Aligner Dental Academy explains how to monitor Invisalign treatment over time to ensure optimal results and patient satisfaction.
How do we define success in our patients? If patients loved their final smile, their restoration has not caused any pain or perhaps their gums have stopped bleeding after months of periodontal treatment?
But how about their experience through it all? That surely impacts their end of treatment outcome as well.
The end point is just as critical as the journey to get there. And with Invisalign treatment, the patients really do go through a journey with their teeth and their smile.
Patients have their sight set on that ‘in smile visualisation’ image you have shown them from the start. And if you’ve planned the case well and your patient is compliant, each monitoring visit should require minimal intervention on your part
However, we know that this is not always the case, and so the Aligner Dental Academy (ADA) have provided a streamlined guide to help you navigate each monitoring appointment and get your patient to their end point as smoothly as possible.
1. Plan ahead and stay organised
Prior to each visit, review the patient’s treatment plan and prepare everything you’ll need, such as IPR strips, IPR gauges, new chewies, and any other necessary tools. Review the ClinCheck clinical photos, radiographs etc as necessary.
2. Patient update
At the start of each visit, assess patient compliance and confirm they have been getting on well since the previous visit. Ask the patient what number aligner they are on and how many hours per day they are wearing them. Ideally, patients should wear their aligners for at least 20 hours a day, with 22 hours being the goal.
3. Evaluate aligner fit
Once the patient is in the chair, examine the fit of the aligners, paying close attention to the incisal edges and gingival margins. A close fit indicates that the teeth are tracking well. If the fit is slightly off for more challenging teeth, it can be acceptable but ensure there is enough space for movement. You can check this by passing a yellow IPR strip between the teeth.
If tracking isn’t perfect, advise the patient to continue using chewies, consider extending the wear time, and monitor the situation. Document this in your records. If there is a significant gap (more than 2mm) between the aligner and tooth, or if extended wear time doesn’t improve the fit, consider taking new records and ordering additional aligners.
To find out more about troubleshooting tracking issues and how to resolve it watch our webinar with Dr Jasmine Piran here.
Poor fitting upper aligner.
4. Check attachments
After removing the aligners, verify that all attachments are still in place. If any are missing, use the attachment template to replace them, not the aligner itself. You can cut the template into individual teeth or order a replacement for the current stage via IDS. Cutting the template is usually faster, as it avoids the need to rebook and wait for a new template to arrive.
5. Perform IPR and attachments
If needed, perform any interproximal reduction (IPR) or place/remove attachments. Record the amount and location of IPR in your notes. You can also document this on the treatment overview form for easy reference.
6. Ensure free movement of teeth
Run a yellow interdental strip through every contact point to ensure that there is free movement. Invisalign applies gentle forces, so it’s important that tight contacts are addressed. If a contact point is too tight, release it with the yellow strip to facilitate proper tooth movement.
7. Check posterior occlusion
Examine the posterior occlusion to ensure that the posterior teeth are meeting normally and that the occlusion is stable. If you have any doubts or concerns, take clinical photos and upload them to the forum for further evaluation.
Occasionally a posterior open bite may develop towards the end of a treatment plan. It is important to address this issue.
See our webinar which covers this here.
8. Review progress and celebrate success
Review the ClinCheck plan with the patient to discuss their progress. If the treatment is going well, it’s likely due to the patient’s compliance. Recognise and celebrate their efforts during the visit. Positive reinforcement can help maintain motivation and adherence to the treatment plan.
9. Provide the next series of aligners
Finally, provide the next series of aligners to the patient, document this in your notes, and confirm the next appointment. Staying organised and proactive throughout the treatment process ensures a smoother experience for both you and your patient, leading to successful outcomes.
10. Document and seek advice!
Make a simple template for your Invisalign monitoring treatments. Have the above titles set as prompts for you, so you and your nurse have a checklist ready to go with every appointment.
And remember, if it ever seems like the teeth are not tracking, take a scan and photos at that appointment. You can post that case on the ADA Forum where one of our mentors will reply to you within 48 hours with a detailed response advising whether to take records for additional aligners or to try any chairside techniques that could help get the teeth back on track!
‘The getting there is every bit as important as arriving at the destination.’
Granted most people do not exactly enjoy the treatment process itself. But you can make your patients’ Invisalign journey smoother and easier by following ADA’s simple guide for monitoring and guiding them every step of the way!
Become a member today.
This article is sponsored by Aligner Dental Academy.
