StraightSmile Solutions®

The response to my blog post from last week about the future of Align Technology® has been quite overwhelming. Doctors and industry professionals from around the world have been messaging me with words of support and asking if I’ve finally buried the hatchet with Align Technology®. Mostly, everyone wants to know if Joe Hogan called me. I am excited to let you know that he did reach out! Although I am not able to give more information on the details of the call, I did want to give a big “Hi-5” to Align® for being proactive.

So how did this epic beef start?

Let me tell you a little story that I’ve never really shared with my followers.

Most people know I was on the initial team that launched SmileDirectClub. Love me or hate me for this journey, I am proud to have been an integral part of the disruption that brought down a monopoly, fundamentally changed an industry and provided more access to care. Although I haven’t been with SDC since 2016, a part of me will always be with what I helped to create. Heck, even my own 86 year old mother-in-law knows what a clear aligner is now!

After I left SDC in 2016, I was at a crossroads. I knew the orthodontic profession was rapidly sinking and I feel in love with the freedom of being an entrepreneur. I decided to launch a company that wouldn’t compete with SmileDirectClub but would support dentists and industry professionals wanting to learn more about orthodontics through training and educating doctors and teams. I wanted to learn and teach about all kinds of orthodontic products, not just aligners.

Fast forward 3 years: I now have over 20000 followers on my various social channels. When I first started I only had a handful. I wrote a post about Invisalign® being like the brand Kleenex, eg: it’s the brand name of an industry. It was initially meant to be a compliment, but once I published it, the phone calls started coming in from various contacts from Align Technology® threatening me and demanding me to take it down. My own TM (who I won’t name, because ultimately she was a super-nice individual and I think she was set-up by the powers at be) took me out to lunch, effectively told me I was a “nobody” and gave me an ultimatum: either take it down or she would “cut me off” from the support and collaboration we’d had for years. She left the lunch in a fury and stuck me with the bill. Revenge is best served on a cold platter.

The prophecy was fulfilled. For the past 3 years, I’ve had no collaboration from team Align®. I’ve had to get creative to stay educated and I move on to other systems to educate and support my customers and clients.

So yes, I appreciate Mr. Hogan reaching out and attempting to hopefully bury the hatchet.

That’s the end of the story.  I’ve got a few other bullies to tackle in the industry now!

What’s next?  Stay tuned!

Is your Invisalign®, ClearCorrect® or generic, clear aligner treatment as productive as it could be? I recommend that all of my StraightSmile Solutions® clients run this basic test to calculate the efficiency of your orthodontic services:

1. Run a report of the last five orthodontic cases you’ve completed successfully (D8050-D8090). Calculate the collections and average them. Write the number here: _________

2. Calculate the overhead on each case. The overhead includes:

· The sum of lab fees for all the appliances, aligners, refinements, revisions and retention

· The sum of all supplies used

· The sum of the overhead on the chair time throughout the lifetime of the case (from consult to retention) for both doctor and staff chair time.

· Average the overhead on the 5 cases. Write the number here:____________

3. Subtract 2 from 1. Write the number here:______________

If the 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, stay tuned. I’ll be posting a series of articles over the next few weeks highlighting some tricks and tips about about ways to take back control of the profitability of your orthodontic cases by leveraging technology to reduce chair time and lab fees.

Looking to scale ortho? You can click here to schedule a call: https://calendly.com/straightsmilesolutions/20min

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!

Let’s meet up! Click here for our social links so you can stay up-to-date on future lectures and trade shows to meet our team!

Click here to watch our video

Is your Invisalign®, ClearCorrect® or generic, clear aligner treatment as productive as it could be? I recommend that all of my StraightSmile Solutions® clients run this basic test to calculate the efficiency of your orthodontic services:

1. Run a report of the last five orthodontic cases you’ve completed successfully (D8050-D8090). Calculate the collections and average them. Write the number here: _________

2. Calculate the overhead on each case. The overhead includes:

· The sum of lab fees for all the appliances, aligners, refinements, revisions and retention

· The sum of all supplies used

· The sum of the overhead on the chair time throughout the lifetime of the case (from consult to retention) for both doctor and staff chair time.

· Average the overhead on the 5 cases. Write the number here:____________

3. Subtract 2 from 1. Write the number here:______________

If the 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. I’ve also included some of the existing DM® programs and features so you can fully understand the scope of this system.

1. SmileMate®:

This product will be a game-changer in GP (general practice) and DSO orthodontics. You’ll be able to use this tool to take initial diagnostic photos and have the technology screen the complexity of the case. It will prompt you to refer to an orthodontist, as needed. Each doctor can customize the variables. It’s a great way for an orthodontist to work symbiotically with GPs in their area and to increase the rate and value of their referrals.

2. 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.

3. 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.

4. DM Live®

DM now allows doctors to track not only their aligner patients but also their braces and functional appliance patients with DM®. Patients will scan at home at a regular, predefined frequency of 4-8 days. It will detect everything that could unravel or slow down a case using A.I. (artificial intelligence). You’ll be able to pick from a comprehensive list which has over a hundred different conditions for DM® to screen. Here are just a few:

· aligner unseats

· broken attachments

· poor OH

· inflammation

· passive archwires

· broken brackets

Doctors will receive a daily report on their patients with alerts they can follow-up on with their patients. They can also create a “master monitoring protocol” as a template to personalize communication and preferences. There are turn-key protocols for braces, aligners and phase 1 treatment.

5. AOD™ (Appointments on Demand)

Those using DM® most efficiently are using the AOD™ feature. Gone are the time-consuming and often unnecessary, pre-booked orthodontic appointments. AOD™ patients are only scheduled an appointment when determined by the AI through the DM Scan Box. They have weekly, virtual check-ins from home. We all know that if an aligner treatment design or bracket placement is idealized, the cases just track as-planned. Revisions, refinements, mid-course corrections, wire bends, and bracket repositioning are now a thing of the past.

Many speakers at the DM® Symposium said their revision/refinement rate had dropped from 80-90% down to below 10% in their patients who were fully using DM®. This helps your bottom line immensely and also patient satisfaction. Their average aligner case duration also dropped by 50%. This frees up chair time and allows you to see more production patients. Again, I want to circle back to the quiz you did at the beginning of the blog. How much more production could you make from your orthodontic cases if you were more efficient?

6. Hybrid Treatment

There is nothing new about hybrid treatment but DM® makes the process more streamlined. This is one of the first products on the market that will allow the doctors to transition a case from braces to aligners without that mid-course scan, as long as you had the initial STL file and the weekly AI from DM®. This is a game-changer. The ROI of hybrid treatment is still pretty much an unknown in the GP and DSO arena, but it is the best way to scale your operations and everyone reading this blog can get a head start! Start with a scan and IDB. Use self-ligating braces and an initial 16 NiTi to idealize all the challenging movements like extrusion and rotations over 30 degrees. These mechanics are notoriously difficult to do with aligners. It’s also a great way to open a deep bite and level the arches. Once the wire is passive, as determined by the DM®-AI, you can schedule the patient for debonding and the delivery of the aligners to finish the case.

As a DM® hybrid case, you’d need only three chair side appointments:

1. Initial IDB Scan and records

2. Bonding

3. Debonding/Aligner Delivery (attachments and IPR aren’t likely needed since the difficult movements were already completed in the braces)

Looking to scale ortho? You can click here to schedule a call: https://calendly.com/straightsmilesolutions/20min

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!

Let’s meet up! Click here for our social links so you can stay up-to-date on future lectures and trade shows to meet our team!

Click here to watch our video.

As an orthodontist and dental consultant who has been around the block a few times, most people know me as someone who speaks the truth about the orthodontic industry. I pride myself on throwing punches on where they are due and standing-up for the little guy. Inexplicably, I find myself actually feeling sorry for Align Technology and I wanted to write this blog piece to throw them a small bone.

Joe Hogan, if you’re reading this blog, I truly do like your product and I enjoy having it in my portfolio of services for StraightSmile Solutions®. Nobody holds a candle to the ease of use of your platform or the rapid turn-around times.

There are two main reasons that people doctors are turning away from your product:

1. The culture and snotty attitude of your team

2. How you invoice your lab fee

If I can subscribe to Amazon Prime® yearly and get small shipments on demand, why can’t I pay for my Invisalign® case the same way? The reason why Invisalign® is losing its market share is because of that $1800+ lab fee that has to be paid upfront. Doctors are having to give the average, middle-class patient a personal loan in order to close the case and get it started. The average American doesn’t have $1800 to put down for a deposit. This seems like a no-brainer for Invisalign® to change its billing policies and procedures and allow doctors to start cases with just a set-up fee of $99 and pay for the aligners as you go along. The aligners could be shipped in smaller, more frequent packages on demand and the case could be cancelled at anytime without penalties. A DSO would love this new fee structure because it would allow them to charge the same way they do for braces and would also allow more control over non-compliant patients.

You’re welcome Align Technology®.

Looking to scale ortho? You can click here to schedule a call: https://calendly.com/straightsmilesolutions/20min

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:https://www.youtube.com/straightsmilesolutionsortho to check it out and subscribe!

Let’s meet up! Click https://www.straightsmilesolutions.com/where-is-dr-amanda/media/ for updates on future lectures and trade shows to meet our team!

Click here to watch the video.

The contents of the aligner take-home kit is critically important for your branding for any Invisalign®, ClearCorrect® or Your Own Brand Aligner® case.

The following are the items I suggest in creating a kit:

1. Retractors. You may want to consider an OptraGate™ or single unit retractor instead of dual. Have your patient take photos in the mirror at regular intervals and use Dental Monitoring® or your own HIPPA-Compliant messaging app to review tracking.

2. A Case. Extra bonus if it has a mirror or your branding on it.

3. A flosser. Make sure it fits in the case. It’s very handy.

4. An “outie”. This sample is from Gestenco™.

5. A designated aligner cleaning brush.

6. Chewies

7. Chapstick

8. A nail file for edges

9. Cleaning tablets

10. Take home instructions

If you have questions about orthodontics or launching aligners in your office, please visit StraightSmile Solutions.

Having a child with an overjet (colloquially overbite) malocclusion can a be stressful and confusing experience. It doesn’t help that many doctors disagree about the best treatment practices to correct this bite discrepancy.

1. Early Skeletal Correction- Phase 1 Functional Appliance Correction before skeletal maturity (usually ages 6-9)
2. Late Dentoalveolar Correction- Use rubber bands at the same time as braces (ages 11-14)

Research actually supports both philosophies, but the aesthetic outcome may differ.

Early Skeletal Correction:

Pros:
Early correction and actual skeletal change through the growth of the lower jaw can be obtained easily with removable, functional appliances. Two of the most popular appliances are the Twin Block™ and the Bionator.™ Headgear is another common way to correct overjet, but StraightSmile Solutions® doesn’t support traditional headgear for bite correction because it moves the upper teeth backward instead of forward, which may affect the tongue space or airway volume. More research is still needed to understand all of the possible effects. My professional experience does indicate that children who have early, successful Class II correction are less likely to need premolar extractions and orthognathic surgery as an adult.
The Twin Block™ is a comfortable appliance that can be customized and “blinged-out” to make wearing it more fun for a young child. It looks very much like two retainers. The Bionator™ is a one-piece appliance that may be more challenging to wear at school, but it does have the favorable side effect of helping to correct mouth breathing and oral habits, which may also improve facial aesthetics in the long term.

Cons:
Early treatment often comes with an additional price tag. Many orthodontists charge twice for this set of orthodontic treatments, which pushes the fees to around $6000-$10000 for the whole correction. Timing and compliance (full-time wear) are the key. For the best outcome, these need to be worn up until the peak growth spurt. This can be as early as age 8 in a female and as late as age 15 in a male. Parents often don’t understand the importance of timing with these appliances.

Late Dentoalveolar Correction:

Pros:
The advantage of Class II elastic treatment to correct an overjet is that it usually costs less overall. It can be accomplished with either clear aligners or traditional braces. With clear aligners, intraoral elastics may be worn from the very start, with the first align¬er, which may be a quicker correction. In contrast, with braces you have to wait until about halfway through the braces treatment to initiate the elastics so that the wire is heavy enough to support the forces.

Cons:
Class II elastics are a common treatment modality to correct a Class II dental malocclusion, and their effects are primarily dentoalveolar. That means that bone isn’t growing; the teeth are just tipping to fix the bite. This could be considered a less stable outcome in the long term, and it won’t provide the patient with the accompanying improvement in profile aesthetics.

For support with your orthodontic cases, please visit www.straightsmilesolutions.com.

Tax refund season is here, and orthodontists are getting ready for one of their most profitable times of the year. As the CEO of StraightSmile Solutions®, I am often contacted by consumers looking for honest advice about selecting the best doctor. The Invisalign® Advantage® tiered doctor program can often be confusing for prospective patients, so I am writing this blog piece to set the story straight.

1. Your doctor gets points for every Comprehensive® case he/she submits. He does not get points for “limited”/ “express” cases.

2. The more points your doctor accrues, the more discounts he/she receives on lab fees. Last I checked, private practice doctors can get up to a 38% discount on lab fees if they are diamond providers. This brings the lab fee for a Comprehensive case to about $1150.

3. That discount may or may not affect the fee paid by the patient, but it’s certainly something you may want to bring to the table when negotiating fees.

4. Orthodontists’ offices work like car dealerships. Everything is negotiable, and cash is king. If you are using insurance, you don’t have as much leverage to negotiate.

5. If your doctor is in a group practice or has multiple locations, he or she may be more likely to be a Diamond provider. This doesn’t necessarily mean they have the most experience; it just means they’re better at “playing the game”. It also doesn’t necessarily mean they will give you the best treatment.

6. The best way to get the best treatment from your Invisalign® provider is to ask to see your ClinCheck® before you contract to start treatment or start to pay for it. Ask to have a copy of it sent to you for your records, and ask the doctor to explain your treatment plan. Shop around for the best treatment plan.

7. A doctor who has an intra-oral scanner (not necessarily an iTero® brand) is a good indication of experience, as is a doctor who will sit down to explain your ClinCheck.

8. If your Clincheck® is between 14-25 aligners, ask if there is an option to get generic aligners. Now that many Invisalign® patents are expired, it’s often possible to use a generic brand of aligners, which might lessen the lab fee by $1000 for the doctor. The doctor may be willing to pass some of that savings on to you.

If you are interested in scaling orthodontics in your practice, please visit www.straightsmilesolutions.com.