Is there a recommended way to insert the aligners?
If aligner insertion proves challenging, try these techniques:
| Front to Back: |
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| Back to Front: |
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| Side to Side: |
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| Anterior then Lingual or Buccal: |
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Ensure that aligners snap into place upon insertion. If they don't or there's a small gap, providing the patient with chewies to bite on for a few days can help the aligners fully seat.
What are the main signs that a patient is ready to progress to the next aligner?
The current aligners fit perfectly and completely.
The patient can easily take out and insert the current aligners.
Gaps and loose contacts have been closed.
The planned tooth movements have been achieved.
Can I request custom trimming?
While we adhere to a standard trimming protocol for all aligners, we understand the desire for customization. Unfortunately, we are unable to accommodate custom trimming requests directly. However, you can modify your aligners using a buffing wheel in your office if needed.
What should I check if my patient complains of sore gums?
It is common for patients to experience some discomfort during the first few days of wearing an aligner. This often indicates that the soft tissue is adjusting to the presence of a foreign object in the mouth. These changes to the mucosa typically resolve once the patient stops wearing the aligners.
If the gums are being impinged, it may be due to inaccurate capture of the gingiva in scans or impressions. Ideally, 3-4 millimeters of gum should be included in the impression.
Additionally, check for frenum pulls, which can be tricky to detect. While the aligner may initially feel comfortable, the frenum can become irritated and ulcerated as the patient speaks and moves. This dynamic movement is not captured during impressions. Clear photographs can help identify frenum pulls. These are rare but, when they do occur, they are typically found in the maxillary premolar and midline areas. If this is an issue, consider trimming the aligner shorter in the affected areas.
Will a patient's use of antihistamines impact treatment?
Xyzal, a widely available over-the-counter antihistamine, is typically used for allergy relief. Research indicates that antihistamines, particularly H1 blockers, might impact bone remodeling activities, specifically osteoblastic and osteoclastic actions, potentially slowing down the tooth movement process, although the extent of this effect remains unclear.
When used as recommended by the manufacturer and barring any allergies to the medication itself, Xyzal is generally considered safe with no significant health risks.
For orthodontic patients using antihistamines, treatment duration may be slightly extended. However, the standard use of such medications does not prevent orthodontic treatment. Although there may be a slight extension in the wear schedule for clear aligners, adjusting the duration is not mandatory.
Should my patient be concerned if they're receiving oral hygiene notifications in the ProMonitoring App?
Orthodontic treatment involves intricate biological processes, including bone and soft tissue remodeling, inflammation, and healing, which can be adversely affected by poor oral hygiene. Complications such as decalcification, caries, recession, gingival inflammation, and periodontal disease may arise, negatively impacting the patient. Poor oral hygiene can also make tooth movement slower, less predictable, and less stable. Therefore, maintaining good oral hygiene is crucial for the successful and efficient progression of orthodontic treatment.
What is normal clear aligner wear and tear?
It's natural for clear aligners to experience some wear and tear during treatment. Here are common examples:
Normal usage can lead to a decrease in elasticity over time, causing aligners to fit less snugly than when initially worn.
Body temperature can soften aligners, affecting their shape and fit.
Saliva may gradually break down aligner material, resulting in minor alterations.
Discoloration may occur when aligners come into contact with colored beverages or heavily dyed foods, potentially causing wear.
Failure to remove aligners before eating and inadequate dental hygiene practices can contribute to wear.
Bruxism (teeth grinding and clenching) can accelerate aligner wear, leading to deformation or even cracking.
Missing teeth can exacerbate wear and increase the risk of aligner breakage.
If an aligner breaks replacements can be ordered. Additionally, patients typically use a new set of aligners every few weeks, and so wear and tear will usually not disrupt treatment progress.