amanda with strength smile solutions street smile solutions.com and today we're going to
talk about retention for open bite patients and we're specifically going to be talking
about what you do now before you even listen to this video you have to watch all the rest
of my open pipe videos because i give you tons of tricks and tips on managing them
what to take what not to take how how not to get yourself caught in you know deep in hot water with
these patients so to watch all these pain these other videos you're going to want to go into my
youtube channel not your youtube channel so go to your youtube channel type in straight
smile solutions in the search bar it'll take you to my youtube channel which has a green banner
once you're in there there's a tiny magnifying glass top right not corner but just top right um
you're at the end of the tabs at the top and you type in open byte and it'll bring up all my open
by videos some will be antero bytes so it'll be poster open bite but in any case someone before
a liner so it'll be for braces look through those videos watch them so you can fully understand the
whole story this is the last video in the series of open bite anterior open bite videos retention
so retention is extremely important and like i always tell doctors if you work with me on an
open byte pace no guarantee that if you could even get it closed that we can even retain it
so anytime you have an open byte patient you always always always want to use a special
informed consent i have one on file it's something that i do give for free to any of my clients who
are on the subscription plans if you want access to any of my documents you can get them from the
document store at straightsmile solutions but you always want to cya cover your you know what
to make sure because i can't guarantee if this is going to retain or not even if the patient even
if the patient is the most compliant person in the world it may not retain if there are counter
forces that you haven't controlled like cheeks tongues airways mouth breathing tongue thrusts
extra oil habits it's not going to retain and a lot of you think you've controlled the habits
but you probably have it unless you're using an omt and appliances and all kind of other stuff
it is very very tricky okay so no guarantees so make sure you cover that because i've personally
been stung by this before i thought i had all the right paperwork and that's why i'm so adamant
about this and later the patient complained to the insurance company i did absolutely nothing
wrong i had them sign a compromise for them i told them it may not work they were like
it's fine i just want to try i want to try to improve it as much as i can i understand well
yeah everyone says that until the end when they realize that they might be able to get money back
then they're going to try and then they pull that money for me and i spent two years working on this
and i was very frustrated so after this i said that's it i'm going to either stop doing this
or i'm going to do it much more strict and have all different documentation to
cover me because i don't want to give any more refunds i told you this might not work you know
so i mean the only guaranteed way to control this often is to use omt which is oral myofunctional
therapy to use a habit of plants and or to get a jaw surgery so a lot of times patients don't
want to do those they just say give it a try so anyways let's go back to this so retention
any open bite patient needs to have the most robust retention possible so i often build that
into the fee if i can because it's gonna cost me a lot more and be a lot more effort for me
to put it on and to maintain it so you need a bonded retainer that goes at least three
to three okay so canine decay 9 top and bottom do not make your own bottom retainer send out for it
use an orthodontic lab the retainer must be made passively and if you're just slapping a braid of
wire on it it's not passive you're not doing a good job this is sloppy orthodontics i see it
all the time and it's going to cause more trouble than good have it passively and professionally
made this will cost you a couple hundred dollars so build this into your feet then on top of that
once you have good balance bite on all the back teeth then you also make it asics to go over it
that's really really important okay that you make the acids and then they have a dual retainer
basically you know they wear the the bonded is always on and they wear the essex at night and
when they are home and that usually solves the problem usually that works pretty well but again
we can there's no way any type of retention can counteract the external forces if there
are extra habits going on can't control it okay they're very very strong alright thanks so much