hey it's dr amanda with straightsmilesolutionstreetsmouthsolutions.com
and today is going to be a part two of a series that i did about a year ago about
easy interceptive techniques that are less than 200 that can make a big change in a patient's
potential orthodontic health and future so if money is tight you know here's some easy really
quick appliances that you can just insert let them cook monitor them not much you have to do
um to really help out a patient so that there can be some orthotic improvement without even actively
having to do braces or aligners or anything like that so these photos that i'm showing you here
are just from google search so you can see who the they belong to down below this is the uh the
property um of these different companies here or different people um it's just an easy way for me
because you can't always find stock images nor do i have photos of all these different personal
photos all these different types of appliances but i'm just going to kind of walk you through
some of them and tell you how i'd use them what i'd use them for remember you probably can't build
a d8060 or d8050 for this because you're not fully doing the whole phase one necessarily
you're just putting in appliance to help things so sometimes you know you
i really believe that all patients from age three four five six seven eight
nine should be screened for interceptive ortho the failure of the orthodontics profession is
that we tell patients not to come in till at least age seven which means by time they
actually come in it's eight or nine and often it's too late to use some of these tricks
so if you're a pediatric dentist or a general dentist and you have a patient that maybe doesn't
want to refer to ortho but you know or they're saying i just can't afford phase one i don't
want to use my insurance yet you can put sometimes some appliances in of course you're going to just
charge the patient a fee for that maybe not um bill insurance because i don't think there's a
necessarily unless it's a habit appliance i don't think there's necessarily a code for that because
you're not doing the full interceptive ortho but you know you can bill as needed you know there's
unspecified orthodontic procedure code and other codes um i'd probably bill maybe i mean your lab
fee is going to be less than 200 i'd probably bill 500 if i placed one of these in i mean it's really
taking very little time from me the only lab only chair time is gonna take is the scanning
um i might need to place some spacers about a week before a week to three or four days before
insertion delivery and then just monitoring and removal so the 500 is pretty affordable i think
for most people to make an improvement at least and to wear an appliance for six to twelve months
so let's talk about some of these appliances this is your nance your standard nats we use this as a
standard space maintainer in pediatric dentistry as well as in orthodontics nances are great so
i like to put these in of course if i had an early x loss um early exfoliation of um a baby
molar you know like a or j or one of the lower ones that would be a great idea to put that in
it's also great to use in class 2 cases so places with that have a slight class 2 angles class
2 malocclusion if you place it in before they lose a or j it really really helps because it
holds those sixes or three and fourteen back so that when um four and thirteen come in
these sixes are gonna get held back there's always a little extra e space in there about two two and
a half millimeters so it holds these backs so that we don't slide forward because what usually
happens is when you already have a class two bite in a pd in a mixed dentition child they lose a
and j and then three and fourteen slide forward even more and we went from just a mild class 2 to
a severe class 2. so by holding those at 3 and 14 back with the embracing them with the nance
then naturally you can have some improvement on your own the teeth will start to actually
slide back into the space instead of these moving forward so it helps you it basically eliminates
two to three millimeters of the class 2 correction that you'd have and it takes
a case that could have been really hard and makes it moderate to easy so just by placing this a
little appliance at the right time which would be before you know shortly before a and j come
out you could do a similar thing on the lower in a slight class 3 patient not a class 2 patient with
a lingual holding arch a lower lingual holding art same concept for a slight class 3 patient
so and then if there's you know random spaces that show up or anything like that
then it's good because the random spaces you can also leave it in if you put buckle tubes on here
and brace against it as you close space okay what else do we have here that's useful this
is a anterior bite plate and if you've worked with me before on cases you know i really love these
appliances um it's similar to the nan except the acrylic button here is on the palette the anterior
bite plate the acrylic button is on the front teeth so what you're going to do is you always
want to submit an opposing model when you make one of these because they want to make sure they build
the acrylic ramp in the right position where the lower teeth are going to hit and you would use an
anterior banded anterior bite in a similar way that you use this same sequence of appointments
except for you use this in a patient that had a deep bite so of course when you get braces
on you can put anterior bite turbos on you can level it out if you've got invisalign you can put
bite ramps on but it's always great to fix that deep bite when the patient is still
growing and younger and more compliant you can put this appliance in on a patient with like
a severe deep bite and what it'll do is it'll prop it almost works as like an anterior deprogrammer
it's gonna prop the bite open in the front so that the bottom teeth will level out a little bit more
and naturally open up it also will help you know the airway and other things like that so
definitely recommend the anterior bite plate and by the way a lot of these appliances can be
combined to do more than one thing but obviously and doesn't necessarily make sense to do a nance
anterior bite plate you could do an anterior bite plate tpa that's an option and here's a tpa
nance that's another option all kind of things you can do here's another whoops oh i didn't
know we did that hang on let me fix this um hang on here right here is yeah another nance tba so
probably not super necessary because i think the nas does a pretty good job holding transverse
but that would be something that you could use in a situation where maybe you did some expansion
and the patient didn't want to wear the expander anymore and you want to hold the expansion so that
would be an option for that this is a removable anterior bite plate so it's like this fixed one
that we saw before but it's removable the problem with the removables it doesn't usually get worn
because you know initially obviously the more you wear it you want to be wearing it full time and a
lot of times people take it out to eat and talk and then it's not going to work it has to be in
full time but that is a removable one um and it's a little less discreet and a little more clunky
so yeah so you've seen some of my favorite ones bite plate nance tpa definitely some of
my favorite appliances that you can use to get all kind of cool things that are
fixed less than 200 it can make big improvements in a more difficult case if the patient isn't able
to do pay for the full phase one treatment so just a suggestion and of course you've also got
the whole pile of different my functional products and some of these other ones and i went over these
in my other video i have tons of videos on those all right hopefully that was helpful thank you