StraightSmile Solutions®
Choosing the Best Type of Retainer after Orthodontic Treatment
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The retention phase of orthodontic treatment is one of the most important steps but often one of the most overlooked. Near the end of the treatment, you may want to present your patient with their options for retention. These are explained, along with the risks, benefits, and alternatives. There is no “one size fits all” option for retention. There are four basic types of retainers which we will review in this post.
The Essix®-Type Retainer
Essix®-Type is a classification for clear, thermoformed retainers. There are many other brand names within this classification: Zendura®, Invisacryl®, Vivara®. An Essix®-type retainer lasts on average 1-2 years. If your patient bruxes or has parafunction, you may need to replace it every few months. It’s important that patients understand that retainers are for a lifetime so the patient and doctor need to prepare the workflow and costs for proactively replacing broken or worn-out retainers before a relapse occurs. For this reason, it is not uncommon to sell Essix-type® retention in sets.
The Hawley
The Hawley retainer is an old-school, traditional retainer with acrylic in the middle and a metal wire across the front teeth. Hawleys are durable and can last on average 10-20 years. There are many variations of Hawleys, but my favorite is the wrap-around or circumferential Hawley. This design is helpful to balance and close bites after orthodontic treatment, especially in aligner patients. They aren’t as aesthetically pleasing as the Essix®-type and they do need to be worn 24 hours a day initially.
The Fixed Retainer (aka, Permanent Retainer or Lingual Retainer)
There are dozens of types of fixed retainers but the best ones are 3D-printed or custom-bent in a lab. These are metal wires, bars, zirconia or magnets that are glued onto the lingual of the incisors. Hygiene, caries, and breakage are all an issue with these retainers. If they are improperly placed, they can cause the teeth to move so I encourage custom-made, bonded retainers so that they are totally passive when placed.I like to say if you place a bonded retainer, you should plan on “marrying the patient for life” because the liability is always present. Be sure you’ve worked this into your recall flow and have a compliance and breakage contract in place with the patient. If the fixed retainer breaks without the patient’s knowledge, it can go undetected until the next appointment and hence cause the teeth to relapse. Ultimately, unless you had those compliance contracts in place, the dentist is responsible for treating the relapse.
If you have to wear a permanent retainer, the patient really does need to floss daily in order to maintain proper dental hygiene. Pick your patients carefully for bonded retainers to reduce liability and mitigate risks unless you integrate some kind of virtual recall app into your workflow, like Dental Monitoring®.
The Positioner .
Positioners have been around for 50+ years and are the most overlooked but most effective retention solution. They can either be custom or semi-custom and are excellent retention not only in the Phase 1 to Phase 2 period but also long-term, comprehensive retention. Although they are bulky, they are very effective and can only be worn at night. If a minor relapse occurs, the positioner will correct it. Positioners also help to guide unerupted teeth between Phase 1 and Phase 2 (eruptive guidance) and encourage nasal breathing and proper airways.
Looking to scale ortho? You can click here here to schedule a call.
Check out some of the new services we’ve launched in 2019, too! www.straightsmilesolutions.com/services/
Our YouTube site has a ton of great information on all kinds of orthodontics and tip to save money on lab fees, click here to check it out and subscribe!
DM Blog #3- DM Stability®
I posted an article about measuring orthodontic efficiency in your practice. If you haven’t taken my challenge, please click https://www.straightsmilesolutions.com/blog/challenge/ before you proceed with the rest of the blogs in this series.
If your margin isn’t at least enough on each case, you aren’t doing it efficiently. You should be profiting at least $1500-$2000 on each case. If you aren’t, read on. I’ll be talking about ways to take back control of the profitability of your orthodontic cases by leveraging technology to reduce chair time and lab fees.
I’ve been preaching remote consults and remote aligner check-ins for years with my StraightSmile Solutions® clients. This is not at all DIY or DTC dentistry. It’s actually quite the opposite. It’s just reducing unnecessary chair time and increasing efficiency in your practice.
Dental Monitoring® (DM) is launching a myriad of programs to increase the ROI in your aligner, braces and functional appliance patients. I attended their symposium in Las Vegas this month, and we previewed some of the new products and features that will officially be launched at AAO in May. Today we’ll be focusing on DM Stability®.
This is a new retention-for–life program that is being supported by DM®. Retention is low-hanging fruit for doctors and the opportunity is often dismissed and patients are neglected. Doctors can pay extra for this optional program, but it creates an additional revenue stream. You’ll be able to use the existing DM® services to monitor your patient during the retention period and intervene as soon as the retention starts to need intervention using the app and the doctor dashboard. Doctors may or may not access an additional fee to the service for their patient.
If you’d like to learn more about DM Vision®, be sure to visit AAO in Los Angeles in May or connect with the Dental Monitoring® team. You can email me for an introduction.
Looking to scale ortho? You can click here here to schedule a call.
Check out some of the new services we’ve launched in 2019, too! www.straightsmilesolutions.com/services/
Our YouTube site has a ton of great information on all kinds of orthodontics and tip to save money on lab fees, click here to check it out and subscribe!
DM® Blog #2- DM Vision™
I posted an article about measuring orthodontic efficiency in your practice. If you haven’t taken my challenge, please click here before you proceed with the rest of the blogs in this series.
If your margin isn’t at least 50% on each case, you aren’t doing it efficiently. You should be profiting at least $1500-$2000 on each case. If you aren’t, read on. I’ll be talking about ways to take back control of the profitability of your orthodontic cases by leveraging technology to reduce chair time and lab fees.
I’ve been preaching remote consults and remote aligner check-ins for years with my StraightSmile Solutions® clients. This is not at all DIY or DTC dentistry. It’s actually quite the opposite. It’s just reducing unnecessary chair time and increasing efficiency in your practice.
Dental Monitoring® (DM) is launching a myriad of programs to increase the ROI in your aligner, braces and functional appliance patients. I attended their symposium in Las Vegas this month, and we previewed some of the new products and features that will officially be launched at AAO in May. Today we’ll be focusing on DM Vision®.
This is basically like an iOSim/iTero® product, but it will actually simulate the look of aligners with or without attachments (or braces) on the patient’s actual teeth and face. I can see this being a very powerful tool to help the patient pick the right orthodontic product. We’ve all done Invisalign® cases where the patient was mortified to recognize the reality of how incredibly unattractive a smile full of attachments is. It will also replicate the color and morphology of the actual teeth of the patient so it will look very realistic, unlike other options out there on the market. I believe this is a critical took for explaining the R/B/A of each product (risks/benefits/alternatives) and allowing the patient to make the most educated decision.
If you’d like to learn more about DM Vision®, be sure to visit AAO in Los Angles in May or connect with the Dental Monitoring team. You can email me for an introduction.
Looking to scale ortho? You can click here here to schedule a call.
Check out some of the new services we’ve launched in 2019, too! www.straightsmilesolutions.com/services/
Our YouTube site has a ton of great information on all kinds of orthodontics and tip to save money on lab fees, click here to check it out and subscribe!