What Care Providers Can Learn from Patient Testimonials Online
Patients will reach out to their dentists to inquire about orthodontic aligners, but they will also hear about the treatment from family or friends. If they don’t know anyone who has worn aligners, they may turn to the internet, where there are countless “My Invisalign Experience” videos and blogs that patients have posted online, (many of which use “Invisalign” as a catch-all term for other brands of aligners).
If you watch these videos or read these blogs, you may wonder who all these care providers are that don’t tell their patients some of the most basic information about aligner treatments! It may also be possible, however, that after hundreds or thousands of clear aligner cases, our case presentation approach needs regular review and a greater emphasis on process expectations. Being thorough about sharing the realities of clear aligner treatments can help us ensure that our patients get the best experience possible.
What Patients Share in Public Forums
For this post, we watched or read 22 videos or blogs from independent bloggers who did not represent a particular aligner brand. Their goal was to share the realities of aligner treatments to help anyone who is considering starting a course of treatment. The common threads among all these individuals include the following issues.
Pain and Sensitivity
Almost every “what they didn’t tell me” testimonial mentioned being surprised by the level of pain they experienced in the first 2-3 days of treatment. Beyond the general ache caused by the movement of the teeth, several patients spoke about the sharp edges of the aligners cutting into the soft tissue of the mouth. None of these individuals mentioned asking their care-provider to help with this problem. Some attempted to file down the edges of their aligners, with varying levels of success.
What You Can Do: As a provider, you may want to explain to patients that “new tray day” is often as traumatic to the teeth as “wire-tightening day” with traditional braces. If a patient is seeking out aligner treatments because they believe them to be less painful than braces, they may be in for a rude awakening after they have already invested their money in the treatment.
Beyond that, many providers will happily file down any sharp edges on the aligners if a patient contacts the office and asks. Mentioning this service to your patients before treatment might spare your patients’ gums and lips a great deal of trauma.
Difficulty Removing Aligners
Several patients were surprised by how difficult it was to remove aligners, especially in the first few days of each set. Many recounted elaborate struggles to remove aligners and a steep, unexpected learning curve. More than one patient recounted their trays “filling up with blood,” in the struggle to put them in properly.
What You Can Do: Explain to your patients that removing the aligners may require the use of a special tool, and that they may need to plan extra time in their schedule to remove them. You may also wish to provide guidance in how to plan meals and wear-time to minimize taking the aligners out and putting them back in more often than necessary.
Planning Meals and Hygiene
Every blogger mentioned the challenges of changing their eating habits to accommodate the daily required wear time. Several individuals mentioned that even though their dentist had explained the realities of meal planning, they were still unprepared for the significant changes to their routines. Many patients spoke of how smelly and “icky” the aligners get if you skip any step of the recommended hygiene regimen, which seemed to provide incentive for following recommended hygiene practices.
What You Can Do: If you don’t already talk a prospective aligner patient through an average day of wearing aligners–explaining every step of hygiene and the timing of meals and snacks–this practice can help patients decide if they are willing to commit to the treatment. This seems to be the most significant change to a patient’s routine, and should be covered during case presentation.
Other Miscellaneous Concerns
A few patients spoke to the fact that they could no longer wear lipstick or kiss their spouse when wearing the aligners, and several were surprised by the challenges of having attachments on their teeth. A few mentioned the challenges of overcoming an aligner-induced lisp, while others did not experience any changes to their speech.
A few savvy patients took the time to explain to their viewers/readers that the same brand of treatment can vary in costs, based on which dentist you use. A certain patient from North Carolina recounted going to five different dentists before choosing the most cost-effective option, which saved her approximately $4500 on her orthodontic treatment.
A Telling Detail
As mentioned earlier, many patient testimonials referred to their treatment as “Invisalign,” even if their aligners came from ClearCorrect or Smile Club Direct. This shows that patients, as a whole, are not as aware of the different levels of quality and that different providers are seen as interchangeable. More patients are turning to less-expensive options and will seek out the option they can afford.
If you would like to offer your patients an alternative to Invisalign with a solid foundation of scientific study backing its efficacy and safety, visit www.OrthoSnap.com to learn about our aligner system. OrthoSnap aligners are fabricated with a moveable molding system that creates a better-fitting aligner and can treat more complex cases than the 3D printed aligners everyone else offers. The process also happens to reduce patient costs up to 30 percent. To learn more about OrthoSnap, contact inventor Yan Pogorelsky at firstname.lastname@example.org.
Talking with Parents and Younger Patients
Clear aligner treatments are becoming extremely popular with young people. Invisalign specifically markets to teenagers now, with a separate teen version of the product. Young adults and teens love clear braces as much as adults do, so many can improve their smiles, due to the broad range of issues aligners can correct. However, aligner orthodontics for young people is still a relatively new territory. Many of the old habits we have regarding kids in braces simply do not apply.
The role of the parent in traditional orthodontic treatment is pretty straightforward. The parent pays the bills, wants to understand the treatment plan, and can reinforce good hygiene habits at home. The parent basically makes all the decisions (except for the color of the bands!).
With aligner treatments, things get a little more complicated. Yes, the parent will be making the investment, but the everyday compliance is going to rest solely in the hands of the patient. A child can’t decide not to wear his bracket-and-wire braces for a day or two when he feels like it—but an aligner patient can. If a young person is physically developed enough to be wearing aligners, he or she is old enough to be independent in his or her daily eating habits and oral hygiene.
This presents unique challenges when you consider the broad range of habits and behavior you can expect from adolescents. Most teenaged patients try their best to follow the plan, but teens are not best known for their ability to manage time and pay attention to details. Ultimately you have two clients to think about, two sets of expectations, and two people who need to understand what it will take to make sure the treatment plan works!
Who Wants the Ortho? Parent or Child?
Since compliance is key, it’s important to make sure the patient is on board. He or she has to be really on board in order for the treatment plan to work. If the patient isn’t deeply, truly intrinsically driven to change his/her smile, there’s a good chance those aligners aren’t going to get worn and the eating habits aren’t going to change.
Being able to spot a lukewarm patient can save you the headache of having an unsuccessful case or having to re-do the treatment plan midcourse. It can also save a parent thousands of wasted dollars and a damaged relationship with their teen.
Having an honest conversation about the daily routine changes required for clear aligner success isn’t just a box to check off during your treatment planning and patient intake. The outcome of that conversation, and an honest commitment from the patient should really be a prerequisite to treatment.
Two Clients, Not One
In treating patients, we’re used to having one client make a commitment, financially and otherwise. We have a standard set of procedures and signatures required before we proceed with treatment. But with teens wearing aligners, you have to split that thinking into: two clients and two messages.
A few tips that may help you help your teen patients and their parents:
1. Don’t Start Treatment Until You are Convinced – Have the compliance talk as soon as a patient asks about clear aligners. It’s not right for everyone. Don’t even conduct an ortho assessment until the patient understands that it’s not an “easy” alternative to braces.
2.Consider an Informal Patient Contract – If a parent commits to treatment, ensure that the patient does, too. A formal-looking patient contract to do X, Y, and Z will get any teen’s attention. Having your teen patient sign a commitment may help reinforce the message that a positive outcome is dependent on his or her actions. Draw up a printed document for the patient to sign. It should promise to wear their aligners the full 20-22 hours per day, refrain from eating and drinking while wearing them, and follow the prescribed oral hygiene routine. Such a “contract” may not be legally binding, but it will help the parent/patient dynamic if compliance problems pop up. It may even pre-empt them.
3. Treat Your Patients as Adults, Even if They Aren’t – They may not be the legal adult responsible for paying for treatment, but teen patients wanted to be treated as adults. If a patient isn’t wearing his aligners enough or is developing calculus and staining from inefficient hygiene, they’ll want to hear it from their doctor, not their parent.
Are some of these tips more parenting than clinical care? Yes. But that doesn’t mean they are outside your purview as a provider. If your heart and soul is committed to giving more people a healthier smile and a better life, they are small considerations to make.
Stay Connected for More Helpful Tips on Aligner Treatments
Stay connected with OrthoSnap for more tips on giving your patients a great experience with their clear aligner treatments. There are many aligner orthodontics providers nowadays, but OrthoSnap is unique because we use a patented molding system to create a better-fitting orthodontic treatment. You can hear it in the “snap” of a perfect fit. Our system moves the teeth faster than 3D-printed trays and costs less to manufacture. With OrthoSnap, you can give your patients more treatment options, with equally effective, predictable results. Learn more about OrthoSnap by contacting us at 516-606-7606.
Common Pitfalls in Clear Aligner Usage
Taking the step to wear clear aligner orthodontics reflects a desire to improve one’s oral health and appearance. However, when faced with the everyday routines required of wearing an aligner system, many patients find themselves inadvertently adopting habits that may be harmful to the treatment. No one does this intentionally, but unless you have advanced knowledge of the chemistry of the mouth environment, you may be more likely to make some common mistakes in judgment.
As a provider of Invisalign, OrthoSnap, or other clear aligner systems, you can encourage patients to stay vigilant in their treatment by reminding them of the importance of the following specific steps. These steps are some of the easiest to forget, yet are critical to maintaining good oral health and ensuring a positive outcome.
1. Clean the Aligners in the Morning
It’s common for patients to overlook the need to clean aligners after a long night of sleep. If one’s teeth were clean when the aligners were put into the mouth—and no food was consumed—doesn’t it thereby follow that the aligners will still be clean in the morning? Unfortunately, that’s not how mouth bacteria work. Bacteria can never be fully removed from the mouth with home-based oral hygiene. During the night, even small amounts of bacteria will grow and multiply, even in the absence of a new food source.
You can remind your patients of the need for a morning cleaning of the aligners by pointing to the presence of “morning breath.” When saliva is reduced during sleep, mouth bacteria proliferate and cause this common phenomenon. If your breath is bad, this indicates the presence of bacteria that need to be cleaned (not just rinsed) from the aligners, as well as the teeth. Overall, if the teeth are being cleaned in the morning, the aligners should be cleaned as well.
2. Protect the Aligners When Not in Use
Clear aligners should never be placed on a napkin or a tray (or shoved into a pocket or desk drawer) during lunch or dinnertime. This leaves the aligners open to cross-contamination and can introduce new bacteria into the mouth. Patients should have a clean, reliable case for holding the aligners whenever they are not being worn. Even if meal times may seem too brief to put the aligners at risk, those periods of exposure can add up over a period of weeks. Aligner cases should be cleaned regularly, as well, if not as frequently as the aligners themselves.
Careless placement of the aligners can lead to other problems beyond contamination. Leaving them in a car on a hot day can lead to warping; putting them in one’s pocket can lead to accidental pressure and cracking; and putting them on a napkin on a cafeteria tray can lead to accidentally throwing them in the trash. You can help your patients protect their aligners by reminding them that the aligners should always be in something. If they aren’t in the mouth, they should be in a case.
3. Brush and Floss Before Wearing Aligners, Even After Beverages
It’s not a challenge to see the value of flossing after a meal. Food gets stuck between the teeth and flossing is a great way to make sure it all gets removed. After drinking a cup of coffee, however? Or a fruit smoothie?
Patients might assume that purees and beverages don’t require flossing, as the teeth have not been chewing or grinding anything. However, the purpose of flossing is to remove bacteria and residues as much as it is to remove obvious bits of food. Remind your patients that even liquids can leave residue on the enamel in the small spaces between the teeth and at the gum line. Flossing reaches the spaces toothbrush bristles miss. Coffee residue left between the teeth before wearing aligners can cause staining and enamel damage. You can save your patients time (and whitening treatments!) by reminding them of this distinction.
4. Clean the Aligners Regularly and Correctly
Everyone loves the feeling of just-cleaned teeth. Brushing with a generous dollop of toothpaste is a very satisfying way to make the teeth feel smooth and clean again. Could you imagine cleaning your teeth with anything else? However, with the heavy consumer focus on whitening in recent years, toothpastes have become more abrasive. Patients may be tempted to apply that belovedly-effective abrasive cleaning method to their aligners. The problem with cleaning aligners with abrasive toothpastes is that it can damage the finish, make the fit less precise, and reduce their effectiveness at shifting the teeth.
Aligners should never be cleaned with abrasive toothpastes. Given how many products are labeled as “whitening” these days, patients may not be able to tell the difference between a toothpaste that is gentle enough for aligners and one that may damage them. The best way to help your patients avoid this potential mistake is to encourage them to follow a daily aligner-tray cleaning regimen that is safe and effective. This can include cleaning the aligners with a clear hand soap, soaking the aligners in an approved cleaning solution, and using a soft-bristled brush that does not have abrasive toothpaste residue on it.
Stay Connected for More Helpful Tips
Stay connected with OrthoSnap for more tips on giving your patients a great experience with their clear aligner treatments. Many companies provide aligner orthodontics nowadays, but OrthoSnap is unique because we use a patented molding system to create a better-fitting product. You can hear it in the snap of a perfect fit. Our system moves the teeth faster than 3D printed trays and costs less to manufacture. Learn more about OrthoSnap by contacting us at 516-606-7606.
What Direct-to-Consumer Aligners Neglect
Clear aligner orthodontic treatments are more popular than ever. Who wouldn’t want to wear removable orthodontics that blend in with your smile, as opposed to cumbersome metal brackets and wires? Who wouldn’t want to check in with the dentist less frequently? However, all that convenience and self-guided use still involves a precise orthodontic process that is as equally dependent on careful treatment planning and monitoring as traditional bracket-and-wire braces.
More than five million patients have purchased a course of Invisalign (the most well-known name in clear aligner treatment) and more dentists and orthodontists now provide it as a treatment option. At OrthoSnap, we provide a similar treatment that tends to work faster and more effectively, due to impression-moulding and closer attention to detail. Despite our differences in process and results, there is one thing we agree on: the role of the supervising doctor is critical to safe, successful treatment.
Do a quick internet search of “Invisalign without a dentist” and you’ll find a number of businesses willing to customize a series of aligners, sight unseen. They send out a home impression kit, which is then assessed by one of their remote dentists. The consumer gets their bargain-price aligners and is left to complete the treatment to their own best ability. There are several things wrong with this scenario! Direct-to-consumer models may make people feel empowered, and they may work if circumstances are just right, but there is much they are neglecting. The risks to one’s oral health are too great to ignore.
The first benefit of having a dentist or orthodontist supervising your treatment is assessing your candidacy for aligners. This always involves an oral health exam to check for signs of decay and periodontitis. If a patient begins a course of aligners with untreated issues, he or she may be putting the teeth at risk of rapidly advancing decay or gum disease. The damage that could be done in as little as six months is staggering. Considering that most people don’t keep a DiagnoDent in their medicine cabinet or know how to measure their periodontal pockets, having a dental provider clear you for treatment is a critical prerequisite.
Orthodontic Treatment Planning
Beyond basic oral health, most laypersons are not skilled at assessing the severity and nature of their malocclusion and bite issues. You need a doctor who understands the underlying anatomy and how the product works to determine whether it will be capable of successfully realigning the teeth. Neither alignment issues nor overall oral health can be assessed properly by a remote dentist who only sees a model built from a home-administered impression kit.
Radiography an important part of the oral health check and treatment planning, and a growing number of providers go beyond x-rays to include CBCT scans, as well. Three-dimensional imaging is superior to 2D radiography when you are trying to assess the position of the roots and supporting structures.
Dr. Jeffrey Miller’s 2016 presentation “10 Things You Will Not Hear from Invisalign” raises an important point regarding better screening and treatment planning. Call it housing, boundaries, or orthodontic walls—but, in some cases, there simply isn’t enough bone to support the movement of individual teeth. Poorly planned aligner treatments can result in a situation that ultimately ends in root dehiscence or fenestration. Two-dimensional imaging does not always give us the ability to screen these patients properly. You need to be able to see each individual tooth’s root-bone relationship to assess the limits of the buccal and lingual cortical plates.
Long-term oral health can be compromised by aligner treatments that don’t screen and plan treatment accordingly. As far as we can tell, the direct-to-consumer models don’t even require x-rays to begin treatment. That is scary, to say the least.
Check-Ups and Mid-Course Corrections
If you read patient reviews of direct-to consumer models, you’ll start to see a pattern of patients noticing their teeth moving improperly and requesting corrections. Sometimes it takes them months of customer service nightmares to have the treatment plan corrected, and they may have to pay additional fees for this.
With a supervising dentist or orthodontist, these problems can be corrected before they escalate to the point that a patient notices a problem. Trying to do it alone can result in a three-steps forward/two-steps-back scenario that can drag on for years. This can add up to stress on the teeth and bone, prolonged treatments timelines, and a general sense that you are wasting your money! Having a professional to monitor a patient’s progress, face-to-face, cannot be undervalued.
The Bottom Line
Ultimately, there are two things that patients and consumers need to be reminded of: no two mouths are the same, and a dental impression is never the full picture. There may be cases in which the role of the doctor is minimal—but an unvetted, unmonitored course of orthodontics carries terrifying potential risks. Orthodontists and dentists are trained to see the whole picture and use their specialized knowledge to make sure treatment is appropriate and effective. Taking him or her out of the picture is like playing Russian roulette with your smile.
Give Your Patients an Affordable Alternative, with OrthoSnap
A great way to discourage your patients from seeking out direct-to-consumer aligners is to offer them a more affordable option. OrthoSnap provides a clear aligner system of straightening the teeth that uses dynamic modeling and moulding, rather than 3D printing. This gives patients a faster-working, better fitting treatment. (You can hear it in the snap of a perfect fit.) Our system also happens to be less expensive.
To learn about OrthoSnap’s dynamic physical modeling system, visit our webpage How OrthoSnap Works, or email OrthoSnap inventor Yan Pogorelsky at email@example.com.
Are Teens the Fastest-Growing Demographic Group for Clear Aligner Treatments?
Invisalign announced last year that over a million teens have used their product, and it’s clear that young people care about correcting their smiles. Perhaps we can thank selfie culture for making young people more conscious of their oral health, but the trend is clear. Teens and young adults are seeking out clear aligner treatments and their parents are supporting this choice.
Typically, it is parents, not children, who decide whether a child will undergo orthodontic treatment. On the whole, metal braces are still less expensive than clear aligners, but that may be changing. More and more insurers are providing partial coverage for clear aligner treatments. Between in-house financing at private practices and consumer credit programs like CareCredit—many parents are finding they can afford clear aligners as easily as they can afford more traditional treatments for their children.
Why Teens Love Clear Aligners
Teens prefer clear aligner treatments to traditional braces for the same reasons that adults do. They are less noticeable in appearance and more flexible when it comes to eating and cleaning the teeth. Beyond the basics, teens have other reasons for preferring the treatment.
They are perceived as less painful. Having your wires tightened at the orthodontist’s office every month hurts. Young people know this because they have watched their friends complain of sore teeth due to braces. Most patients report clear aligners to be less painful, since the progression of changes to the aligners is more subtle.
They may feel like they will be teased less by their peers. One could argue that kids are more accepting of differences today than in the past. You probably won’t hear “brace-face” or “metal mouth” as jeers in many high schools nowadays, but metal braces do make you look younger. That’s something no young adult wants, if there is an alternative.
Clear aligners are easier for sports and other activities. Since clear aligners snap in and out quickly, young people appreciate that they can use their normal mouth guards for sports. This aspect is also appreciated by young performers who can remove aligners easily before singing, acting, or playing an instrument on stage.
They want to look their best before heading to college. Kids who have put great time and academic efforts into gaining admission to their preferred schools want to be ready for this new phase of life. If a six-month course of aligners can correct their perceived flaws, they may be more inspired to seek treatment.
The “accidental diet.” Adolescence is a time of identity-building and appearance is a part of that. If you read online posts and videos from young people who are pleased with their aligner treatments, many of them view it as an added plus that their treatment forced them to change how they eat, which led to losing some weight. Many report less snacking and soda consumption, which has obvious health benefits.
Leveraging the Growing Teen Market for Aligners
How can dentists and orthodontists benefit from this growth in the teen market for aligner treatments? It can often be as simple as knowing of the opportunity it presents and starting conversations.
It’s been long known that “kids can’t use clear aligners,” and it’s also been long known to parents that standard braces cost less than aligner treatments. Due to these biases, parents may say “no” on impulse if they are unaware of the affordability and benefits of the treatment. If you aren’t already sharing the aligner option with your teen patients and their parents, you may be surprised by the difference an enlightening conversation can make.
Are You Looking for A More Affordable Option for Your Patients?
At OrthoSnap, we provide aligners using a simpler process than the big-name provider. Instead of 3D printing aligners, we use a more accurate moulding process that creates a better fit and more precise treatment. It also reduces the overall cost of the treatment, which means you can offer your patients price-point options for orthodontic aligners.
You may have noticed that with the expiration of the original patents, Invisalign’s monopoly over 3D printed aligners has ended. Many companies are 3D-printing aligners, and some of them are even disregarding clinical precautions with a direct-to-consumer model. Having a more affordable, yet equally effective technology to offer your patients may help you protect them from trying a potentially unsafe alternative.
To learn about OrthoSnap’s dynamic physical modeling system, visit our webpage How OrthoSnap Works, or email OrthoSnap inventor Yan Pogorelsky at firstname.lastname@example.org.