This article covers the following topics:
- Getting the patient to sign the Informed consent & agreement and important initial patient education
- Prescribing the case and the pre-submission worksheet
- Getting intraoral scans or PVS Impressions
- How to take one-step impressions
- Taking the required photos and tips on taking photos
- X-rays (optional)
Your first steps in starting a case with ClearCorrect will be collecting patient records. You will collect the records in your first appointment with the patient.
Informed consent & agreement
We recommend as the first action for you to review the Informed consent & agreement with your patient and sign it together. The document is provided to prepare patients for the various issues that can arise during treatment as well as potential risks associated with clear aligner therapy. The Informed consent & agreement is a legal agreement between you and your patient establishing that your patient consents to receive treatment and understands the risks involved. Though we don't require a copy of this form for our records, we strongly recommend that you keep it with your patient's records for future reference.
Educating your patient is key to obtaining positive results in clear aligner therapy. It is important to take time to educate your patient in this first appointment.
Some doctors have created additional agreements to serve as confirmation that you have educated your patient on specific important aspects of their treatment. While using any additional forms or agreements is entirely at your discretion, we encourage it. Below are a couple examples of forms used in some dental practices:
- A "Patient Cooperation Acknowledgement" showing that your patient has been educated on such things as wearing their aligners 22 hours a day, cleaning and proper brushing, consequences of non-compliance, etc.
- An "Aligner Orthodontic Consent" form confirming that your patient was educated on clear aligner therapy, patient agreement on appearing for appointments, consequences of not appearing for an appointment, etc.
- A "Holding Form" for when a patient's treatment goes on hold.
- For when treatment is complete a "Patient Satisfaction Form" confirming that the patient is satisfied with their treatment.
Easily one of the most important records you'll send us is your prescription. It tells us what you want us to do. You treat your patient, not ClearCorrect. What happens with the case is entirely up to you, so it's important that you guide us with a thorough and detailed prescription.
We've tried to make it as easy as possible for you to send us the information we need. Simply complete the prescription form on ClearComm when you submit your case.
Some doctors prefer to use our pre-submission worksheet when sitting chair side with the patient. With the pre-submission worksheet you can collect needed information for your case submission while you're with the patient. While we don't accept pre-submission worksheets for submitting cases (all cases must be submitted online), it can be a useful tool for doctors to collect information in the first appointment.
Intraoral Scans or PVS Impressions
The aligners we make are custom appliances. We make them to specifically fit your patient based on a series of molds made from the intraoral scans or PVS impressions you're required to send us when submitting your case.
Intraoral scans work best, but PVS impressions have been an industry standard for years and continue to work well.
If submitting scans for a case, we require scans of both the upper and lower arches, even if you're only treating one arch. Why do you need both impressions for single arched cases?
We also require that the scans be positioned in occlusion. You'll know they're positioned correctly if they appear articulated when opened in a 3D viewer like in the image below.
If you don't have an intraoral scanner or just prefer taking good old-fashioned PVS impressions, we'll still accept them. As with scans, we require both upper and lower impressions, even if you're only treating one arch.
Bite registrations are now optional. There may still be a few scenarios where the bite registration is preferable (for instance, when the patient has a posterior open bite), but in most cases the bite registration is no longer needed.
You can use nearly any type of tray you like for your impressions except for metal trays. We don't return your impressions, so it's best to use disposable trays anyway. Make sure your trays are properly sized to fit all the teeth and the surrounding gums.
PVS or VPS materials work best. Polyether (Impregum) will work as long as the detail for the gum lines are there. In our experience, Sultan Genie™ VPS and Premium Dental VPS impression materials are easy to work with and deliver consistent results. If you prefer a different polyvinyl or polyether impression material, feel free to continue using that.
Alginate is not acceptable because it dries out and distorts.
The final set of records we require is photos. Photos help us understand your prescription and interpret your instructions. If you don’t have the photos on hand when you submit your case, you may be able to upload them later on the case page, but don’t wait too long—the case won’t move forward until we have all required records.
We need photos of eight specific angles:
Your photos can be sent as separate prints, as digital files, or printed together on one page as shown here. The exact format of your photos isn’t important. What is important is that you include clear, well-lit photos from all eight angles.
Below are the eight different photo angles required for your submission. These photos will help us produce the best aligners possible:
- Full face (smiling)
- Full face (not smiling)
- profile (not smiling)
- Upper occlusal view
- Lower occlusal view
- Right lateral view
- Left lateral view
- Front view
For a printable photo template click here.
Tips on taking photos
With most cameras, pressing shutter button (the button that takes the photo) half way (before you feel that main resistance before the "click") before actually snapping the photo will help to focus the photo. Snapping the photo without first giving the lens a chance to focus usually results in blurry photos.
Light is your best friend. It's what makes photography possible. So it's always best if you can take your photos in the most well-lit area of your office. Using a flash is sometimes necessary, but be careful—it tends to flatten images out and can sometimes cause problems by washing out details if it's too bright. If it looks good in your view finder or on your screen, try not using a flash first.
Avoid getting too close to what you're photographing. Many cameras have a hard time focusing on things that are extremely close; in addition, if you have to use flash, the flash will wash out a lot of the detail in the shot if you're too close. Instead, take a tiny step back and simply zoom in on the subject.
Before and After photos
You already have to take the "before" photos when you submit a case to us. Upon placing the final retainer we always encourage doctors to take a series of "after" photos, to keep a record of how effective the treatment was. We love seeing those new smiles, and doctors who take the trouble to take an extra series of photos are always glad they did! Great treatment outcomes are the strongest tool you have for growing the clear aligner aspect of your business.
We recommend that you provide x-rays, but we won’t hold up your case if you decide not to include them. Even though you'll tell us in your prescription about the sorts of things we'd look for in x-rays--things like ankylosed or fused teeth, restorations, implants, etc.--that old adage "a picture's worth a thousand words" really does hold true, especially with x-rays. It just makes it that much easier for us to understand what you're trying to accomplish with the treatment.
We're happy to accept either a panoramic x-ray or a full-mouth series.