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all opinions are those of straight smile solutions
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now enjoy the show
let's talk about staging and movement per aligner one second
so much talking okay so less is more in ortho there's a philosophy that the healthiest roots or
the healthiest movements are slow and low forces slow and low easy to remember right keep it slow
keep it low braces not slow and low because we're putting in a wire we're tightening they're coming
back six to eight weeks later so the force goes like this super super painful more tolerable
not painful probably not doing anything until we get into the next office next visit they come
in we tighten them put a new wire in tighten them back up super super painful because force is going
up right it's an undulating force that's actually not healthy which is why we get way more root
resorption in braces than we do with the liners but you can make your aligners even healthier even
more comfortable even more predictable by staging your forces slower and lower so let's talk about
um default movements so invisalign default movement last i heard was 0.25 millimeters
per aligner clear correct's default movement is 0.3 millimeters per aligner might even be 0.35
sometimes a little bit faster a little more aggressive um which is perhaps why people think
say invisalign's a little more comfortable my default movements are not even those i
take them even slower and lower um i'm sure the aligner companies hate me for this but guess what
my refinement rate very very very very very low so um and patients very very very happy
so you know i want raving reviews for my patients i want patients to love getting
aligners from ours you know it should be awesome so i take it and i have them so for invisalign
whatever they give me for the treatment plan once i've kind of optimized it i double it so
i have the doublet philosophy double it two times so if they tell me if i've optimized it it's a 20
it's now a 40. i just say change this treatment plan to 40 aligners that's the last step i do
you can't put that in a preference because they just won't do it because obviously for them
they're spending more money right although you would think they're actually spending
less money because you actually have way less or fewer refinements which actually
saves them a ton of money but i've been pushing invisalign a lot of times i make
tips or suggestions and a lot of times they take them so i've been saying hey
publish our refinement rate and for those of us who are under 10 20 give us a volume
give us another discount because obviously we're more efficient we're spending less of your money
why are we paying this 1900 you know we should get an additional bonus for being efficient and using
your system correctly so i've been asking for that we'll see if they actually do it it would be cool
but yeah i just double it and for clear correct i triple it so if it's a clear correct they say 15
it's now 45 and we're going to get all my cases are comprehensive or unlimited like there's no
express there's no light there no i don't do that if it's a super ridiculously simple case that i
know is like two to three millimeters of crowding or spacing i'm gonna punch it to white label which
is a whole nother workflow it's not branded i can tell you more about that if you want to know about
it just contact me outside but really really cheap but no freebies no bells and whistles no
pretty packaging no pretty labeling nothing like that it's just cheap cheap cheap um but all my
invisaligns are comprehensive even if they're simple why well because i don't have to worry
it's not that much more money i have five years to finish which i should never take if the patient
comes back in three years and they had relapse they can just pay me for my time maybe we'll only
pay like 500 900 because i don't have a lab fee for five years so let's just you know let's just
not stress out about it you don't have to worry about it if they're not compliant obviously we
try to have accountability loops for compliance but also you get way more advantage points and
then you get the volume discounts so that's the goal but yeah double it so really really really
easy way to reduce your refinement rate and also the patient is going to be way more comfortable
um if the trays don't get all gross because they can change it more frequently and we'll go into
that a little bit more and this is just kind of my analogy you know we had this amusement park when i
was a kid this zoo where they had this like lake and it was really shallow it was only like eight
inches of water and it had stones that you could walk and they had ones that were far apart and
ones that were really close and obviously when it was far apart you're more likely to fall in which
was really fun when you were a kid but i'd like to think about that with aligners because the more
spread out it is the more likely i'm gonna fail so i'll rather have them close together and then the
cool thing is if your patient saves all their old aligners or at least the last five or ten
you probably never have to do refinements assuming you had a good initial treatment plan because they
can just go back and find the one that fits really easy saves you a ton of time again i kind of told
you i don't this is just my personal opinion and when i work with doctors in my own consulting
practice that's the first thing i say stop stop the go stop delay don't do it they always end
up spending more money you can't upgrade once you start it now if you have a cyst you can upgrade to
comprehensive because it's actually cheaper you have to throw a big tantrum to get out of assist
and i highly recommend that get all your cases out of assist it's a nightmare in my opinion
um but try to do all your cases as comprehensive you're just going to be happier we kind of talked
about tips with the liner tracking saving all your old aligners um you could even just buy
like a cheap tackle box and label it i mean this was like super trashy whatever i did here but
you get the idea unless you give your patients a place to store it because they put it back
in the bags they get moldy so you need to kind of have something that's eerie and whether you punch
you know punch holes in it if you're really crafty have some in your office only cost you like five
or six dollars to make something like this and it could be a lot smaller but i'm telling you it's
going to save crazy overhead and crazy time if they save all their old aligners and you train
them bring the box to every single visit with all your last aligners from the last visit and that
way if it's not tracking we just go back and find the one that is assuming that we have small little
steps and the treatment plan was optimized also you need to understand the basics of tracking so i
told you i'd explain to you my my basic scripting and again i've got whole playlist on this so ping
me if you want a copy of the playlist and i even have a handout with the tracking instructions i
will give it to you that one is branded with my logo but you can unbrand it and use it i don't the
photos are mine i don't care if you use them be my guest i've had them for like 20 years but this is
my basic scripting okay and i think i even have it written here i'll just read it so default change
from my aligners assuming you're doing the doublet philosophy or the triplet for clearcorrect is
every seven days we're going to start off planning for seven days but that seven days doesn't start
until you get the aligner fully seated and tracking and you have to spend at least two or
three minutes explaining that philosophy because patients aren't going to get it i say the liner
is custom made for your teeth and your teeth only it's made to fit like a wetsuit there should never
ever be an air bubble or any type of even minor gap like this between the tooth and the aligner
it should fit custom like a glove you whenever you put a new liner in first thing i want you to do
is to brush and floss have have dinner brush and floss um right before bed put it in and use
your chewies to seed it for at least 10 or 15 minutes and we talked about chewie's everyone
should be giving chewies please do not chop up a slow sheen section that looks chat like trashy
you can buy chewies on amazon lots of different flavors color shapes i don't really care
ortho munchies are even better but they're crazy expensive i do use them on harder cases
but yeah make sure you're giving at least one set of chewies to your patient and explaining
how to use it and then don't just say chew on this you know you have to explain it 15 minutes
chewing around as soon as you put it in chewie's can be left everywhere we have them
my daughter has invisalign and my husband does too they're all over the house they're in the car
and they're all over the floor i mean the cat plays with them they're
chewies yeah they're and you can give one set to the patient it's like a consumable thing it's
like floss you might give them one demo right for your dental floss but then they buy the rest of
their floss on amazon they can go to amazon about whatever flavor color shape they want i don't care
but i want you to use them you know there's also something called ortho it's called movements yeah
movements it is it's not chewy but it's a u-shaped mitt that they can suck it's sugar-free it has
xylitol and they can bite down on like a chewy and that's great because it tastes good so i recommend
that as well we use both of those but the seven days doesn't start until you have your aligner
fully seated sometimes especially if you have those if you weren't using the doublet philosophy
if you are this really is less of a problem um sometimes it can take a day or two to engage it
and to get it fully seated that seven days doesn't start until it fully seated so some weeks you
might be wearing it for nine days some weeks you might be waiting for 10 days it could be 14 days
it might be seven days so and then i tell them the seven days starts once it's fully seated i'm gonna
give you if you can't get it fully seated within three days i don't want you to change to that
eyeliner you go back to the previous liner wear it another week then try again if you still can't get
it fully seated within the three days i want you to give me a call we'll do a virtual check-in and
that's a whole nother story you should definitely be using virtual resources for your check-in it's
just ridiculous to have the patients coming in for these changes it makes zero sense to me
invisalign has a free virtual app that you can use it doesn't have any ai
um but it's it works you know simple they have a patient-facing app a doctor-facing app i actually
have it on my phone it pings me when cases come in um to look at really really really easy and they
kind of came up with that during kovic there's also other branded companies that are out there
you've got a line flow is really great um i think that's the most affordable company that's out
there um it's not crazy expensive um simple but easy to use everything's loaded into one dashboard
you don't have to just use it with invisalign it could be any aligner company any braces case
any functional aligners case dental monitoring is kind of more the ferrari of the options out there
it's crazy expensive the implementation piece is expensive but a lot of people like it and it
does have ai so again i have tons of videos on all these different options i don't care which one you
use just use one you have to do it and it needs to be hipaa compliant don't don't be doing this on
text messages because that's not that's not hipaa compliant so that's not a good idea but yeah i
mean if you get your we talked about compliance and accountability loops you have to create a
system how are you going to do this in your office everyone can do it differently i don't care how
you do it but come up with your own system talk to your team come up with a plan how are you going to
do it and you know i'm taking this basically as a tip out of the direct-to-consumer playbook right
how do they do things well they've treated a million cases in the u.s alone so obviously
you know maybe not everyone's satisfied but a lot of people are seeing a lot of great outcomes
um and they use this you know virtual tracking and accountability loop it works
so if it works for them it can definitely work for your office we are done yay