and with straight smile solutions straightsmithsolutions.com and today
we're going to talk about teeth shape and how that affects orthodontics and what our options are and
what patients sometimes might ask for and even what doctors often ask me for so what's possible
what's not possible and sometimes we don't really notice that patients kind of have uniquely or
funky shaped teeth until we straighten them up and we look at the clincheck and we're like
is that a space is that it's not a black triangle because black triangles up here you know so i call
this tapered teeth which is what i call them and sometimes we have square shaped teeth sometimes
we have tapered taped sheets we have triangular shaped teeth so black triangle was more like a
triangle shaped teeth right and then the the space is here but it's touching down here
this is the opposite so often i get asked okay well and this is something that really bothers
me that they teach in some gp ortho programs that it's okay to go ahead and swing the roots
distally now if you swing the roots distally sure that's going to approximate these segments more
now what else is going to happen first of all from a health perspective why would you
blindly want to swing your your roots distally because i know i'm going to have to swing them
at least 10 20 30 degrees in order to make this look better and still not going to look great
and then the roots are going to be going this direction and this direction and they're going
to run into the roots of the twos and now we just possibly damaged our roots cause resorption
may need endo might lose the tooth i mean why why why you know um why do you want to do that that's
not the way you're meant to leave to finish your ortho treatment ortho treatment is supposed to
be finished with parallel roots not funky tipped roots okay if you do that because the patient's
begging you to first of all patient wouldn't even understand that so you'd have to bring it up
second of all if you do that and the patient disappears and goes to another dentist and they
take an x-ray and they see those roots like that they're going to be like who damaged your roots
and that could be a major liability for you even though the patient told you to do it supposedly
don't do it just say no so also what's going to happen if you do that is that these distal aspects
are going to hang down lower okay so that the mesial aspect is going to go up the disc is going
to hang down and you're still going to have to restore it anyways it's going to look really dumb
i mean you don't want to go whacking off the whole distal aspect on somebody's tooth just say no put
the teeth parallel and let the patient know ahead of time hey it's going to look like there's space
but it's actually touching right here there is no way for me to fix this without doing just some
easy composite you can do a composite laminate you can do a for service composite we could do
a veneer you know actual veneer i mean especially since these teeth are kind of funky shapes anyways
they're very rounded um it's going to look better when this person grows up to have four veneers you
know as opposed to just two that would look or you know four really nicely shaped composites for now
so i really love it when you bundle that into the big price of the treatment so we've got the
ortho but part of the ortho is also gonna do the restorative it's not going to look great it's not
going to be done until the restorative is done so let's go ahead and collect the deposit on all of
that get you committed to the whole treatment plan and then one thing you can actually do if you're
using invisalign is you can use the invisalign export feature and i do have videos on that if
you want to search them up go into my youtube channel to get there go to street smile solutions
youtube channel go to the little magnifying glass in the top right and put in for example
export that keyword and i'll take you to the invisalign export feature which allows you to
export the final stl which would be this version where everything was done and then you can export
it to your lab not all labs take um stls from align technology iteros so um you might want
to ask them if they'll take that stl now keep in mind once you activate that stl invisalign does
have a pop-up alert that comes up saying hey hey if you choose to proceed with this we are going
to bill you if you do not accept this treatment and i don't know what how much the bill is they
don't say it's probably a couple hundred so you only want to hit that export feature i say if the
patient if the case has already been approved to be honest that way you can export that your lab
they can create a digital wax up which is a few hundred dollars and the patient has the ability
to see what it's going to look like once you do the virtual wax up and if there was some issue
about you know moving things around or moving teeth around or you know extruding or intruding
or leveling out gum lines you could always maybe you want to intrude this too so you
have the gum lines a little more even who knows okay so let the lab tech tell you how to do it
and there is a feature dsd digital smile design does collaborate directly with invisalign and they
can also do it but i heard it's a lot like four or five hundred dollars all right thanks so much