this is an excerpt of a webinar by garrison dental thank you to garrison dental for allowing
us to post this excerpt to see the full-length version please contact www.garrisondental.com
all opinions are those of straight smile solutions
we are an orthodontic consultancy company that helps general and pediatric dentists with their
ortho cases and education for help with a case please visit www.straightsmilesolutions.com
now enjoy the show
make sure you sign up for the event on may the 17th now this event is going to be it does have
a little fee to it but we're going to have a promo code at the end because it's actually free if you
think about it because you will actually get an ipr kit that retails for a couple hundred dollars
as well as a type it on and it's going to be we're only taking a limited amount of people it's going
to be really intimate we're going to be going over how to do ipr you're going to practice it
on a type of dot before you do it on a patient um iupr is really really great especially on adult
patients patients with full discrepancies if you don't know what that is i'll send you the playlist
on that two size discrepancies or anything like that so um and perio patients for sure i use them
on so you do not want to be pushing teeth through the buckle plate and that's really important
so you should know what ipr is obviously if you're sloppy with your ipr you're buying
a cheap kit you're just using a disc or a bur it's probably not very accurate if you're not
doing it accurately you're going to need a lot more refinements right and the patient's going
to get upset and or you could just really mess up their teeth i've seen crazy stuff happening
so be really careful about what system you use again this is my system that's just i started
using the system before i even started lecturing for garrison and i most of the people i know use
it so i think you'll feel really comfortable with it and i think it's a really affordable system too
um here's the webinar it's going to be on 5 17 at 7 00 pm eastern a little earlier but it is like a
two and a half hour lecture so we're gonna go over some general ortho stuff we're gonna go over ipr
we're gonna do a hands-on stuff so um and a lot of q a so i definitely recommend that you join it
let's talk about round tripping and this might be a concept you're not familiar with
but most orthodontists are very familiar with it so round tripping is exactly what it sounds
like you're taking a round trip but it's not a good thing so um but it will be part of
most of your ipr treatment plans unless you ask for otherwise and this is my tip on my preferences
it says no round tripping big bold bold bold things never ever i don't want round tripping
on any of my cases why because basically what it means is most people invisalign clear correct
sure smile reveal whatever who cares they don't know what ipr system you're using they don't know
if you're using a disc a bird they don't care but they know that most general dentists like
to do ipr on straight teeth and not crooked teeth because otherwise they'll legend and weird things
will happen it'll be uneven the cool thing about the garrison system and this is why i started
using them is that the files can be curved to fit the conjurer of crooked teeth so if you can master
doing ipr on the first aligner before we even get started when the teeth are crooked then you don't
have to round trip eg straightening the teeth then doing the ipr then pulling them back into the
space why is that bad well i mean it's not always bad if it's a young patient but again i don't do
ipr on patients i only do ipr in older patients so yeah it's usually bad um if it's a older patient
basically okay i'm going to have an analogy hang on i'm all about analogies the funny thing is i
took this in from outside and my cat almost went to the bathroom in it so i had to kick them out
okay this is a dwarf banana plant because we grow bananas here but anyways if you have a potted
plant say let's say i took the plant itself right it's in the middle now right let's say i moved it
all the way to the edge let's see i just scooted it over i just dragged it over in the dirt right
what would happen it probably wouldn't be very healthy it wouldn't be very happy and then i said
never mind i'm gonna drag it back to the middle well all those little bitty roots i almost think
of a plant like a pedial like a root like like a tooth and the root and the pdl's because it has
lots of little bitty fibers and things like that it's not going to be happy it might rebound and
be fine but it might never recover it might die it might tip it might never be stable or healthy
that's basically how round tripping works with the liners don't do it but you'll you'll be doing it
unless you say don't do it so just a little tip um but as far as i know garrison is one of the
only um might be the only i don't know um kevin kelly's later company that has the precurved files
otherwise you're going to have to round trip there's no other option which is unhealthy and
i've seen many teeth die even my own auntie she had ortho um they round tripped guess
what she lost her lower incisors so that's a personal story okay another tip always capture
your terminal molar fully on your impression or scan and double check so this is something that
we see sometimes in direct consumer aligner companies because people take home impressions
and they don't capture the terminal molar they don't know i'm not gonna say names or anything
but they don't know because they don't have an x-ray right so what happens those terminal
molars will extrude because they're not covered and funky things will happen with the bite so you
have to always capture that full terminal molar which is part of the reason why i say just take
a scan especially if they have third molars too tricky right um another tip is whenever you do
even an initial but definitely the refinements you always want to double check your articulation
so i always train my doctors pardon me to use articulating paper whenever they take their
photos or occlusal photos it doesn't matter and to take lots of photos throughout the treatment
there's lots of power in the photos but tap tap grind grind i know some people say oh when
i need to take pictures because i'm taking a scan but i swear at least 80 percent of the time the
articulation is wrong you know and i always say oh let me see those occlusal photos it doesn't even
match up you know they just guess even if you have a scanner even they're like tarot they're guessing
at the time and if it's not accurate you guess what you get another refinement guaranteed so this
is a super easy one cent way to ensure you have fewer refinements on every single occlusal photo
just a tip and i feel like it's it's worse with impression but it's still terrible with with scans
it doesn't matter the scanner company it doesn't matter the aligner company they're all terrible
okay i told you i love working with kiddos so but this isn't even just about kiddos habits
habits habits and i know you're thinking habits are just sucking your thumb sucking your fingers
past these binkies things like that guess what adults have tons of habits a lot of times they
started with the kibo kiddo habits and then they have adult habits and they might not even know
so this is another if you worked with me before one on one we get all kinds of arguments i'm like
nope you need to eval for habit something's going on listen i have the the skill like i said i've
seen tens of thousands of cases i have the skill to know if there's a habit the patient might not
even know there's a habit they won't even admit it guess what i have a habit and i just found out
two months ago and i'm an orthodontist i had no idea i had a habit so right now i want to teach
you a little trick i want you to freeze exactly where your mouth is where your tongue is where
your lips are freeze wherever you are where is the tip of your tongue resting right now in rest
feel it if the tip of your tongue and this blew my mind i don't know why i didn't know this they
never taught us anything like this in residency if the tip of your tongue is not right up here
behind or on the incisive foramen you have a habit so what can happen well it can make your ortho
case very unpredictable it's basically either a tongue resting position habit or it's a tongue
thrust habit i found out i have a severe tongue thrust habit and sometimes you can hear it in my
voice and i'm going through omt therapy to fix it i was in speech therapy as a kid um i had a lot of
relapse issues i had ortho three times surprise guess what it was due to my habit no one ever
told me and i went through residency and 18 years of being organized and never figured it out blew
me away so now i hired my own omt yeah i'm paying a fair amount of money for it but
the benefits are crazy like i can just go on i'm obsessed with it so i would love to share with
you my whole habit omt playlist everything i'm learning um how i mean there's so many benefits
i'm totally obsessed with it and i think omts are absolutely fabulous and guess what
you can bring an omt into your office and this is another tip you can train any hygienist in your
practice or any dentist in your practice to be an omt in order to be an ot you can either it's
only a four day course with the test it's really really not a big deal i'm thinking about doing it
too busy right now but you can be a dentist a physician a hygienist or a speech and language
pathologist that's the four people you can be to take this accelerated program um you can get
certified really easy there's no licensure at this moment in different states i think that's going to
change eventually so i feel like everyone should really get someone in their practice because you
can bill separately for this um i'm paying someone independently to do it but i'm like shoot with him
you know i should just do this you know as a side hustle i mean it's not cheap so um check
it out you definitely should research omts if you don't have someone your practice that's
licensed to do it you need to find somebody because if you're going to take harder cases
there's going to be times you're going to need to involve the omt to eliminate that habit
now there's other ways of eliminating habits this is the way i always did it before with
cribs but you need to do it before the aligners like six months to a year before and a lot of
patients don't want to wear this for a year before they're ortho so um and i don't even know if that
fixes the problem fully so it'll blow you away what habits are and it's really cool you can do
an omt evaluations a lot of them do it for less than 100 150 the full session you can
find out if you have a habit and for me it was life-changing so um definitely recommend it okay
this is more tricky stuff i told you we're gonna get a little more advanced
you