about lock-in molars and why you should never ever ever [ __ ] your molars on especially on
Invisalign on clearcorrect on really any aligner system and I know this is going to blow your mind
and it's just totally counter intuitive but let me explain from my 20 years experience
where I don't recommend locking molars I mean there's nothing wrong with doing it as long as
you know what can happen it can actually make things worse and I know you're thinking oh well
moles or Galler and some of these other ones they lock molders that's great I see these cases every
day all day long for the past how 20 years I've been doing this not Melissa Gallard but you know
I've been seeing Invisalign cases and I see what happens when you lock molars so for some reason it
makes things worse and you're gonna sometimes people lock molars because it's a go case or
it's a mullus case or it's a gallery case and that's just the default and they're thinking oh
I'm only moving front teeth what can go wrong lots of things can go wrong first of all even
though you locked molars if you have anterior interferences you can get a posterior open bite
which can make your case go way longer it might have been our 10 or a 15 or a
20 aligner case well now it's an 80 because we have to fix it and if you did some type of light
or go or assist or one of these ones where it doesn't have all the features or all the links
or all the refinements that we need or all the duration that we need in order to fix it you're
gonna pay twice you're gonna pay once and then you're gonna pay again a lot lot more than you
would have have you just done comprehensive and done it right to begin with and this is where I
just find it's just so much more predictable to keep your molars unlocked it doesn't mean
that we have to actively go out of our way to move them but at least they're they're not
they're not static they're Dynamic so if needed we can move them now remember I know I I realize it's
not making sense to you guys and and I I don't even know if I can fully explain it but even
though we locked it and even though it started with occlusion to begin with and even if there's
not anterior interferences a lot of times we get this we get a posterior open bite even though
you locked them and you guys go well I don't understand how this happened I locked them well
it just happens because you have plastic that's over the top of the teeth and what the software
and the AI does not take into account yet I'm not saying they're not planning on doing this I'm not
saying it's not in the pipeline maybe it is maybe it's not is when there's so many variables you're
not even considering you guys are thinking that you're moving teeth in a vacuum and just because
you told something not to do something it doesn't mean it's not going to happen that was a lot of
knots sorry for the double entender but when you have plastic covering the whole teeth and a lot of
other forces remember for every action there's an equal and opposite reaction so think about all the
other forces you have going on you have chewing forces you have biting forces you have clenching
forces you have brux system forces these forces are happening 24 hours a day some harder in some
patients than in others so they're top top they're talking they're grinding they're clenching they're
stressed they're grunting teeth at night and what can happen is the pressure from that plastic can
cause intrusion of a tooth even though if you didn't ask for it it can still happen
and you're going to lose your contact and what you can't do is you can't leave your patient at
the end of treatment with a posterior open bite with an unbalanced bite with more forces on one
side than the other side weird weird weird weird things will happen to the jaw joints to the bite
to canting of the bite you could actually cause damage to the patient permanently
um and I've seen it I've seen it so many times where the yeah maybe now the patient has straight
teeth but you totally messed up their joints in their bite and now they need surgeries and
now they need omt and now this just got really expensive and now this is a liability for you why
because you locked molars so don't lock molars so that's all I've got to say or if you really really
want to lock molars do a comprehensive case so we can unlock the molars later and use all
the features that we need to fix things if things get messed up and the other thing I want to bring
up and if you work with me on a la carte cases or a premium member or a comprehensive member
comprehensive member um as a blanket on all my all my all my things we've got a la carte we've got
premium we've got concierge yes I knew it started with the c if you've worked with me over time and
some of my doctors I've worked with goodness we're going on seven years now it's insane
um and I really appreciate your business but you will see that I will tell you when you're
doing these check-ins whether you're checking in weekly with Invisalign virtual or in hand Dental
or using dental monitoring are you just doing your own in-house HIPAA compliant version or the
patients just coming in every few weeks and you're checking them I always tell you use articulating
paper because I can't tell just because it looks like it's dragging doesn't mean the bike's not
messed up I can't tell if the bite's messed up unless you are either taking scans regularly or
if you are using articulating paper and it always blows I feel so bad sometimes because I get these
doctors they started with a go or they started with a moderate and or they did gallery and it
looks really easy or they're doing maybe they're doing Invisalign three they're in one of those
countries where they have invisaligned three and now all of a sudden the bike got so much worse
just recurring treatment because there was plastic over the teeth and because they locked molars and
now it's going to what it was a 20 aligner cases now a 90 aligner case to fix it and like I said
they're paying twice or maybe they're not maybe they were smart and they did comprehensive which
is great we can fix it but you told the patient four months and now it's a two to three year plan
to fix it because you did damage and that's a liability for you and sometimes there's cool
patients and sometimes there's not cool patients and this can become a very expensive headache
so moral of the story is don't use engines in my opinion do not use moderate in my opinion there's
a couple situations when I'll recommend using it it's very do not use Express in my opinion
do not use light in my opinion do not use go do not use assist to just use comprehensive
and occasionally moderates on certain cases and very occasionally I'll say okay to light
it has to be a crazy easy case no IPR no major movements anything like that and no long bars all
right so that was a long diatribe hopefully you get the idea do not lock mullers thanks