In the Pankey Institute’s Invisalign focus course, course leaders invite you to consider the ways in which Invisalign can be used to enhance what you do for patients on a daily basis.

One of the most significant benefits to be gained from Invisalign is achieving a more optimal environment for eliminating gum disease and maintaining periodontal health. Another is the preservation of natural tooth structure.

In my position as Director of Content for Patient Prism Academy (at www.patientprism.com), I work daily in helping dental teams communicate with their patients and prospective patients, and sometimes even among themselves. Knowledge translation is my strength. I’ve made it my business to know what patients want to know. The following information is provided in a form you can easily include in your treatment presentation when discussing dental alignment with your patients.

You know this, but I remind you here. The ideal candidate for aligner treatment is not limited to esthetic cases. Your patients who are battling gum inflammation and inflammatory diseases such as diabetes and CVD, or your patients whose teeth are worn, chipped, crazed, or perhaps even mobile, will be receptive to this particular discussion.

They Just Don’t Know

The ADA has told us that, although 75% of adults (80% of adults over age 65) have some form of gum disease, only 60% have any significant knowledge about it. It’s not surprising, then, that even fewer have an understanding of the association between their dental alignment and the health of their teeth, their dental alignment and the health of their supporting bone and gum tissue, and their dental alignment and their systemic health.

Your Patients Want to Know What Studies Have Shown

• Gum disease has surpassed tooth decay as the leading cause of tooth loss.
• Plaque accumulates more where teeth are crowded.
• Where teeth are crowded, more types of harmful oral bacteria are present in the plaque below the gum line.
• When teeth are crowded, there is increased risk for development of periodontal disease and tooth loss.
• When teeth are crowded, there is increased risk for chronic gum inflammation.
• Even low grade chronic inflammation harms periodontal tissues and systemic health.
• Crowded teeth, in combination with any of the following, increases the patient’s risk of gum inflammation, periodontal disease, and systemic diseases:
  • Tobacco use
  • Diabetes
  • Heart disease

This is to say that, if more than one of these factors is present, the risk to health is even more.

• Gum disease, chronic or acute, exacerbates (makes worse) cardiovascular disease and diabetes.
• Poorly aligned upper and lower teeth put abnormal force on each other. Over time or suddenly, this abnormal stress wears down, chips, or creates cracks in precious dental enamel. The stress can also weaken root support, inflame periodontal ligaments and nerves, and result in loose teeth (teeth that wiggle).

Your Patients Also Want to Know

• Battling gum inflammation, periodontal disease, and systemic disease can all become problematic due to crowded teeth. Until teeth are aligned properly, the personal cost can (will) grow in terms of the extent of treatment needed and the time and expense required for treatment to restore health and quality of life.
• Additional benefits of Invisalign treatment will be a more esthetic smile and proper tooth spacing for restoration of damaged teeth (and replacement of missing teeth if one or more teeth are missing).

Feel free to copy any of this to an information sheet to utilize in your consultations. Because your patients view videos fed from YouTube via your social media, I encourage you to use these bullets to organize your thoughts to prepare a video presentation for patients.

Patients tend to want to spend as little time as possible in their retainers after orthodontic treatment. It’s common in my practice for patients to ask me how long they have to wear them, with the implicit understanding that an extended time period is undesirable.

As dentists, we don’t want to give the patient bad news, but we also want to ensure they receive the best healthcare possible. In this case, we can benefit most from looking at the question with an orthodontist’s perspective.

Though there isn’t a ‘right’ answer, we can find one that will serve our purposes best.

Why You Need a Strategy for Dealing With Questions About Retainers

I dislike questions about retainers because there isn’t a simple answer. It makes me uncomfortable when patients ask. For one thing, practicing dentistry has shown me the evidence that relapse occurs after ortho.

Patients will ask about retainers immediately at the end of their Invisalign trays or even years later when they still have a lingual wire. Instead of speculating about how to respond, I’d like to consult with an expert.

The short answer to orthodontic retention is that it’s never OK for patients to stop wearing retainers. But clearly this is not going to be satisfactory for many patients.

The long answer requires us to ask orthodontists:

1. What with regard to retention is the orthodontist responsible for?
2. When does their responsibility end?
3. What do I do if I have a patient whose orthodontist cannot or will not see them for retention?
4. Should I be responsible for a patient’s retention?
5. If so, what should I know about retainers?

It’s likely we will have to deal with patients curious about their retainers. This means we should have a strategy in place to answer their questions.

Look for the next blog with answers to these questions soon … How do you respond to patients in this tricky situation? Please let us know your thoughts in the comments!