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Delivery of clear aligners I

Updated: Nov 2, 2023

This is the initial post out of four, focusing on standardizing the initiation of treatment for your clear aligner patients. This approach aims to reduce the time patients spend in the chair while enhancing their overall satisfaction with their treatment.

In this post, I discuss the patient experience and how to optimize it.

In addition, you'll get an overview of:

3 things you should always check before handing out clear aligners

4 tips for planning attachments/engagers

Tips for delivery

Patient is provided with a clear aligner

After treatment acceptance

When a patient has accepted treatment, it is usually based on a digital mockup that shows the patient a possible outcome of the treatment. Of course, this mockup needs to show an end result that is realistic. The path to get there is not essential at this point. To save resources, the final plan should only be drawn up once the patient has accepted the treatment plan and the total investment. Of course, this requires the ability to recognize whether the first mockup from the aligner company is anywhere near realistic, safe and predictable, or if it is completely unrealistic.

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Before delivery

Before delivery

From acceptance to delivery of aligners, the digital setup/ClinCheck is optimized to be realistic and predictable. The aligners are then produced and shipped to the dental practice.

Once the box with the patient's aligners has arrived at the clinic, everything is prepared for the patient to receive their aligners.

It is important to remember that most patients are excited to get started with their treatment. For most patients, it is a relatively large amount of money that is invested in the treatment. This is worth remembering as a practitioner. Because it requires a special focus on making the dispensing a special experience for the patient.

Make the delivery of clear aligners simple

We prefer simple procedures, as it allows us to focus on the patient. Rather than having to remember a procedure or follow a checklist (checklists are still recommended, but they shouldn't be the center of attention).

Important detail

For the first 4 weeks of an aligner treatment, the teeth do not move more than the periodontal gap allows. This is because it takes around 4 weeks to activate the biological processes that drive bone re-modeling.

How long will the patient need the first 2 sets of aligners?

ClinCheck/setup is planned so that the first 2 sets of aligners are worn for 2 weeks each. This is because there is too much risk of teeth not tracking if more frequent changes are made (unless aligners number 2 and 4 are copies of aligners number 1 and 3 respectively).

Fit test

Check the fit of the patient's aligners. There should be no air between aligners and teeth. However, be aware that there may be air between aligners and teeth when changing aligners, as the planned relocation of the teeth has not yet taken place.

Check the approximal contacts. The contacts should not be so hard that a dental floss has difficulty passing through. If this is the case, the contact point should be lightly sanded with a polishing strip until the floss slides easily. (Typically a single pass through the contact point with a yellow perforated metal polishing strip).

With each delivery of new aligners:

  • Check that the aligners match the attachments.

  • Also check that the attachments are intact between each check of the aligners.

  • Check that floss slides easily between all aproximal surfaces throughout the dental arch.

Magic tip for attachments / Engagers

One of the magic tips for attachment/engager bonding is to plan your ClinCheck/setup in a way that attachments/engagers are not placed before the first 4 weeks have passed. There are a few reasons for this:

  1. It is much easier to instruct the patient on how to put the new aligners in place and take them off when there are no attachments/engagers on the teeth.

  2. The patient will have a much better experience with their aligners when there is no clinical procedure to perform at the first consultation.

  3. If the patient regrets their treatment (It happens extremely rarely, but it does happen). Then it is much, much easier to take the first 2 sets of aligners back and give the patient a refund for the treatment (excluding the lab fee). Rather than having to spend time removing all the plastic that has bonded to the teeth.

  4. When the patient arrives for the scheduled bonding of attachments/engagers, the patient is informed that it will be more difficult to remove the aligners from the teeth.

  5. This is where the magic happens. Now, patients almost always say that it took them a while to get used to placing and removing their aligners. But that it was only a matter of time before they got the hang of it. Similarly, they also expect that it's just a matter of getting used to the new conditions.

  6. In other words, it will be much easier and less time-consuming to provide aligners to patients who are new to treatment.

Once the patient has been trained to insert and remove their aligners, most of the tension and nervousness is removed for the patient. This way, the patient is more ready to receive the important information about use, hygiene and storage when the aligners are not in the mouth.

In the next blog post, I'll be writing about what information you should give patients when they receive their first aligners. There are tips on how long the patient should wear their first aligners so that the treatment is as predictable as possible.

Make sure to stay up to date on Invisalign, ClearCorrect, Spark and SureSmile treatment when we post new content.

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In the next post, I will write about the hygiene instructions we give patients when dispensing clear aligners.

tandlæge og clear aligner ekspert Jesper Hatt

Many kind regards

Jesper Hatt DDS

Phone: +41 78 268 0078

AlignerService helps dentists create realistic, safe and predictable treatment plans with clear aligners.

Currently, we help approximately 1500 dental clinics in 19 different countries optimize their Invisalign, ClearCorrect, Spark and SureSmile treatments to make them realistic and predictable.


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