hey this is dr amanda with straight smile solutions
straightsmilesolutions.com and today i wanted to revisit this topic
how to reduce your invisalign mid-course corrections refinements
this all doesn't just go for invisalign of course this also goes for
clearcorrect reducing their mid courses their
revisions whatever you want to call them in other words how do we get from a to z
correctly the first time around now there seems to be a huge
misconception that revisions refinements mid-course
corrections are normal and they're actually not normal
they're not normal at all it is very possible to have i can't promise you
you'll never have any because things are going to happen right
they're going to be one-offs but your rate
should be very low it should be 10-20 if your rate is above 30 40 50 60
you're doing something wrong and i've made a ton of videos about this so
i just got to keep doing it because i think people just aren't getting
the concept so um i'm using this analogy today because someone gave me this
analogy and um it made sense to me so let's say we
were crossing like a lake okay or a river or whatever
and there was stunt okay let's say that we could space the stones far apart and
we could space the stones really close together would you be more
likely to accidentally fall in if the stones were
close together or far apart right well you'd be most
likely to accidentally fall in occasionally if
the stones were far apart right so the closer the stones are together
the less likely you'll occasionally fall in it's going to happen but it's going
to be less frequently right and i use the same analogy with aligners
okay so let me let me connect the dots here so the
beauty of invisalign comprehensive or clearcorrect
unlimited is that you can speed up to a point or you can slow down the
treatment plan within their own parameters they have a lot of wiggle
room within their own algorithms okay within their own ai
they're gonna give you an attempt but i feel like most of their tents are
lowballing i look at these attempts and i go
very rarely do i think it's possible to do
or predictable to do what they give me on the first round in this few aligners
as they give me sometimes maybe less than 30 of the time
i almost always increase the number of aligners by 50 60
70 80 100 percent double um clear correct someone's like
triple something's like quadruple it's just
like there's no way so the thing is that remember i mean
we're orthodontists so orthodontists tend to have a way lower revision
refinement rate than general dentists who do invisalign or
clear correct i mean that's just we know we know it's predictable we know it
looks right we look at something and we call bs on it if it's not possible
um i don't want my revision refinement rate to be 80
i want it to be zero so yes sometimes i'm gonna slow stuff down
and i'll if the patient ends up being like
crazy crazy you know after a few visits they come back with their first check-in
and they get it like they understand that the aligner
needs to fit like a glove like a second skin
if there's any micro gaps between the aligners and the teeth
they shouldn't progress they need to go back where their previous liner another
week or two until it's fitting and try again they
need to use their chewies and try again i don't even start an
invisalign that one week until it's fitting
and it might take one two three four days to get it to fit with chewies
sometimes sometimes you got to get it seated and
then once you got it seated then your one week starts that is the
key to success and it's very similar to the
analogy of the river rocks being close together and that if you slow down the
treatment plan and you have a little less movement pearl liner and do
more frequent aligner changes nobody's saying
it's much better to do what i'm saying than to do two week wear pearl liner
that's really not going to do anything for you
and that's the secret sauce it's really the secret sauce if you start doing this
don't get so hung up on the two-week changes the one-week changes the
five-day changes the 10-day changes that's not what it is it has really very
little to do with it it has to do with the fit and you know
there's undercuts and there's so many variables there's osteoclasts
there's osteoblasts and there's musculature and there's
compliance which you might get some truth from the
patient and you might not and the patient may actually have no
earthly idea how often they're popping them out of their mouth they might say
they're wearing them 22 but they're only wearing them 12.
they may think they're wearing them 22 and they may lie straight to your face
but they really don't know how often they're actually popping them out
and the more the seesaw effect is happening with the aligners and they're
coming in and out and in and out and in and out
they're really not wearing them enough so hence
the benefit of the smaller and more frequent
stepping stones so you don't fall in if you have smaller steps in between each
aligner it's almost impossible to get off track
as long as the patient is checking in regularly
which is why i love virtual check-ins of course invisalign has a virtual
check-in app you can also use data monitoring you can also use gp ortho
tracking and other ones you can create your own in-house system whatever do
whatever you want if you do a combination of that and
having the patient check in before every aligner change i know it's a lot of
check-ins and you're going to get more emails and you're going to get more
alerts you can have someone in your practice
run it if you don't want to deal with it then pay the extra cost for dental
monitoring system and let them deal with it because their
ai will run this if you have that much volume but you're going to pay for it
you know it's going to be expensive but if you don't have like a ton of
patience like hundreds you might just create your own in-house
or use gp ortho tracking or use in the invisalign virtual system which
is free as long as you opt into it and you're
using on invisalign cases it's very convenient
so yeah these are my tricks and tips okay more stones
less smaller strides you can ask for it all you have to do is ask for it so what
i'll do is i'll take a plant and i'll optimize it i'll get it so i love the
movements looks great looks predictable this will
happen this is possible you know with the attachments we have on
and the movements and everything like that and then i'll say you know what i
see you made this 25 hours can you please take this plan and stretch it out
to a 50 or 40. and then patient comes in
you know they're freaking out oh my goodness this is gonna be 50 weeks well
i like to think most braces cases are a year to two years
or a year to 18 months you know why are you wanting to speed things up so much
it's actually not that healthy for the patient to speed things up
and take such big steps it's not healthy for their bone it's better to have slow
and low more frequent forces than to have
huge undulating swings it's actually that's how you get root resorption
that's how you get bone problems that's how you get mobility
that's how you get discomfort it's better
now of course the aligner companies don't like anything that i'm saying
you know even though you think that they would because
it's actually making more success and it's making less revisions refinements
mid-course corrections which saves them money
and the patients are gonna be happier and the doctors are gonna be happier so
i consider all this a win but it's also gonna cost them more off
the bat because we're taking a plan where the average doctor said okay to 20
and i'm saying make it up 40 which is gonna cost more overhead for
them right because it's unlimited but actually my doctors that do this
they have way less revisions refinements if you pair it the key is you have to
pair it with more virtual check-ins no patient is gonna come into the office
every three aligners during coven it's just not gonna happen so
you're gonna have to create virtual you have to start doing it it's out there
people are using it the doctors that are using it are successful
if you personally as a doctor don't wanna run it then have someone your team
run it and have them grab you to look at the you know
the emails when they come in if that's how you're running it with hipaa
compliant email or whatever the alerts the dashboard whatever you're
using but you have to look at it and you have
to give them the go no go red like green light yes you can change no you can't
change so anyways hopefully this was helpful i
think once you start to get this you'll it'll blow your mind it'll totally
transform any frustration that you have um
with your online treatments but i think the biggest mistake most doctors make
is that they just like oh here's five trays where i'm each for a week i'll see
you in five weeks oh no that's not gonna work
you might have one patient that gets it you know or just gets lucky but you're
going to have four for everyone that are going to go off track and it's going
to end up being so much more hassle especially if you don't have a scanner
it's like a thousand times worse so um time to get a scanner anyways
hopefully that was helpful have a good day and of course go to
straightsmilesolutions.com and ask us any
questions if you haven't alright thank you