Active Aligners Top Tips for Successful Treatments

Although treatment planners will treatment plan for the best possible outcome, based on Orthodontic principals and our movement protocols, your input is important. Please give them your instructions, your concerns and what your patient expects. By considering these 3 inputs, your treatment plan will be designed with the desired outcome in mind. Specific instructions will also avoid delays due to a design not having to be sent to ‘redesign’ any number of times. Remember to include any details that may hinder tooth movement, e.g. an implant. This will help the treatment planners plan around these limitations. The more detail the treatment planners have, the better they can design for a successful outcome.

Please make sure you review the case in detail. Look at movements, as you will need to monitor these throughout treatment. Look at outcomes: Make sure the patient understands what improvements can be done and the potential outcome. A link for the treatment plan can be sent to a patient for review. You do not want cases approved and the patient is not happy with the planned outcome once the treatment has been completed. PLEASE NOTE: Treatment decisions and case diagnosis are entirely the responsibility of the prescribing Dr.

Please make sure, from stage 1, that when fitted, the aligners are seated correctly. This means there should be no gaps, specifically on the occlusal edge. Show the patient what a good fit looks like so that during changes of aligners, this is closely monitored. The fit must be snug and all the attachments engaged. If the fit is not right, do not proceed further. Rather analyse why the stage is not fitting. Is it an issue with attachments, compliance or a stubborn tooth, etc.

Always use an IPR gauge to check that the correct amount of IPR has been achieved. Make sure that you check the treatment summary to see at which stage IPR is required. IPR may be required at multiple stages throughout a treatment. Insufficient IPR is one of the biggest causes of mis-tracking (We have a comprehensive guide to IPR in our Dr’s Library).

Make sure the attachments are clean without too much excess material. Always make sure the template is seated correctly when applying attachments as this will affect all future aligners. If attachments do not engage properly on an aligners, the aligner will put pressure in the wrong direction on the attachments, and this will cause unplanned for movements for those teeth (guide to attachments in our Dr’s Library).

Remember to monitor patients sufficiently during treatment, especially difficult cases, to make sure the case is tracking (you can always check back against the stages on the platform to see if they are tracking). Pay special attention to areas where IPR needs to be done. Movements can be blocked due to contacts. Additional IPR can then be done to free the contacts. If there are stubborn teeth, we recommend wearing a stage for an extra week to try and get the movement. MONITORING, FITMENT AND COMPLIANCE ARE ESSENTIAL.

If a patient does not wear their aligners as directed, they will not reach the desired outcomes. If not compliant, each stage will have a worse fit, until eventually fitment is not possible and the case will not track. You may be interested in the TrayMinder app that helps busy aligner users to remember to wear their trays so that they can achieve their best possible smiles.

Patients need to know that not wearing retainers for a couple of days can have an immediate impact. We recommend full time retention for 3 months or more, and then indefinitely at night. Fixed retainers assist with not wearing removeable retainers at night. For some patients, this may be the preferred option to prevent a relapse.