A combination of low- and high-tech solutions can go a long way to great results with aligner treatment
by Greg Thompson
This article is sponsored by 3M.
Orthodontists know all too well that even the best treatment plans and the best clear aligners won’t get results without proper compliance from patients. With more than three decades in the field of orthodontics, Donna J. Stenberg, DDS, MS, has seen the consequences of poor compliance, and dealt with the problem using low- and high-tech solutions.
Start with the basic setup
Now a corporate consultant with 3M and independent contractor for two practices, she firmly believes that compliance begins with the basics of setup. “Compliance starts with a comfortable, properly fitting aligner,” says Stenberg. “Make sure you’re creating a setup that is going to fit well, stage well, and track well.
“That means spending my time up front to evaluate each case,” she continues. “I work with the set-up design technicians as an extension of my team. Just like my clinical team in my office, the set-up team needs clear, detailed instructions from me to create a successful aligner treatment.”
Turn on a tracking app
From her home base in Stillwater, Minn, Stenberg started offering clear aligners to patients back in 2001, but it wasn’t until the smart phone revolution that high tech trackers would allow patients (and orthodontists) to easily monitor progress. For teenagers who are keenly tuned into their phones, digital tracking apps, like the 3M™ Treatment Tracking app, allow them to see results. “They are motivated when they see change,” Stenberg explains. “App users can take photographs of themselves, compare, and see what’s happening. It shows them their efforts are paying off.”
Plenty of adults are starting to enjoy the tracking apps as well, and they have only gotten more user-friendly and intuitive over the years. Stenberg adds: “Another way apps help with compliance is that a practice can connect with patients more readily without having to go through their internal management system. Teams can also offer motivational suggestions [via various apps] that help patients continue to be compliant. We can connect through a smart phone or via the web portal.”
Patients who come to believe that treatment is not working can quickly become discouraged and non compliant. A dose of objective photographic evidence can do wonders. Stenberg encourages patients to “take that picture, upload it, and toss me a question.” The high level of interactivity with orthodontists works, but timeliness of the response is crucial.
Old school education
For all the digital aids, an old school devotion to patient education can go a long way toward keeping patients compliant. Stenberg explains: “The first thing you want to do is educate people about aligners. They read a lot on the internet, yet we can better prepare them for the benefits and realities of aligner wear. Reality hits when patients are actually wearing aligners, and that’s when you’ll know whether compliance coaching is needed.”
Too often, the reality of 22-hour-a-day compliance is not properly understood by enthusiastic new patients. And while every lifestyle is different, it should not be considered a failure of either party to opt for a hybrid model if aligners are not working as hoped.
“If they’re in the middle of treatment, and I see them struggling, or if I review data from the app and things are not going well, we can change course,” Stenberg admits. “From there, it’s an honest, no-blame conversation that simply asks: Can we do something different to help you succeed?”
Sometimes a hybrid model is appropriate, and Stenberg may suggest patients keep the aligner treatment but add some fixed appliances that are discreet enough to not cause an esthetic issue—if that is the patient’s primary objection. “They’re still getting the esthetic benefit of the aligners,” she says, “but you’re also adding into the mix some additional mechanics or force generation.”
An apt analogy can hammer home the point for reluctant patients. “If you’re pulling a trailer with an SUV, you may not be able to get up the hill,” Stenberg muses. “We could keep trying, but we might just spin our wheels and not really get anywhere. However, if we use a powerful pick-up truck, we’re up the hill in no time. We all want success, and it is okay to consider correction that has a bit more gusto.”
The 3M™ Treatment Tracking App is for users age 13 and up.
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