hey it's dr amanda with street smile solutions street smile solutions.com and today we're going
to talk about avoiding premolar extractions and why i often think invisalign is better
than braces if you're looking to avoid extractions and i'll explain why and again i'd never work for
invisalign online technology i never will never have i actually do i've gotten really good at
the product and i'd love not to be good at it you know because i just hate everything they stand for
but it's a great product so i mean what can i say and there's a lot of other
aligner companies that are also great for more simple cases but when it comes to a super hard
case what it comes down to is the doctor's experience with the product it always cracks me
up and i work with a lot of doctors helping them optimize their treatment plans and a lot of times
you know they'll heal from other orthodontists oh no or or patients will hear from other
orthodontists oh it's not possible to do this with invisalign anytime someone says that i go
let me prove you along wrong it's very rare that i can see a case that quote is possible
or better with braces and not possible with invisalign there's plenty cases that are not
possible without jaw surgery yes i agree with that but with maybe two exclusions
you know there's you're much more likely to have a case that's going to turn out better with
invisalign than braces than the other way around and i'll kind of go over that a little bit more so
what are the cases that would be better with braces i can think of two off the top of my
head and there might be more so certainly if you had an impacted um impacted teeth you know
anything that needs an exposing bond a gold chain and packed a second molar impacted canine easier
with prices i'm not saying you can't do it with invisalign because i have it's just a
million times harder and i'd probably charge a lot more for it um but for any other type of case
actually there's more tricks up your sleeve with invisalign and let me explain why
and a lot of times i doctors have a hard time believing me with this but it is really true
so let's talk about crowning okay so what are the different ways we can fix crowding well
there are many different ways so just simple straightening like in this situation expanding
the arches so right now that that arch is a certain width if you measured the diameter of the
arch from molar to molar you can actually as you straighten with a wire or with invisalign you can
expand the arches if the bone permits if the patient is periodontally compromised maybe not
in a healthy younger patient yes if it's a teenage patient i highly recommend using an expander first
it's going to be much more predictable and much healthier for the patient and give them airway out
benefits and with their airway as well so use an expander first then go into invisalign
but yeah you can expand the arches make them wider okay another way you can do things is
you can procline incisors now you're not always going to want to do that it depends on the bone
it depends on the bite it depends on the lip position you would need a theft in order to know
if you should do that or not you really can't just wing it but that's leaning the front teeth out so
we've got expansion and proclination are two ways we can do both of those with braces and aligners
but now we're going to start getting into some other options that you could only do with a liner
specifically invisalign i haven't some of my white label has been okay with some of these movements
but clearcorrect no sure smell no reveal i don't know um i just haven't seen as good of
outcomes yet i don't feel like their software is predictable for these more difficult movements so
another way that you can go and i have a ton of videos on this so anytime you want to learn more
for one of my videos you can just go into my youtube channel which is
youtube then go into the search bar and put in straight smile solutions and then that will
take you into my youtube channel and then you can put in any keywords so for this keyword i
recommend if you want to know more you can put in the word distalization and the word distillation
will take you to those videos where we're going to learn about what i'm going to talk about next
so one thing you can't easily do with braces is distalization you can do a
tiny bit with an open coil spring they have all these kind of mouse trap appliances you know
these distal jets and stuff like that that you can get but they are the most uncomfortable painful
appliances ever i would never put one i think i have put some in the patient's mouth but that was
back when invisalign wasn't good i would never put one now if someone needed distillation i'd
say sorry you got to do invisalign i'm not doing braces on you too much work so you know and you're
gonna hate it so let's just make you comfortable so what it will do is of course you have to have
you can't have erupted or impacted wisdom teeth in order to use distillation they have to be out
gone and healed and then you could just it's called sequential distillation you're just
scooting this tooth back better on the top there's a lot you can get a few millimeters on the top
scoot this molar back when that's scooted you have a space now then you scoot this back when
that's scooted you have a space now and so on and so on until you've done the whole mouth
it does take time but it really works you can definitely depending on the ridge get a
few millimeters up top and at least a millimeter millimeter half on the lower you can usually get
less because the ramus um but it works very very well so now we've gone over different
ways that we can avoid extractions we've gone over arch expansion proclination distalization
another way is ipr or interproximal reduction i can do that in both invisalign and braces the nice
thing about invisalign is the software quantifies it and stages it for you and finds the best place
to do it with the most enamel and stuff like that um so i feel like it's more accurate basically
with all that assuming you can do all that if it's not a periodontal patient the wisdom teeth are out
there really should never be any need and you know if the patient's young to do extractions you can
totally avoid them so that's why i wanted to let you know that if you've got a super hard case you
really should consider invisalign if someone tells you it's not possible that person is probably not
very experienced in invisalign because in the right hands you know they'll say yes
so if you want to find the best doctor don't even go to the invisalign doctor locator and
you can to get started but you just want to call your orthodontists and even general dentists who
do ortho you know but you know i would at least want to see them as gold or more that's going to
tell you at least they do a fair amount of cases on the doctor locator and ask them you know you
do ortho yes what percentage of your cases aren't are invisalign or clear aligners and if they're
not telling you it's at least 50 then they're not experienced because anyone that is experienced
would do more of it you know because they realize it is probably a superior product over braces
so i'm not gonna say just invisalign i'm gonna say clear aligners because there's a lot of
orthodontist and dentists out there that are doing amazing ortho with just generic white label clear
aligners which are work just as well for a mild to moderate case and the it's like a fraction of the
price the lab fee so that way they can lower the overall fees to the patient and they don't have
to charge them an arm and a leg because invisalign does charge us a huge price in order to use their
product and it goes down as we do more cases but unless you super high on the doctor locator you're
not going to get a volume discount the minimum you can be is gold to get a volume discount so
and it's a minor volume discount if your diamond or whatever it's upwards 38 so that's that's a
pretty sweet volume discount and hopefully they're passing that on to their patients not everyone is
so anyways hopefully this was helpful if you have any other questions about invisalign cases or if
you want help with your invisalign case we'd love you to visit straightsmilesolutions.com thanks