it's dr amanda with straight smile solutions straightsman solutions.com and today as promised
i'm going to make a video with all kinds of talking points to help to guide a patient and or
parent who is on the fence about invisalign versus braces to move in the direction of invisalign
and if you're a consumer and you're listening to this you're probably like oh why is she doing this
listen i've never worked for a line technology invisalign nor would i ever work for them i don't
drink that kool-aid at all however a lot of times patients and parents come into an orthodontic
office or a gp office where you're offering orthodontic services and they have an inherent
bias so i feel it's my job in order to explain the risk benefits and alternatives even if they're
coming in with a preference i'm gonna explain the risk benefits and alternatives completely and then
you can make your choice but nine times out of ten when a patient comes in and you know we always
like to ask initially when they come in hey you know what did you have in mind today did you have
a preference of what you're looking for obviously if they're coming in and their preference is
invisalign boom that's a go then because almost never am i going to say no to an invisalign case
first of all you should always charge the same so it's not a way to make more profit
but it except for a few exceptions which might be like an impacted second molar
i've actually managed to succeed now with impacted canines with invisalign takes a little bit longer
but it's a way better patient experience and you can definitely be successful you
just have to think outside the box so there's really nothing they can't do with invisalign
i'm not going to say it's always be the fastest way but sometimes it is faster
so if they're straight out asking me what's faster most circumstances invisalign will be faster
just because you are changing the liners every five to seven days it's a slower lower force
it's actually healthier for your teeth and gums definitely having there's just there's tons of
research and if you want any of the research on this just talk to your invisalign territory
manager because they definitely have all the r d on this and they have great published studies
that shows i mean this is a no-brainer even as an orthodontist having done a lot of invisalign and
having done a lot of braces okay invisalign is a zillion times better on teeth and gums you know
we have so much serious side effects with braces over the years and i've seen so much damage done
with brackets poor hygiene decay around the edges moving too fast root resorption perio issues that
come from the brackets wires themselves and or the movement being too fast and too strong
remember traditional braces you're usually coming into an office every five to ten weeks having a
tightening done which is a very high force which then dissipates the grades and goes down slowly
over time so that force is really undulating so it's peaking and then it's going down and it's
peaking it's going down and that's why whenever if you've ever had traditional braces you know
the extreme discomfort you're gonna have one two three four five days after your tightening visit i
mean i remember having had braces more than once especially being at high school having braces
i remember that next day after your orthodontic adjustment you were going to be in extreme
discomfort at school not only having new things on rubbing against your gums in your
teeth cutting open your lips bleeding infections mouth sores that kind of discomfort but also just
the achiness because it's such a high force when they come in and they do that adjustment because
you're not changing that aligner at home every five to seven days which keeps the it's still
the same amount if not faster movement it's just it's so much more incremental and gradual that it
doesn't hurt like that nor does it cut up in your mouth and bust it all up and cause mouth source
so i mean i remember being on basically liquid diets it was not abnormal after you got your
braces on to easily lose 10 to 15 pounds of course once you get comfortable you're eating
again and you're putting on the weight but um very very normal to lose a ton of weight the first
matter of fact people would sometimes ask for braces in order to lose weight it was like a
weight loss tool because it's so uncomfortable you can't eat so i mean that just sounds like why put
yourself through torture when you don't have to so of course with the liners you can still
be sore as you change aligners but that usually means that that treatment plan is too aggressive
if you're feeling any more than just like a twinge for an hour or two your treatment plan is probably
a bit too aggressive and whenever i work on treatment plans i tend to slow them way down
do more frequent aligner changes and have smaller incremental steps because it's healthier
for the bones and the teeth than doing a big step every two weeks that's just how i operate
i have seen oh my goodness between my own private patients patients i've seen in different companies
i've worked for as well as now working with straight smile solutions and supervising a lot of
supervising but having a high level view of a lot of progress progress patients from a lot
of doctors who work with me or have hired me i have yet to ever see damage to roots
gums or teeth with invisalign and as far as i know inline technology does say they
don't know of a single root resorption case in invisalign or at least severe i mean reabsorption
meat can be iatrogenic it could be caused due to an inflammatory or autoimmune you know
situation um it could be caused by an infection that's not related to invisalign it could be
you know concurrently happening at the same time that you had invisalign so you can't necessarily
pinpoint that on the invisalign but the frequency of damage that i would see in braces patients was
significantly higher than anything i've ever seen in invisalign and since invisalign's been out for
20 years i feel very confident saying that and i know that the team in the line technology says
the same thing so going back to the original discussion how can you commit to parent or team
i the first thing i say is you know let's let's talk about your life
you know let's talk about daphne we could do braces we could do aligners let's talk about
what's that's what's that life like in your life i want to know a little bit more about you
what you do what's your average day like what do you do after school what do you do on the weekends
that's how i always start that conversation if they haven't fully made up their mind and
even if they have and they're saying braces i'm still going to have this conversation because
again you have to give all the risk benefits and alternatives of the options whether they come in
with a decision made or not and that's part of it so i'd like to hear about their day you know um
they say hey i go to school i say oh you know what's your favorite subject what do you think
about doing in the future i always like to know are they are they a good student is school their
thing are they thinking about college you know i think about vocational school what do they do
after school do they do music do they do sports you know um do they make their practice if they
do sports do they make their practices on time i'm gonna get to what i'm getting at here if they do
music are they doing this you know lessons are they in an orchestra how are they doing you know
do they do they practice all these kind of little things i'm working up to you know i like to know
okay you know are you an academic person is school something you enjoy so from there i'm learning a
little bit more you know you and scouts about the patient letting me know if they're going to be a
compliant individual or a non-compliant individual obviously even just walking in if they're walking
in looking disheveled they don't wash their hair they don't brush their teeth they don't look happy
to be there to be really honest i don't want to treat them at all because even if mom's coming in
saying johnny needs braces johnny looks like all he does is game smoke weed um sorry to you know
guess these things but i mean hey i'm from california this is kind of normal you know he's
not washing his hair he's not brushing his teeth well i'm going to say you know what mrs so-and-so
i'm a little concerned doesn't look like johnny's taking care of his teeth looks like doesn't seem
like it's a priority in his life right now i don't know if i really think orthodontics is a
great time for him to do it right now it's a good time for him sure we could install braces on him
but my concern is he's not gonna take care of them we're gonna have frequent breakage it's gonna be
frustrating for me it's gonna be frustrating for you um if he's not taking care of his teeth and
gums we're gonna have decay around the teeth we're gonna have damage to the teeth and gums
i want to wait for a time when johnny's really ready for this and then sure she might drag her
kid to some other orthodontist but that's fine she can because sometimes the patient isn't happy
to be there because mom says you're getting braces and they want the liners so this is where you know
i'm gonna ask questions like i said if they tell me that you know that they're doing things that
show me that they might be a responsible patient i'm going to say yeah we could be an invisalign
patient or we could be a traditional braces patient let me break it down the pros and cons
in little johnny's situation and of course i go over the discomfort and the
medical reasons for aligners versus braces the medical benefits then i can go over
treatment time in terms of would it be faster and one or the other and sometimes braces will
be faster and sometimes invisalign will be faster but either way it's an option
we break that down we talk about the experience and then i like to relate the experience to what
the patient does so if patient tells me he plays for example football basketball some
type of you know water polo some type of more high impact sport of course they need to be an
invisalign patient matter of fact i might even decline doing braces on them i want to say you
know what for even though it costs me more you know i have more overhead doing i mean it does
cost me more i'm not saying anything correct is right on the front end it does toss me more
i purposely unlike some other orthodontists i purposely keep my prices the same because i want
patients like little johnny here to be able to be able to afford you know if price is an issue
and make the right decision for them i don't want them making a decision based on price i want them
to be able to pick what's healthiest and best for them so for this situation i think that invisalign
would be a superior choice to traditional braces because little johnny is so active in sports the
chance of him getting hit in the face elbowed in the face and having breakage or even severe damage
to his lips gums and teeth from having metal braces installed is high you know i think it's
a healthier choice to be able to have a removable appliance and you know a lot of times mom will
push back and say well i don't think he's going to wear them and i'm going to say well you know
little johnny you know tell me a little bit about about your water polo you know do you show up for
practice on time yes does your coach play you do they say that you're being responsible yes
do you follow the rules yes okay do you think that obviously ultimately it's it's mom's choice
you know but i do believe that you're telling me that you're a responsible individual and i
trust that if we did invisalign that you would be responsible and leave them in your mouth
and they usually say i said would you be willing to do that you know ultimately again it's mom's
decision and a lot of times they go yeah yeah yeah i'd much rather have that and you see their let
their eyes light up um and there and you know i can always tweak a treatment plan to slow it down
if they're not being super compliant it's still gonna work there's a lot of different ways i do
it or we can actually speed it up and do what i call leave-in plan so there's there's no reason
for the parent to say no because there's all different workarounds if they're saying they're
gonna lose it at lunch i say okay we'll tell you what let's do this let's see how it goes
um usually this is not a problem you know do you wear pants with pockets yes well here's
how the case is let's try this case in your pocket and see if it fits and they're super
streamlined can you drop this in your pocket yes can you put this in your backpack can you tell me
little johnny how this is going to work at lunch time at school tell me how this is going to work
do you have any friends that have invisalign oh yeah what do they do yeah they just pop them out
and put it in the case put it in their pocket yeah it's really not that hard i have six and
five-year-olds that do this mrs so and so you know it's and it's really not a problem and we even
offer up to three lost aligners with the with the treatment it's you know i mean invisalign doesn't
offer any more with tea and i don't think lost a liners but they're only like 10 bucks each so
i mean just like you know you'd have a few broken brackets that you'd include you know you just tell
mom we're gonna include up to x amount of lost aligners after that they're only ten dollars if
you lose them um but you know we can definitely waive the first few i'm really not concerned
and you know another thing we can do if somehow he's really having issues losing it at lunch if
that's happening you know there's there's all kinds of cases that can be clipped on
backpacks and clicks clipped on pockets but we could always modify the treatment plan so that
little johnny can wear the aligners all day not take them out at lunch and you can do that you
actually speed up a treatment plan they don't take them out they eat with a man which actually
makes treatment go faster so you can speed it up and they're going to change the aligners
twice a week or you know every four days yes it gets nasty yes when they come home they need to
brush floss really well super scrub the aligners cause they're gonna be disgusting but they're
changing they're throwing away a pair getting a new pair twice a week it's really not that
hard um and most time this works really really well we do this with little kids all the time
the little kids we just tell mom patient never ever takes them out as soon as he or she gets home
from school time for dinner you're going to take them out of their mouth you're going to brush and
floss the appliances after he eats you're going to brush and plos his teeth and you're going to check
for plaque and then they go back in and there's no more snacking and the cycle repeats tomorrow
and just make sure they're using a lot of fluoride and they're not drinking any sugar sodas or eating
any candies with them in but that works out just fine so in any case i know this was a long
lecture today but hopefully gave you some good talking points to be a little bit more enabled
to be able to explain the why for removables over fixed braces in a practice thank you