StraightSmile Solutions®
When can you STOP wearing retainers? How many Retainer visits should an office offer for free?
When can you STOP wearing retainers? How many Retainer visits should an office offer for free?
I. Introduction
Dr. Amanda from StraightSmile Solutions your go-to resource for orthodontic expertise. If you’re eagerly awaiting the day you can bid farewell to your retainers, brace yourself—it’s not a swift journey. In this exploration, we’re addressing the persistent query that lingers in the minds of many. Whether you’re navigating this as a curious patient or a fellow practitioner seeking clarity, a fresh perspective is in store. Join us as we unravel when to part ways with your retainers. Spoiler alert: it’s a lifelong commitment. But fear not; I’ll guide you through managing this commitment tailored to each unique case. Stay tuned as we delve into the vital realm of retainer checks and discover the magic number for your office’s complimentary checks.
II. When to Stop Wearing Retainers
A. Importance of emphasizing lifelong wear
1. Reinforcement in debonding material and handouts
2. Discussion during office visits, braces tightening, or aligner check-ins
B. Handling patient inquiries
1. Responding with a focus on long-term results
2. Customized approach based on patient needs
C. Factors influencing retainer duration
1. Unique considerations for each patient
2. Exploring options to wear retainers less over time
3. Reference to available content and courses
III. Retainer Checks: How Many and Why
A. Setting the stage for retainer checks
1. Establishing the importance of post-treatment monitoring
2. Addressing the question of free retainer checks
B. Recommended retainer check frequency
1. Initial checks at one-month, three months, and subsequent three-month intervals
2. Emphasizing the flexibility in the number of visits
C. Documenting retainer fit
1. Capturing photos with retainers in and out
2. Importance of documenting perfect outcomes
D. Handling missed retainer checks
1. Initiate communication with patients
2. Documenting attempts to reach patients to avoid future complications
E. Addressing potential relapse
1. Emphasizing the role of retainer checks in preventing relapse
2. Risks of neglecting regular retainer visits
IV. Handling Requests for New Retainers
A. Post-one-year retainer checks
1. Offering free consults for retainer assessment
2. No charge for retainer checks within the first year
B. Dealing with lost or damaged retainers
1. Recommending more than one set-up front
2. Providing options for upgrading to premium retainers
C. Storing digital files
1. Emphasizing the importance of STL final scans
2. Cloud storage options and limitations with aligner companies
D. Encouraging digital file backup
1. Suggesting periodic storage of STL files
2. Preparing for potential long-term retainer replacements
Available resources
1. Mention of Straight wear course and retainer menu
2. Access to forms and documents through memberships, webinars, and document store
V. Conclusion
Dr. Amanda emphasizes the lifelong commitment to wearing retainers for optimal orthodontic results, dispelling any notion of a set timeframe. Regular retainer checks are important, with suggested frequencies and reminders to document patient follow-ups. Dr. Amanda advocates for meticulous record-keeping, including photographic evidence, and offers practical advice on managing retainer replacements. The importance of clear protocols and policies, supported by available forms and resources, is highlighted for orthodontic practitioners to ensure the success and longevity of their patients’ treatments.
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Dec 18th, 2023
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Orthodontics Treatment Plan Options for Premolar Root Agenesis
The Orthodontic Implications of Premolar Root Agenesis in Panoramic X-rays
Taking a panoramic X-ray before starting work on new treatment plans is integral; just one reason is that this can give you a clear insight into the symmetry of your the roots. This can help you determine the most appropriate treatment plan – and understand the implications on orthodontics associated with the asymmetry.
What is Premolar Root Agenesis?
Premolar root agenesis occurs when one of the permanent premolars has not fully formed, either due to slow or arrested tooth growth, meaning that there is very little in the way of root growth (or none at all). In very young patients, there is the possibility that a slowly developing permanent tooth may catch up eventually. However, in older patients with fully erupted 4s, 5s, 7s, and one undeveloped premolar tooth, this will typically be a premolar root agenesis.
Orthodontics Treatment Plan Options for Premolar Root Agenesis
If you have a premolar root agenesis patient to create a treatment plan for, there are a few options. You could have a skilled oral surgeon pull the undeveloped tooth out, or you could leave it stacked with both the baby and the underdeveloped tooth.
However, if you leave it stacked, you likely won’t be able to move the teeth in that area through orthodontics, and if you attempt to move teeth on the other side, you’ll likely want to avoid braces and use clear aligners with a locked area instead. In line with this, delicately extracting the tooth will often be the preferred treatment plan.
Before you extract, it is often worthwhile to delay the treatment plan for a while to ensure that the tooth is no longer developing. However, this will delay the start of orthodontics work.
We strongly recommend consulting with a radiologist and an oral surgeon before starting on premolar root agenesis treatment plans, to find the most appropriate approach for a patient.
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Dec 14th, 2023
12:11 pm
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Tags: pathology, radilology, radiology
IN HOUSE alternatives to My Two Front and SDC Partner Network
IN HOUSE alternatives to My Two Front and SDC Partner Network
I. Introduction
Dr. Amanda from StraightSmile Solutions discusses the challenges of launching orthodontics in a general or pediatric practice, including nervousness, lack of confidence, and needing support. She suggests White Label Aligners as an affordable option, charging only a one-time $90 setup fee and $18 per aligner, with batch printing reducing fees further. Dr. Amanda also advocates for third-party financing options and clinical training programs to facilitate ortho adoption. Additionally, she cites the potential for $300k-400k in revenue through comprehensive ortho offerings. Ultimately, Dr. Amanda stresses that practices can successfully integrate orthodontics through the right aligner partnerships, payment programs, and continuing education.
II. Options for Ortho in GP or Pediatric Dental Practices
A. Two Front, My Two Front, and Invisalign
1. Invisalign requirements
a. 150 new patients or recall patient visits per month per office
2. Use of alternative aligner systems like ITARO
a. Messy and difficult to manage
III. Alternative Aligner Companies
A. White Label Aligners
1. $90 setup fee (one-time)
2. $18 per aligner
3. Batch printing to reduce lab fees
a. First three or five aligners can be used for batch printing
b. Lab fees are reduced to $200 or less every few months
IV. Handling Lab Fees
A. Importance of a white label company that can handle lab fees
1. White label option
a. One-time fee that includes revisions and refinements
b. Lab fees reduced to $200 or less every few months
V. Third-Party Aligner Company
A. Lower cost than Invisalign
1. One-time fee for setup, revisions, and refinements
2. $18 per aligner
B. Benefits
1. Cost savings on lab fees
2. Allows dentists to focus on other aspects of their practice
VI. Potential Benefits of Using White Label Aligner Company
A. One-time fee for setup, revisions, and refinements
B. $18 per aligner
C. Significant savings for dentists with limited financial resources
VIII. Additional Information from Dr. Amanda
A. Benefits of batch printing for aligners
1. Lower cost than traditional methods
2. The company offering service at $18 per aligner, even less for higher volume
B. Third-party payment plan option for collecting money from patients
C. Clinical check service that is easy to learn, taught by Dr. Amanda
D. Advice on communication and education for patients about available options
IX. Two Front Services
A. Ability to collect money, put patients on a payment plan, or build insurance
B. Percentage of production offered, lower than what dentists would receive
C. Caution against building insurance due to potential negative impact on practice reputation
X. Ortho Revenue Potential with Two-Front
A. Offices potentially bringing in $300 to $400,000 in Ortho Revenue
B. Services offered, including aligners, braces, phase one, removables, and fixed braces
C. Introduction to teams for computerizing and placing brackets
XI. Educational Courses and Webinar
A. Phase One educational course
B. StraightWire course covering all necessary knowledge
C. Free Clear Aligner webinar on January 18th, with CE credits
XII. Conclusion
A. Availability and willingness to help with any questions
B. Encouragement to attend the free Clear Aligner webinar on January 18th
C. Emphasis on the benefits of batch printing, increased production, and potential revenue gains.
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Dec 14th, 2023
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Class 3 Treatment Planning Considerations in Males Vs Females with Elevated SNB
Class 3 Treatment Planning Considerations in Males Vs Females with Elevated SNB
I. Introduction
Amanda from StraightSmile Solutions delves into a crucial aspect of orthodontic treatment: addressing the unique considerations for patients based on their biological sex. Focusing on distinguishing between biological males and females, Amanda explores the challenges posed by mandibular prognathism, especially in those with a class 3 tendency. Stressing the importance of meticulous diagnosis and treatment planning, she outlines potential interventions for children exhibiting signs of mandibular prognathism. From lingual arches in mixed dentition to strategic timing of interventions, Amanda emphasizes the need for a proactive approach to prevent potential complications, including jaw surgeries or retreatment.
II. Class 3 Tendency and Treatment Planning Considerations
A. Emphasis on biological factors, hormones, and birth attributes
B. Significance in patients with class 3 tendency, mandibular prognathic, elevated SNB
C. Importance of distinguishing class 3 tendency early on
D. Reference to relevant educational resources on the Straightsmile Solutions website
III. Phase One Course and Free Content
A. Recommendation to take Amanda’s phase one course
B. Availability of free content on the website
C. Phase one playlist for comprehensive information
D. Specific topics covered, such as class 3 treatment planning and metric x-rays
IV. Identifying Class 3 Tendency in Children
A. Age-agnostic approach to identifying class 3 tendency
B. Emphasis on ruling out CRCO shift, capturing SEF, and analyzing SEF numbers
C. Impact of maxillary retrognathism in different populations
D. Consideration of family history in diagnosing class 3 tendency
V. Challenges and Considerations in Girls
A. Likelihood of worsening in girls
B. Age-related considerations in puberty
C. Role of handr x-rays in assessing pubertal growth
D. Caution against overreliance on family history
VI. Challenges and Considerations in Boys
A. Extended mandibular growth in boys with class 3 tendency
B. Possible growth spurts up to age 21-22
C. Need for careful treatment planning to prevent worsening
D. Avoiding premature interventions like excessive IPR
VII. Orthodontic Strategies for Overcorrection
A. Lingual Arch in mixed dentition for leeway space preservation
B. Delaying treatment until after lower third molars eruption
C. Invisalign and sequential distillation for controlled correction
D. Informed consent emphasizing potential need for retreatment
VIII. Informed Consent and Overcorrection
A. Additional informed consent for potential growth-related issues
B. Responsibility disclaimer regarding outgrowing treatment
C. Suggested age for IPR to maintain flexibility in treatment
D. Strategic planning to leave a margin of overjet for potential future growth
IX. Conclusion
Addressing class 3 tendencies in orthodontic treatment requires a nuanced approach, especially when dealing with biological males and females. Understanding the patient’s growth patterns, familial traits, and potential for further mandibular growth is crucial. Treatment planning should be tailored to overcorrect and accommodate potential changes, especially in cases where mandibular prognathism is predominant. Emphasizing the need for proactive measures, such as delaying certain interventions until growth is complete, utilizing appliances strategically, and maintaining flexibility for potential retreatment, is essential. Clear communication with parents about the long-term considerations and the possibility of additional orthodontic interventions can help set realistic expectations and contribute to successful outcomes.
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Dec 11th, 2023
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Bracket Repositioning: How Straight Smile Solutions Can Help
Bracket Repositioning: How Straight Smile Solutions Can Help
In some cases, you might find that your patients need their brackets repositioned, and knowing how to go about this isn’t always easy. After all, there are several ways you can look at bracket repositioning, and knowing the difference is vital. Luckily, as your professional orthodontics consultancy team, we here at Straight Smile Solutions can help.
Tackling Bracket Repositioning in Orthodontics
There are three main ways you can approach bracket repositioning cases: tip, vertical, and occlusal views. You’ll need to first take a progress x-ray, which allows you to look at the root positioning; ideally, you want to make sure these are all parallel. Always consider that distortions are possible, so check any potential problems clinically.
When checking vertical cases, you need to consider factors such as gum line and the bite, as well as symmetry (especially in the upper 2s or 7 and 10).
Meanwhile, for occlusal cases, you’ll need to consider the upper and lower arches (taking a photo at 90 degrees to the occlusal plane helps significantly) and the current positioning of the teeth to see whether repositioning or rotation are needed.
Of course, if you are trying to reposition on a very minor case, this may not make a significant amount of difference in the final results (and could have aesthetic implications for the patient). As such, you may want to leave and monitor these cases, depending on the patient’s preference. However, more significant cases with root positioning issues will need to be addressed as soon as possible.
All of these factors are important to keep in mind when considering bracket repositioning; however, since this can be a lot to think about and consider (and getting the bracket repositioning wrong can have significant consequences for the progress of a treatment plan), our experts here at Straight Smile Solutions can help. Indeed, as orthodontics experts, we can help you determine the most accurate approach for your own cases.
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Dec 10th, 2023
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Can You Leave Impacted Canines in Orthodontic Cases?
When tackling orthodontics cases, there’s a good chance you’ll occasionally come across a trickier situation, and knowing how to create the right treatment plan for these can sometimes be tough. One such example is for patients who have impacted canines – but can you leave impacted canines, or should these be addressed first?
Can I Leave Impacted Canines in Orthodontic Cases?
In some cases, it can be obvious that an impacted canine will cause problems during an orthodontic treatment plan. As such, in situations where impacted canines are likely to cause damage to the surrounding teeth during ortho treatment, you will need to address the impacted canines first. This is most common when canines have erupted near to the roots of other teeth.
However, even if you think it might be possible, you should always get professional advice before you agree to do orthodontics for an impacted canines client. Indeed, if something should go wrong because the teeth haven’t been removed, you’ll be liable.
Even if the impacted canines seem high and low risk, always send the CBDT to a dental radiologist or OS first. In the referral form, ask the specialist whether it would be okay to do an orthodontic treatment plan while leaving the affected teeth impacted. The specialist should then let you know whether there is any risk with such cases; make sure you get this in writing to cover yourself, just in case. Also, make sure there is a section relating to this for the informed consent form to cover your business.
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Dec 6th, 2023
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When do you need to cover erupting 2nd or 3rd molars with an invisible or clear aligner tray?
When do you need to cover erupting 2nd or 3rd molars with an invisible or clear aligner tray?
I. Introduction
Dr. Amanda from StraightSmile Solutions delves into the intricacies of erupting molars, whether in a 12-year-old or an 18 to 19-year-old patient. Whether it’s the emergence of second molars or the arrival of wisdom teeth, vigilance during aligner treatments is crucial. Failing to cover these erupting teeth can lead to complications, affecting the alignment’s thickness and causing unforeseen challenges. This is particularly relevant when molars haven’t fully erupted, necessitating refinements. The importance of a comprehensive approach becomes evident, emphasizing the need to address wisdom teeth mysteries before initiating treatments.
II. Why Erupting Molars Matter
A. Alignment Thickness
1. Two fractions of a millimeter impact
2. Cumulative effect with multiple erupting teeth
B. Mouth Propagation
1. Open mouth effect on erupting teeth
2. Continuous eruption until contact is made
III. Risks of Uncovered Erupting Teeth
A. Super Eruption
1. Increased difficulty in intrusion later
2. Prevention is easier than correction
B. Overlooking Eruption
1. Common oversight in treatment planning
2. Impact on the alignment process
IV. Considerations in Treatment Planning
A. Mixed Dentition Cases
1. Incomplete eruption of second molars
2. Need for coverage even if straightening in aligners
B. Wisdom Teeth
1. Ensure they are either fully erupted or impacted
2. Risks of mid-treatment eruption
V. Refinement and Rescan
A. Wisdom Teeth Mystery
1. Suggest solving before starting treatment
2. Unforeseen refinements may increase costs
B. Comprehensive Cases
1. Advocacy for unlimited or comprehensive cases
2. Avoid limitations on refinements
VI. Wisdom Teeth Management
A. Importance of Early Assessment
1. Wisdom teeth status before treatment initiation
2. Addressing potential complications in advance
B. Refinement Challenges
1. Uneven eruption timing
2. Planning for multiple refinements if needed
VII. Monitoring Eruption Progress
A. Articulating Paper Check
1. Assessing contact with adjacent teeth
2. Ensuring proper alignment during eruption
B. Accusal Plane Level
1. Trigger for coverage initiation
2. Guidelines for covering erupting molars
VIII. Coverage Guidelines
A. Minimum Coverage
1. A bare minimum of one-half
2. Recommended coverage of at least 2/3
B. Tipping Concerns
1. Risks associated with minimal coverage
2. Aim for 100% coverage when planning movement
IX. Contrasting with Braces
A. Brackets Usage
1. Limited use unless necessary
2. Application at the 18 NTI stage
B. Straight Wire Course
1. Different approach to braces
2. Specific circumstances for bracket application
X. Clinical Considerations
A. Reminder to consider all molars, including wisdom teeth
B. Caution against starting treatment without accounting for all erupting teeth
C. Recommendation for comprehensive cases with many refinements
D. Highlighting the need for planning before treatment initiation
XI. Conclusion
It is crucial to closely monitor erupting molars during orthodontic treatment, whether dealing with second molars or wisdom teeth. Neglecting to cover them may lead to complications, such as super eruption, making future adjustments more challenging. Considering the entire dentition, including wisdom teeth, is essential before initiating treatment, preventing the need for multiple refinements. The key is timely intervention when molars are at the occlusal plane, aiming to cover at least two-thirds to ensure effective results. This approach differs from traditional braces, emphasizing a strategic and customized orthodontic plan.
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Dec 3rd, 2023
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Tags: Invisalign, molar, tray
How we Pay our Associates for Invisalign- W2
How we Pay our Associates for Invisalign- W2
I. Introduction
Dr. Amanda from StraightSmile Solutions provides a unique incentive structure to ensure associates provide excellent Invisalign treatment. Associates receive one-third of the production fee upfront when aligners are delivered, and attachments are placed. To receive the remaining two-thirds upon completion, associates must properly manage cases end-to-end, incentivizing accountability and quality care. This model ultimately benefits both patient satisfaction and the practice’s bottom line.
Background on Straight Smile Solutions
1. Website: straightsmilesolutions.com
2. Expertise in Invisalign cases
II. Compensation Structure for Associates
A. Preference for Owner Doctors
● Emphasis on experience
● Exceptions for enthusiastic associates
B. Consideration of Friends and Family Discount
III. Challenges Faced by Owners and Associates
A. Past experiences leading to financial stress
B. Addressing issues like inadequate treatment planning
C. Importance of commitment to case completion
IV. Compensation Breakdown
A. Patient Acquisition and Initial Deposit
● 33% deposit requirement
● Lab fee coverage
B. Aligner Delivery and Attachments
● Start of compensation
● Associates receive 1/3 of their total compensation
C. Incentivizing Case Completion
● Associates only receive additional funds at case completion
● Encouraging proper treatment planning and patient management
D. Photos as Documentation
● Standard practice for accountability
● Aligners in, aligners out, and bite marks documented
V. Patient Costs and Regional Variances
A. Cost considerations in affluent areas
B. $6,500 to $7,500 range for patient charges
C. Inclusion of one set of retainers in the package
D. Discussion on potential upgrade specials
VI. Financing Options
A. 33% deposit as a standard requirement
B. Third-party payment situations
C. Exclusion of in-house financing
D. Consideration of regional economic differences
VII. Alternative Strategies for Affordability
A. White label aligners with batch printing
B. Cost reduction through volume and efficient screening
C. Flexibility based on the economic profile of the region
VIII. Associate Options at Different Stages
A. Associates receive 1/3 of the compensation at the start
B. The remainder is received at the DB bond stage
C. Bonus option for associates who refer cases to owner doctors
IX. Benefits of Compensation Model
A. Incentivizes excellent planning and patient management
B. Ensures associate remains invested through case completion
C. Win-win for associate with referral option
X. White Label Aligners as an Alternative
● Suggestion for cost-effective solutions in Blue Collar areas
● A brief explanation of white label aligners and batch printing
● Importance of volume for reducing lab fees
XI. Addressing Turnover and Case Completion
A. Turnover in the Dental Industry
● High turnover, especially in areas with military presence.
● The burden of completing unfinished cases.
B. Motivating Associates for Case Completion
● Incentivizing proper treatment planning.
● Accountability loop management.
● Avoidance of incomplete cases and subsequent rework.
Conclusion
The innovative approach outlined by StraightSmile Solutions offers a transparent and fair compensation model for associates engaged in Invisalign cases. This approach prioritizes patient accountability and high-quality treatment planning, tries to avoid unfinished cases, and guarantees patient satisfaction. The flexibility in payment structures, including a referral bonus, demonstrates a commitment to collaboration and success for associates and the practice. This strategic approach addresses financial concerns and emphasizes long-term partnerships and exceptional orthodontic care.
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Dec 1st, 2023
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Tags: invisalign production, pay
Easy Lower 2nd Molar Uprighting WITHOUT TADS
Easy Lower 2nd Molar Uprighting WITHOUT TADS
I. Introduction
Dr. Amanda from Straightsmile Solutions offers a simple method for uprighting a lower second molar, requiring the absence of the third molar and visibility of a portion above the gum line. This technique eliminates the need for temporary anchorage devices (TADs) and is effective for younger individuals with molars angled 30-70 degrees. The technique and associated tools, such as the Halterman appliance, are available for detailed guidance. This cost-effective and comfortable alternative is worth considering.
II. Conditions for Uprighting
Two essential conditions for successful uprighting:
● The third molar must be gone and not impacted.
● A portion (30-20%) of the second molar should be above the gum line.
III. Additional Considerations
● In situations where the third molar is completely below, the recommendation is to wait or consider extraction.
● Ideal angulation for successful uprighting (30-70°).
● It is important to ensure no ankylosis through dentistry or CBCT.
IV. Patient Age Consideration
● Ideal age range for the procedure (11-15 years old).
● Prognosis tends to decrease after this age range.
V. Methods of Uprighting
● Possibility of performing uprighting without temporary anchorage devices (tads).
● Mention of using a lower appliance or a “widget” before braces.
● Recommendation to use a Halterman appliance for cases without braces.
VI. Halterman Appliance Description
● Description of the Halterman appliance.
● Placement on the first or sixth molar, depending on braces presence.
● Discussion of lingual arch usage for stability.
VII. Activation Process
● Explanation of the activation process using a canal lever, hook, and power chain.
● Emphasis on extrusive and distal forces applied to upright the second molar.
VIII. Potential Issues and Solutions
● Caution regarding potential problems, such as periodontal defects.
● Recommendation to avoid rapid adjustments to prevent complications.
● Mention the spacer technique and its role in overcoming certain issues.
IX. Duration of Procedure
● Approximate timeframe for the procedure (4-12 months).
● Periodic reactivation every few weeks in the office.
X. Cost and Accessibility
● Cost estimation for the procedure, including lab expenses.
● Affordability and accessibility as compared to alternative methods.
● Positive aspects of cost-effectiveness and patient comfort.
XI. Acknowledgment
● Mention of previous use of similar techniques in dental residency
● Encouragement to explore further resources on the YouTube channel
Conclusion
The Halterman technique offers a viable, cost-effective solution for uprighting molars without needing TADs. The success of this method depends on specific conditions, including the absence of impactions, a portion of the molar above the gum line, and favorable angulation. While not without challenges, the technique provides a more comfortable and affordable alternative to TADs, making it a practical option for certain cases. The step-by-step approach, involving the use of a specialized appliance, offers a promising pathway to achieving desired results, contributing to patient satisfaction and overall oral health.
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Nov 30th, 2023
10:34 am
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Tags: halterman, molar uprighting, TAD
Missing Tooth Cases; Invisalign and Clear Aligners or Braces?
Missing Tooth Cases; Invisalign and Clear Aligners or Braces?
When we think about typical clear aligner cases, we tend to think about patients who have a full set of teeth – however, occasionally, you may have a patient who has recently lost a tooth asking for clear aligners or braces. Knowing how to approach these cases might not always be clear, which is why we’ve outlined some key things to consider today.
Which is Better for Missing Teeth: Clear Aligners (Invisalign) or Braces?
There’s no simple way to say whether you should use clear aligners such as Invisalign or braces with a missing tooth patient. This will generally depend on two things, in particular:
1) Where is the missing tooth located? First, you should consider where the missing tooth is located. If the missing tooth is in the back of the mouth and the patient doesn’t need a pontic, both braces and clear aligners could work.
2) How big is the span? In addition to considering where the missing tooth is located, you should also consider how big the span is (i.e., is the empty space large or small). If the missing tooth has a small span, braces may work, but this could still have complications compared to using clear aligners.
While you can potentially use braces on a missing tooth patient, this may represent a choking hazard, meaning this can have a lot of liability involved. Moreover, when working up to heavier wires, there may be a greater risk of the wires snapping, so a very soft diet will be crucial.
Fortunately, products such as Invisalign can work with missing tooth cases with a pontic, so be sure to keep this option in mind.
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Nov 26th, 2023
12:07 pm
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Tags: missing tooth, pontic