dr amanda with straightsmile solutions straightsmilesolutions.com and today we're
going to talk about digital smile design tps eg dsd tps which stands for treatment planning
service basically if you are a general dentist um restorative dentist prosthodontist periodontist
anything but an orthodontist for the most part um you might want to consider using the service
they have not so recently maybe in the next year last year's two or maybe more they have
partnered with invisalign not really sure how that relationship works um and now basically if you are
looking a lot of dentists especially restorative dentists the reason for them to do invisalign
is to have better restorations better position better aesthetics better function
that's the reason they're doing invisalign they're not doing invisalign just to have straight teeth
they're doing it so that they can do a better restoration on their patient because nobody
wants to place a veneer and have it break off you know or look bad nobody wants to play an implant
place an implant and have it not function or not take because the occlusion is bad so basically the
process is is that you're going to go and this is all i could find to be really honest i did contact
dsd um my contact c ceo of dsd i contacted quite a lot of people at dsd so far no response but
granted it's only been a few days so um certainly if they do respond to me a lot of times people do
once they see me post something favorable up on youtube and by the way this is their website so
people at dsd if you don't like what i did or what i said here or something was erroneous you're more
than welcome to contact me as always as with any youtube video i post this is just a like a
phishing youtube video i'm just putting out some information because you guys are asking about it
and clearly the information is not clear to the dentist about how this works because they're
asking me for help um and then hopefully dsd will contact me and i can make more content videos on
how this works because i don't really know so um i have seen a few cases i've had a few doctors who
come to me with cases and it looks pretty slick so obviously it's not something i'm going to do
because i'm an orthodontist and i'm not doing restorations so i'm just moving the teeth um
i'm sure there's a way that if i had a referring dentist that all three of us could be on board and
we could get dsd involved obviously i'm not paying the dsd fee that's the dentist who's doing it
so one of my doctors told me the fee is pretty high it's about 400 to 500 i don't know if that's
true or not um i was like whoa that's really really high for smile design but then again and
that's not even paying for the restorations you know that's just the design component of it but
um not really sure if that's true or not so feel free to reach out to me in the comments section
if you're using vsd and let me know what your fee is i would love to know and i this is literally
all the information i could fall on their website you click the learn more and they just take your
contact information i guess they get back to you so i'll probably fill that out too see what
happens um but basically yeah it's the the way it was described to me is it's reverse engineering
so basically you know that you're going to want some veneers on top you don't know if you need 4
6 2 10 and you know that you need to set up this case so that the staging works to optimize the
veneers do i need overjet do i need overbite do i need ipr basically once you tell them kind of
what you're looking for dsd communicates with the invisalign text to come up with the best possible
setup and then the clincheck is designed around that you know and then i'm guessing at the end
you're committed to purchasing the restorations for them i don't really know how that works how
you pay for it what the deposits are anything like that but like i said it's pretty slick now there
is other options if you don't want to use dsd i don't think that they will communicate directly
with the technicians that invisalign though so now you're going to have to be the intermediary
so i've done other videos where i show you how to export stls that you can send to your lab
now you're going to need to ask your lab if they accept those stls from align tech so that's that's
the question i've heard not all labs do i've heard that it could be expensive to accept scls from
align tech and to design around it so um ask your lab if they do before you click that button and
i do know that when you do click that button it does say if you do not proceed with the clin check
that there might be a fee so that's all it says is a little bit of an ominous i do not know how
much the fee is so again if anyone knows about this go ahead and put it in the comments section
i'm certainly not wanting to take the risk on this although who knows i might if i know a
patient is gonna continue i might just go ahead and click it and see what happens but um as with
invisalign usually they kind of threaten you and they don't always charge you things so as long as
you're a good doctor and you're doing a lot of volume i don't think they're probably going to
charge you but anyways i think it's a cool option if you know you're doing aesthetics the other tip
i have for you if you know you're going to do some type of big restorative case a couple couple tips
number one always always always collect your deposit ahead of time on the restorative i
tell people that all the time i don't care if it's two veneers for veneers whatever correct collect
money up front for the restorations as a deposit because i can't tell you how many times
at least as just a regular orthodontist patient would come in clearly had a bulletin discrepancy
clearly had paid laterals they we need to move around the spaces so that veneers could be placed
on the laterals after treatment i contact the general dentist they say yeah they're gonna
do this um i want the space one-third mesial two-thirds distal fine great yeah we do that um
patients on board they say they're on board they sign that they're on board we get to the end we've
distributed the space just as everyone told me to do looks nice we're done we're ready to d-bond
and patient says oh i changed my mind um can i get that lower incisor out instead or can i get a ton
of ipr instead or can i do sequential distillation instead so that we can close the spaces fully um
and it's like what now this takes me another year and i have to go the other direction and that's
so not healthy for the teeth to have to move them one way and then move them back the other
way and that's how you get root resorption so i want my patients to be fully committed to their
chosen treatment plan so i love the idea of really cementing that treatment plan and i mean you could
theoretically you could totally charge the patient for an additional go around obviously if you
did invisalign comprehensive you're not going to have another lab fee but it's just your time
um and it makes me nervous because i don't want to destroy the roots right but that's my one tip
always get the treatment plan in writing obviously i was doing treatment plan and writing but i
wasn't collecting deposit because i'm not the one that's doing the restorations right
um so just a tip for you on that other tip i would do besides that is make sure you're taking
your photos with the invisalign photo uploader that's an app that you can put on your phone
it's relatively new not new new but kind of new not a lot of doctors are using it a lot
of them are still using um the slr cameras which is there's nothing wrong with that
but then without using the invisalign photo uploader which it goes from your phone or a ipad
or something in the practice it's cool because it crops and orients the photos automatically
really convenient uploads them automatically to the treatment planning program to the clinchack
you know up into the invisalign portal um that's that's pretty slick how it does it but it also has
one added benefit that you might not be aware of there is a widget on your clinch that's called in
face and it has like a little smiley face at the top you'll see it it's usually to the left of the
occluse button which is into the right of the like the max man left right button somewhere in there
um maybe your dashboard looks different than mine but that's what mine looks like
if you use the invisalign photo uploader you can click that button and what it'll actually do
it'll show you where the midline would be what the teeth would look like if you proceed with
that particular clinch which is like so helpful if it's a midline case like or let's say it's a
vertical case with a deep bite and you're doing some absolute intrusion of incisors you know you
want to see how gummy is this mouth to begin with and now what would it look like if we did
some absolute intrusion in the incisors or vice versa for an open bite case i love that function
because i'm like okay i got an open bite case yes i got rid of the habit i got rid of the tongue
thrust with omt ahead of time okay i'm okay to go ahead and proceed with you know and i'm gonna
have to do some absolute intrusion of molars some absolute extrusion of incisors but i don't want
this patient look like a horse you know so how much gingival display what is the what is the
percentage that i want of one versus the other so that is an i mean a great it's a hypothetical tool
it's not an absolute so you can't promise the patient everyone's going to respond differently
but it's a nice gauge it's a nice way to kind of help not only help sell the case but to give you
some boundaries as to exactly what the movements are remember i can't tell you this enough your
technician is not an orthodontist they probably have one or two international orthodontists on
their team but especially if you're a lower level doctor you're not getting an orthodontist even
looking at your case all you're doing all they're doing is driving the bus you're telling them
what they want and if you don't tell them what they want what you want exactly like
whenever i see a case i'm telling them exactly what i want i want ipr here i don't want ipr here
i don't need ipr at all do not do any ipr okay i've got crowding this is how i want to resolve
the crowding i want to flare incisors i don't want to flare in sizers i want to expand arches
i don't want to expand i just i want to add ipr but don't do round tripping i want to add ipr but
do do round tripping you know i want to extract an incisor i want to distalize teeth there's like
five different ways that you can handle crowding and if you do not tell a technician exactly how
you want to do it they're just going to guess and most likely they're just going to expand a pro
climb which isn't always in the best interest of the patient it can cause issues um same thing with
they're they're literally doing a puzzle that's they're getting paid on i'm sure
if i had to guess they're getting paid on production you know they have a certain
quota they have to meet and they're just going to try to race through these cases you know as
quick as possible so i highly recommend that you know you check this out and that you really
evaluate your cases and try to make them ideal all right hopefully this was helpful thank you