.
If you attempt Invisalign moderate, there may be a good chance that you’ll need to do additional revisions after the case is done. Why take that risk?
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Jun 2nd, 2023
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What to Do at Every Invisalign with MA Appointment?
Invisalign cases that include mandibular advancement (MA) progress differently than standard Invisalign cases without MA, which means the flow of appointments and when you should stop treating with MA. These key differences stem from the process of MA, which pushes the mandible of a growing child forward to stimulate the mandible to grow.
In this article, we will discuss how to address Invisalign cases with mandibular advancement, including when you should refine or stop an Invisalign MA case.
What to Do at Every Invisalign with MA Appointment?
Invisalign cases with MA have two goals, which is why these cases are addressed differently than regular Invisalign cases. Not only are you trying to straighten the teeth, but you are attempting to grow a jaw. At each appointment in an MA case, you should check tracking and bite. To track this progress, we recommend that you take a set of photos with and without the aligners and mark the occlusion. For an MA case, you are looking for edge-to-edge occlusion.
Tracking an MA case is especially important to make sure that things are progressing nicely. Keep in mind that patients’ jaws grow at different rates, which is why it’s important to check tracking and bite at every appointment to ensure you know how things are progressing. You don’t want to skip this crucial step and miss the window for stopping MA. If the jaw has grown, you should measure the difference to avoid anterior interferences.
At this point, it is recommended that you stop the MA portion of the treatment and focus on refining. From there, you can mostly treat this case as a regular Invisalign patient. You may also consider overcorrecting slightly with MA, allowing for slight edge-to-edge as one to two millimeters of relapse is expected.
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Jun 2nd, 2023
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The Link Between Early Gum Disease and Orthodontics and How Invisalign Can Help
When it comes to orthodontics, one issue that many of us overlook is the role of early gum disease in a patient’s treatment plan – and critically, how Invisalign and aligners may be able to help with this. Indeed, the value that aligners can bring to specific periodontal cases is significant, and we’ve outlined some of the key things you need to know as follows.
What is the Link Between Early Gum Disease and Orthodontics?
There are several simple links between early gum disease and orthodontics, and keeping this in mind can help you find out more about how to help your patient’s recovery.
Periodontal diseases can occur when the structures of the teeth are impacted. And, of course, the supporting structures can, in turn, be damaged via gum disease. In these cases, you might find that the patient may need aligners such as Invisalign to help.
There are numerous potential causes of gum disease, though. Poor oral hygiene, smoking, genetic predispositions, and the like can all also increase the risk of gum disease. An unbalanced bite may also cause break down, which can increase the risk of suffering from periodontal problems. Thus, effective orthodontics may be necessary in some cases to help resolve the issues and prevent further complications.
Final Thoughts
If you’ve noticed the signs of early gum disease in a patient, you may be able to help with this by providing Invisalign support. However, make sure to consult with a professional periodontist to help your patient find the optimal treatment plan for their unique case.
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Jun 2nd, 2023
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Tags: periodontal disease