i'm dr amanda i'm an orthodontist and ceo of straight smile solutions we help dentists
understand orthodontics better this video will share an excerpt from a webinar hosted by clue
dental marketing and dr lanez of modern essence dentistry any patient photos are the property of
modern essence dentistry if you have questions please reach out at www.cluedentalmarketing.com
if you have questions about orthodontics please visit straight smile solutions
at www www.straightsmilesolutions.com
enjoy the video we're going to go and talk a little bit more about liners and we're going
to be talking specifically about branded aligners and unbranded aligners again i don't work for any
liner company i don't care what you use you use you do you you do whatever works for your scanner
invisalign is a really easy one to use and it's to the point when it first came out it
was a junk product i'll be honest i started i got certified in 2002 maybe 2003 back then when they
only worked with orthodontists and they would actually fly the residents out to san francisco
and it was a massive party they'd put you up you know your own hotel room in a fancy hotel they
want you they dine you they take you out all night long clubbing and you just you had the
best time but um yeah they don't do that anymore but um we were told by our program director if
anyone from uconn's on there that if he found out that we went to the invisalign summit or the what
it was called um training course in san francisco that he would kick us out of the program so we all
snuck out i don't know how we got away with it we literally left friday and came back sunday night
and and i think we just took red eyes both ways but uh we were so tired but almost the whole
program went to san francisco from connecticut so it was pretty fun epic okay branded a liner so
oh this kind of got mispositioned hopefully you can see it if your um tiles are in the way you can
minimize them but this is pretty much what i was talking about aligners didn't even come out until
basically i started down middle school i started demo at ucsf um align technology was founded
obviously in silicon valley i remember being a freshman when d1 and invisalign came and did a
pitch to us it was almost like shark tank kind of stuff i mean they were new and i'm pretty sure it
was via christie and all these fancy people that are now bazillionaires that were there pitching
to us like the you know d1 d2s done with dental students telling us about their their concept
and we were like this is ridiculous this is the stupidest thing i've ever heard and now i'm like
oh my goodness i should have got their autograph you know pictures that would have been so cool
but anyways when i first went into orthodontics you know residency there really wasn't a liner so
it wasn't a thing it wasn't a good thing and we weren't threatened by it at all you know pretty
much no general dentists were doing ortho it was a complete referral based thing you got
an unlimited pool of patience came your way you didn't have to market there was no social media
it was just really easy and you just had to know about wires and fixed appliances and some
removable stuff but it was you know it was easy um and it was a hard especially to get into back then
so i mean we had to work really hard to get in but changed a lot so the whole demographics has
changed the whole industry has changed obviously you know everything gets disrupted you know over
time between clearcorrect coming in and invisalign marketing to gps and all kinds of other you got
six month smiles and other stuff blah blah blah um direct consumer onliners you know in the last 20
years orthodontics has changed a lot a lot a lot not on like the contact industry not unlike the um
goodness what else all kinds of different glasses industries stuff like that that have become more
um direct to consumer focus so it is what it is you know a lot of orthodontics are pretty
pretty salty about it especially the ones that are my age are older the boomers and the gen xers
um i chose not to be salty and just make lemonade out of lemons but everyone has a
different opinion but you know if you have an older orthodontist have a little compassion
you know so i'm sorry this slid over a little bit but basically these are a little bit older
prices here but some of the aligner companies do charge a fee you know in order to get certified
some don't some have a lot of resources some don't there's a variety of different lab fees i really
strongly recommend that you do all your cases at least when you first get started i'm pretty
sure dr l is going to tell us the same thing as comprehensive that's the biggest mistake i see
doctors doing is they're like this one's going to be light upper only this one's going to be go
nope don't do that you're going to regret it you're going to get yourself in all kinds of
it's going to cost you more to get out of trouble it's not going to happen predictably
weird things are going to happen because they happen and the patients might be mad basically
you know and you're not going to really save that much money because you're kind of wasting
spinning wheels so do everything is comprehensive your first 100 200 cases um until you get your
just so much more relaxed you know take your time i'm going to give you all kinds of tricks and tips
to try to have your liner cases more predictable um but you know obviously whatever system you pick
wants to be compatible with your scanner we're not really going to go into that but i have a
lot of resources on that if you want it just let me know um also cool things to know aligners can
be done um as phase one now i mean this was kind of novel when i first think made this
slide a couple years ago but it's it's you know definitely more knowledgeable now obviously clear
invisalign has their invisalign first they came out with um as well as their m.a but clear crack
can do it too they don't have a thing but you can just ask for it this is actually my daughter's
phase one case um this is her the the finish you know but just do space consolidation she has an
impacted canine we just want to smush up 7 through 10 so that the k9 had a chance to come down
and we did it with clear correct without attachments because it has a nice high
trim line super easy about 19 aligners just lining up those front teeth and expanding
the arches really really easy stuff but you can totally do it and it's not expensive and it's just
such a great experience for the patients they they're like what you know i didn't know i could
have a liners at age eight you know and it trust me like it's so funny because my daughter's now
in seventh grade and the vast majority of her classmates all have aligners they do not have
braces very few have braces so it's really becoming more of a thing um than it ever was
so let's go into a line of success what can make it successful we already gave you some tricks and
tips we're going to give you a bunch more remember case selection is huge if you don't know bounce
it off somebody if you have an orthodontist friend you have some friends that do a lot of
work though orthodontists all the time we bounce things off each other i have a lot of you know
former classmates and just friends that are orthodontists and all the time they send me cases
i send them cases hey what do you think about this what would you do here it's a two year long
puzzle or a year-long puzzle so it's you want to do it right right and sometimes you know it makes
your head spin so it's great to bounce things off other people so find that network to bounce
someone off of or get a mentor you know either way um the biggest mistake i see most doctors make is
that the treatment plan was just not optimal and you really can't trust your technicians i mean
99 times out of 100 an orthodontist will never see that treatment plan you know
um technicians sometimes are just trained right off the streets they don't know anything
about teeth health gum is that predictable if it's not it's just a video game that they're
playing so you know and they tell you that and that's ultimately why you have to approve it
so you know proceed cautiously and initially first 20 30 40 treatment plans run by somebody
who knows what they're doing you had a friend a colleague another orthodontist in your area
um if you're doing in-house aligners i don't recommend doing that until you're super savvy
at doing you know invisalign clear correct or one of these other ones you want to know
exactly what you're doing because there's just so many more variables that can go wrong and of
course compliance compliance is always going to be there it's always going to be an issue
tons of tricks and tips for that paperwork and i think dr l maybe can tell us a little bit more
about what he does in his office with paperwork and compliance contracts and stuff like that but
i mean you got to be a little bit strict if you have your own kids you're used to being strict
and you know but find that like i said this can be totally assistant run so find that assistant
in your office who's great with kids um but you know is a lo who is a little bit strict and go
from there okay white label aligners um i know i probably have about 10 or 15 minutes left i'm
going to have to blast through this really fast but we talked about in-house aligners there's a
lot of different software companies that can help you with that starts at about 99 per case for the
setup if you want any intros feel free to contact me it's you can use any type of scanner you can
outsource the manufacturing you don't have to have any lab work done it's super super easy um it i
mean i would have a few other cases under your belt first but you don't have to so definitely
something to consider if you really want to try to compete with maybe some of the direct consumer
um aligner companies tracking is huge you've got to understand the concept of tracking and this is
the most important thing for you to know you need to have a tracking handout i have one and again
another gift again if you're watching this live and you contact me by this weekend you want a
copy of my tracking handout it's branded with my stuff but you're welcome to unbrand it i own the
pictures i don't care you can use them so feel free to use them have them your patient needs to
understand tracking i like to give this glove an analogy where your aligner should fit like a glove
um at all times there should never ever be any type of gap it should look like this okay even
right here this is not good see here there's a little space on seven and eight it's not bad i can
deal with that but seven and six not good so this is already off by one or two aligners you know you
can't keep going and this is why you don't want to do that light or that though whether it's limited
on reboots and stuff like that because it's gonna cost you more in a long time now obviously these
are crazy off what you know why are you even still going you got to do a refinement um gotta use
chewies chewies are super huge we can't just give your patients some chews you gotta explain the why
behind chewies um ipr is really useful you need to learn how to do it accurately i do have some ipr
um content that's archived glad to give it to you if you want to contact me um you need to know how
to do it accurately don't do it with a disk unless you know what you're doing don't do it with a bur
unless you know what you're doing there's a lot of other products that aren't that expensive
that are easy always under do your ipr a little bit because as you finish and polish you often
easy to overdo it trim line is a big thing it's a personal preference obviously the higher your trim
line the less the fewer attachments that you need but it's also less comfortable for the patient and
not as healthy for their teeth it goes so you know personal decision a lot of doctors will
use multiple companies some with a higher trim line for the patient who's absolutely refusing
anterior attachments sometimes you can do that some as you can't depends on how complicated cases
depends on if you have extrusions and rotations you know there are more than 20 30 degrees but
sometimes you can so you know definitely educate yourself on the why behind trim line
i like to say never ever do single arch treatment just don't do it don't do it don't do it don't do
it occasionally i do it but it's just especially getting started it's just going to be a mess don't
do it and if you do do it i recommend having some type of disclaimer saying that you might
have to turn it into dual arch obviously if the patient is edentulous on the other arch okay then
but then we don't then you're going to fix you can remake the denture to fit the bike right so
always always capture your terminal molars fully on your impressions or scans double trick your and
double check your articulation on any setup and you can do that on clearcorrect you can do that
on invisalign there's a button for that sure smile shows it as default if you're using global you can
ask them for a heat map to go ahead and see what the byte is you have to ask them for that get a
screenshot double check your initial articulation and double check your final occlusion because a
lot of times the text will not articulate it correctly so i have a pretty good eye for that
you know a lot of times if you've worked for me before i'll be like i don't think this is
right can you check it with articulating paper because if you didn't get the articulation right
you know you as in you're the doctor you're the one that's approving this then it's gonna be a
mess it's not gonna work out um always better to get some type of scanner so that's a no-brainer
correct all your habits before you start find out if they have habits you know don't don't just act
you you know do you suck your thumb don't ask that you know you have to look for signs that there
might be a habit and there's a lot of signs that we're going to i think dr l will talk a little bit
more about that we're going to talk a little bit more about it in a second but correct them first
you know or you can use an omt during but most of the time if you start the ortho then they're
they're like oh well i don't have to do this anymore you know the omt so it's better to fix it
first with a removable or fixed appliance and an omt get that corrected sometimes if they have too
bad of in a habit it's just going to be a counter force pushing against the way your teeth are
moving and it's just not going to be predictable and you're going to be spinning wheels and it's
just going to be a nightmare for both patient and doctor so don't rush into cases if there's a sign
of an oral habit and oral habits can be a lot of things they could be fingers thumbs stuffed
animals pens pencils nails mouth breathing etc tongue thrust you got it be on the lookout for
really strong masseters and low angle cases that can really disrupt your case as well
you can get posterior open bites so be on the lookout for that definitely can mess things
up another tip that i have one is to use bike turbos bike turbos are really helpful
you can do them they come on invisalign they come on reveal they come on global they come on
else your smile and as of yesterday i found that you can get them on clearcorrect but there's a way
you have to ask for them so i can send you information if you're interested it is new
um you can't just say by turbos uh what else i call this double it so less is more invisalign
move by default 0.25 millimeters for a liner clear correct is 0.3 but you can change that so if
you're doing an unlimited case one of the easiest hacks is just a double or triple the aligners
so if they're telling you it's 15 i may get a 30 or a 35. uh why because that slows down
the movement smaller more incremental steps is healthier for the patient more comfortable for the
patient less pain less risk less side effects and more likely to track and actually you're probably
going to get done quicker because you're going to have significantly fewer if not any revisions
refinement so patient is super happy yes initially like whoa 40 aligners someone else told me 15 well
a lot of times when you have that 15 you have two revisions refinements and it's being 50 later
you know plus all the downtime in between and then the patient's like oh my doctor can't finish my
case why not just finish it right the first time by just slowing things down a little bit and if
it's crazy tracking you know and it's starting to get loose after day three or day four well then
you can speed up the wear you go from seven days to five day changes or from five day to four day
changes patients think that's awesome because it's super fresh and clean no one likes a dirty aligner
all right and then we already talked about staying away from your express
go lights anterior only treatments seos i wouldn't recommend that