hey it's dr amanda with straight smile solutions straightsmilesolutions.com and today
we're going to talk about something that i see fairly often which is doctors making a mistake
submitting cases into express or light or even go not knowing that they're basically going down
getting themselves in trouble by picking the inappropriate system for that case and i kind
of have my own guidelines as to how i know where to put a case now first of all i always recommend
that you submit your first couple hundred cases into comprehensive only even if you think it's
going to be an easier case because you guys aren't yet trained to know what kind of troubles you can
get into with the case and how with invisalign if you run out of aligners yeah you can pay maybe for
someone who's an additional liners it's an additional fee but after that at some point
if you get underwater and you run out of that expiration date you know lights expiration date
express is expiration date now you have to pay for a brand new case and i see way too many doctors
paying double if not triple and even way more than they would have ever paid if they had just
done a comprehensive case to begin with trust me invisalign doesn't care they do not care if
you have to pay extra that's on you for trying to be cheap and picking an easier plan so let
me explain how and that you should definitely go into my invisalign playlist and especially watch
there is one um video called express so check that out you can go into my youtube channel which is
where you go into your youtube channel put in the search bar straight smile solutions take you to my
youtube channel which has a green banner from there if you scroll down you'll see an invisalign
playlist click around in there or you can search by keyword put the word in express and that will
take you to my express video which kind of goes over how i pick cases for express which is very
rare okay and this is how i want you to pick cases for express so that you don't get underwater
in these cases end up paying more lab fee than you than you bring in and losing money on a case which
totally can happen i consider that gambling is what i do but in any case just a few guidelines
so for anything that's not comprehensive i'm going to take moderate out of the equation
because that there's some wiggle room i we will do some moderate cases but i actually don't want you
guys doing quite yet but a lot of you are trying to do lights and expresses and i say never ever
ever this is really easy first of all any setup that you get from them you always multiply it by
two okay so they say it's 80 lighters is now 16. if they say it's 20 liners it's not 40.
that is my way to make invisalign predictable clearcracks 2.5 but anyways your smile is 2.5 um
also if they say you need ipr it's a no never no no no light no express never ever ever ever
why because any time you have to do a decent amount of ipr i mean if it's one
site point two millimeters okay maybe i'd do a light i would definitely not do an express
absolutely no ipr ever in express okay with light maybe less than a half a millimeter of ipr like
a 0.2.2.2 or something like that or 0.54 one site okay i'm okay with that but beyond that it's a no
because the more ipr you do the more the error comes up you can never quite do ipr perfectly
and anytime you have copious amounts of ipr even moderate rounds of ipr even a little ipr you're
probably going to have a refinement if you have a lot you probably have two to three refinements so
if you know light has one of refinement express has no refinements well express seven has
one refinement but you should never do ipr with express seven then you don't wanna do ipr right
because if you know you're going to have a couple refinements why would you want to pay double
or probably pay extra right so i want to see from my light or my express cases i want to see a slam
dunk perfect result without ipr that the patient is 100 percent satisfied with as well as i'm
going to play the do the doublet so if they tell me the case is 7 now i know i can make
it 14 because i do the double and it has no ipr and it's perfect fine i'll do a light no problem
because i know i get a little wig room with one refinement but if it's a compromise outcome like
patient's fine with leaving a little space behind upper threes you know it's compromised
what happens so often is that the patient's like i really don't like the space after all can we just
add that ipr to the lower now you did the ipr on the express or the light and now you know you have
another refinement on top of that refinement at least one if not two now you're paying more than
you ever did and there's no upgrade option for invisalign i think you guys are thinking there's
an upgrade option where you can call and be like hey can i upgrade to a comprehensive no you get
to pay double you pay all over again so that is why i don't want you to do express or light cases
with ipr very easy to remember perfect contacts you know make sure there's no blue or black dots
no ipr it turned out perfect no anterior contacts at the end put your bite turbos on the
upper top teeth you can't do that in express though but i believe you can do it in light and
make it perfect perfect including the doublet then i'm fine hopefully that makes sense alright thanks