hey it's dr amanda with straight smile solutions straightsmilesolutions.com and today we're going
to recap a little bit more on the liner tracking and invisalign tracking clear
correct tracking pick your aligner any aligners they all work the same in terms of tracking
i've made quite a few videos on this before suggestions i have a lot of paperwork forms if
you want to watch everything i've already made on this on this topic i recommend that you go to my
youtube channel to get there go to your youtube channel put in the search bar at the top street
smile solutions from there you're in my youtube channel which has a green banner there's a tiny
magnifying glass in the top right you can go ahead and put a keyword in like tracking
and it'll show you all the videos i've made over the last few years on tracking
tons of tricks and tips so today's just going to be a high level overview how to optimize
your tracking and it's really not rocket science of course the first thing you have to do is you
got to pick appropriate case if you don't pick an appropriate case things aren't going to work out
right second thing you got to do is you need to make sure that you've staged it correctly
and that the mechanics are correct you cannot just trust the technician i can't say this enough times
99.999 times when i see a case i know it's probably not going to work out because it's
not done right technicians are not orthodontists trained in the us sorry that they're not they
might have an orthodontist on their team but they're not traded in the u.s and you know what
their ultimate goal is to lower the overhead as much as possible and sell the cases on their end
not to optimize your treatment plan that's just how it is they want to save money they're going
to try to shortchange you i'm sorry even the best of liner companies do this and if you talk to any
orthodontist they never go with the first clinch first of all they they usually take i mean three
four five tries to optimize it and they usually their goodness lots of changes that we make
so you need to learn how to do this or you need to partner with an orthodontist to do it for you
that's my suggestion one or the other my suggestion is to do both initially to partner
with an orthodontist to help you out then you'll learn how to do it and you can take it from there
so anyways how to improve a liner and invisalign tracking so first suggestion that i have
is you need to understand what tracking is what is tracking tracking is only going to happen if
your clinchek or your treatment plan is optimized so if it's not possible and not predictable you're
not going to get it right so let's say i worked on your clin check and it's optimized now i know it's
possible second major thing we need to do is we need to manage the patient's compliance so now if
it's optimized this is pretty much idiot proof as long as the patient keeps it in their mouth
22 hours a day i mean barring an occasional pathology or weird thing that happens and
occasionally strange things happen but 99 times out of 100 if the patient keeps it in their mouth
as directed 22 hours a day that doesn't mean 20 doesn't mean 18 that means 22. 22 is tough i mean
i'll be honest i've had a liners my daughter has the liners 22 can be tough um people have a lot of
habits where they're taking things out and they're snacking and they're drinking their coffee and
that two hours out adds up very very quickly so it really is kind of a lifestyle change um for
the patient now there's workarounds and there's ways you can do this so that they can leave them
in while they eat but i'm not talking about this i'm going with the 22 hours thing
that's a whole nother conversation if you want to watch that video you can find that in my
invisalign channel so basically your patient needs to understand it has to be 122 hours a
day aligners are meant to fit like a wetsuit hence the wetsuit guy here they should be
never ever any space between the eyeliner and the tooth see here for tracking poor tracking and this
is like a severe poor tracking this is off by many aligners this is not just a minor poor tracking
my scripting if you worked with me before i've said this so many times it just like comes out
put in your first aligner use your chewies chew it down for about 15 minutes the first time you put
it in of course you always want to do this after you've brushed your teeth before you go to bed
put your liner in chew it down go to sleep get up in the morning peek around look with a flashlight
if you see any even micro gaps between the aligner and the tooth it should look like this
not at all even close to like this no micro gaps not even a tiny little one that that nothing like
that then you need to keep chewing it down you get 72 hours to chew it down 72 hours three days
to keep working on the chewing if you can't get it to be fully flush against the tooth like a wetsuit
you need to go back to your previous eyeliner and wear it one more week of course if you are on a
liner number one and you can't get it down then you need to go back for another refinement or
warranty fit correction there's something wrong with the manufacturing something was wrong with
the treatment plan okay but assuming you're on two or above if you can't get it seated within 72
hours you need to go back and wear the previous one another week hence this little storage box
here it says please change your liners every seven days use your chewies three times a day
for i said 20 minutes 15 minutes whatever for the first three days after the latter change to help
seat the aligner if there are any spaces between the tooth and the aligner that can't be eliminated
with the chewies after 48 hours i think i said 72 but whatever please go back to the previous eliter
and wear it another week then try to advance again if the aligner still isn't tracking after that
please give us a call stay in your old aligner do not advance the other thing i want to mention is
that normally my clint checks or seven day wears these are ones that i've slowed down and optimized
the ones that you get defaults from invisalign no comment so that seven days doesn't start
until you get it seated so if it takes you two days to get it seated you're not wearing that
eyeliner nine days so seven days is a gray area it's minimum seven days it might be more okay
sure you can tell your patients to wear it 10 days or 14 days but i don't feel like
first of all that's often unnecessary um you're wasting time second of all i don't
feel like you're educating your patient on the process because now they're just
you know roughly changing their aligners every 10 days or 14 days and they're not focusing what they
need to focus on which is the tracking so if you empower the patient with an accountability loop on
the tracking have them save all their old aligners so you can mark this one two three four five or at
least the last five aligners in a little box that you can give them you can buy these from amazon
walmart whatever super cheap you know you can buy smaller ones too you don't have to have you know
15 slots or something like that but definitely they need to save at least their old their last
five bring it into every appointment that way if they come in and it's not fitting 100 you're gonna
go ahead without the old aligners find the one that fits so maybe now you're on 13 upper and 11
lower that's fine just slow down your lower wear the cats just catch up with the upper don't keep
going the same speed eventually we want them to be caught up and you should be fine if you get really
stuck and you can't find the right fit and it's still not tracking well then you have to do the
refinement revision whenever you want to call it mid-course correction that's pretty much it
it's not rocket science it's really really easy if you do all this and if your manufacturing is good
and if your clin check or setup was optimized and if your patient does their part you should have
no revisions refinements on any cases it should be a very very rare one off and i like to talk about
what is your revision or refinement rate there is an analytics tab that they did show us um
in an invisalign webinar and they showed us how what it looks like and how you can show your
rate however i can't seem to find a way to enroll in that nor can i find any more information nor
does anyone from invisalign ever answer this question when i try to ask it multiple times so
if you do work for invisalign corporate and i know you all listen to my videos hey this analytics tab
is brilliant bring it back make it easy for us to find and to opt into or just make it default
because i really really think and i'm gonna keep saying this until it happens because nine
times out of ten when i tell invisalign i want something guess what it shows up within a year
is it from me or are they just smart i don't know probably both but the analytics tab is brilliant
everyone should know what their revision refinement rate is revision refinements are
not normal last webinar i went on that invisalign hosted they said 72 of their doctors have one or
less refinements well that means nothing to me because if a refinement isn't normal
i would like to see 72 percent have zero refinements you know so one or less and then
they're not even factoring in like is this a moderate case did the patient discontinue
of course you're gonna have one or less in a moderate case or a light case because you don't
get any or you only get one right so that's the most absurd statistic i've ever heard it was so
badly done i was just laughing it's one of those things that makes them sound good but it's obs
like break it up i only want to know for for comprehensive and a lot of comprehensive cases
they don't finish patients stop they quit so that really shouldn't be factored into it
i think they should say with ideal outcomes how many percentage had a revision refinement now
that's the stat i want to listen to i want to see the final oh yeah looks like it should have
that looks perfect okay how many refinements did it take the patient the doctor to get there
if it took them one or less okay i'm somewhat impressed then so anyways that's everything i
know about aligner invisalign tracking listen it works for me the cases that i've worked on before
usually have a very low to no refinement rate less than 10 percent assuming the patient is doing what
they're doing and also i forgot to mention you definitely need to use invisalign virtual or
some other virtual check-in process whether you're creating your own whether you're doing a line flow
whether you're doing dm dental monitoring whether using invisalign virtual i don't care what company
you use there's plenty that are out there but you need to use it but in visual and virtual has been
optimized it is free with your invisalign cases there's a patient-facing app i've already done
tons of content on that as well as a doctor-facing dashboard i have it on
my phone it's actually really easy and they send you a notification whenever your patient checks in
sorry for dm i like dental monitoring but guess what whenever you create something that's good
someone is going to copy it and anyways the the invisalign virtual does not have the ai that dm
has so there's definitely certain benefits to dm that's out there i have no problem with dm i live
love felipe and his team it's a brilliant product it has lots of implications but you know it's not
affordable for the average doctor especially a general dentist who's just getting started it's
just not affordable it makes sense for the orthodontist and i know that candid and some
other um direct consumer companies are using dm that's great i think that's absolutely fantastic
and i'm all up for that so um but yeah you need to be checking in every single aligner from home
it makes sense yes it takes you 10 seconds as a doctor to look at the pictures and then
tell them to go ahead and proceed but you know what if you do that you won't have revisions and
refinements which is going to save you money now that invisalign is charging extra for refinements
you have a little extra fee every time you do it i think in all countries now as well as the time
it takes you to take that scan possibly to take the buttons off possibly to put the buttons on
depending if you need more and chair time as well and the patience time and you know what patients
are way more satisfied when they don't have refinements they're much more likely to refer you
other people because the first thing other people ask is how long did it take and if they're like oh
man it took two years well that's bs no invisalign case should be really taking that long unless it's
an extentation case or an extraordinarily difficult surgical case and granted i've
had those so i get it but the average case should not be taking two years all right thanks so much