During Treatment - FAQs

ClearCorrect is a medical device manufacturer . Treatment decisions and case diagnosis are entirely the responsibility of the prescribing doctor.

Treatment Questions:

Where can I check on the status of my case?

You are able to check the status of your case under your "Manage Cases" tab. This is your default screen after you first login to your account. There will be three tabs to review your cases: Action Needed, In Progress, and Closed.

How do I cancel a case?

If you have started an online case submission but you have not completed the submission, you can log into the doctor's portal and click on "Cases". From there you can find the patient's name that has the incomplete submission. (See instructions above for "How to finish an incomplete submission"). Then click "Cancel" to delete the submission. 

If the case has already been submitted to ClearCorrect then you must call, email or chat with Support to cancel the case. Please note that cases with the Setup already approved will not be issued a refund.

How do I order and pay for a remake?

To order a replacement aligner you can contact our Support Team by phone, email, or send us a quick chat. We will just need the patient’s case number, which arch (upper, lower, or both), and which step needs to be remade.

How do I place a case on/off hold?

To place a case on or off hold you'll need to contact our Support Team by phone, email, or send us a quick chat. Cases can only be placed on hold if there are phases left unshipped. We will just need the patient’s case number that you want to put on hold.

Limited 6 and Limited 12 cases cannot be placed on hold once treatment has been shipped.

How do I rush/expedite my case?

To rush or expedite a case you'll need to contact Support either by phone, email, or by sending us a chat. There is a $50 fee for rushing/expediting cases and the case will be shipped 5-6 business days from the date requested. During holidays a rush request may not be available.

Can I extend my case?

We do not offer case extensions. However, Unlimited cases that still have additional phases to ship out, (where the patient is behind in treatment) can have the next phase due date pushed back to a later date. Check the patient's case page in the doctor's portal to verify you have unshipped phases and contact Support to get the next phase pushed back. 

Limited 6 and Limited 12 cases cannot be extended once treatment has been shipped.

What should my patient expect to experience during Phase 1?

It's not unusual for your patient to feel a little bit of pressure or discomfort when snapping in Phase 1 aligners for the first time -- especially if they have never had orthodontic treatment. However, this doesn't necessarily mean that there's a problem. As long as the aligner seats over the teeth, you're good to go.

Phase 1 is staged with reduced movement to gently acclimate your patient to treatment. The pressure normally experienced is the teeth preparing to move and the osteoblast process being set into motion by the slight pressure placed on these teeth, thus speeding up the tooth movements for later aligners.  

They will also get used to cleaning the aligners, taking them in and out of their mouth, and any difficulty speaking, "lisp" or foreign sensations that are associated with wearing any orthodontic device.

Some patients have experienced a little tenderness in the inner cheek and sensitivity around the tongue. They may not necessarily be experiencing pain, it may just be that it takes some time to get used to the aligner. This usually goes away during step 2.

To help ease the discomfort and pressure of a new aligner, try soaking them in warm water or biting down on some Chewies.

What are some of the key indicators that a patient is ready to move to the next aligner? 

  • Full and complete fit of current aligners
  • Patient able to easily remove and place current set of aligners 
  • Loose contacts and spaces closed at compliance checkpoints
  • Planned tooth movements have occurred

What is the best way to determine if the set of aligners has accomplished its goal?

A sign that the aligner has "done its job" can be if there is unquestionable good fit of the current aligner. However, even if aligners appear to fit properly and comfortably, that doesn't guarantee that the teeth are actually moving as intended. For suggestions on how to identify unseen tracking issues before treatment goes off track, see our article on Tracking Issues. A tight fit of the next aligner may very well be due to a considerable amount of tooth movement programmed for the next stage. 

Does treatment need to track exactly as laid out in the treatment setup that I approved?

Yes, precise tracking is very important for a successful treatment result, otherwise, a revision will likely be required. 

What do I do if a patient's teeth feel loose or mobile? 

One doctor asked:

I have a patient that is in the middle of treatment and I noticed that some of the teeth are mobile or feel loose. The patient did not have any periodontal problems before treatment and keeps their teeth clean. Should I stop treatment until the mobility goes away or should I not be concerned about this and continue with aligner treatment? 

Our Chief Technology Officer, Dr. James Mah, responds: 

Tooth mobility of ~1mm is relatively common during active tooth movement. The tooth socket is being remodeled to allow for the tooth's movement. During remodeling, it is slightly enlarged.

In addition, the periodontal ligament is undergoing tremendous remodeling in phases of resorption and reformation. During this time, it is not as taut and does not function as well, resulting in slight mobility.

Also, the supporting bone has a dense cortical border with trabecular bone in between. The significance of the trabecular bone is that it is not homogenous. Rather, its appearance is like "Swiss Cheese" with spaces between the supporting bone scaffolding. As a tooth is moved through bone, it will pass through the bone scaffolding and the spaces. In the latter, there may be more mobility.

Having said this, clinicians should be on the lookout for occlusal interferences, periodontal disease, endodontic problems, excessive root shortening and pathology during orthodontic tooth movement. Mobility of greater than 1mm should be further evaluated for any possibility of these other problems. Most commonly, excess mobility is due to occlusal interferences.

Can I treat a patient that grinds their teeth with ClearCorrect?

Habitual tooth-grinding can make clear aligner therapy difficult -- unless you are willing to work around it. The main problem with this issue is that the constant grinding of the teeth wears down the aligners to the point that the material loses its retentiveness. Therefore, the patient may wear the aligner out before it has a chance to move the teeth adequately during that step of treatment.

However, if you are willing to be flexible and manage the patient's treatment more closely, you can work around the grinding. 

We suggest that you determine how long it takes your patient to wear down one set of aligners, then adjust their aligner wear schedule accordingly. Then, order replacement aligners of each step in order to actively progress through treatment. For example, if your patient grinds down an aligner in two weeks, have your patient switch to a one-week wear schedule. This should solve the problem.

Can a patient wear a mouthguard during treatment?

Protecting the teeth and face against injury with a mouthguard while playing contact sports is extremely important, especially when your patient has invested time and money into their orthodontic treatment.

The patient may simply remove their aligners and wear a standard mouthguard during sports practice or games, then replace the aligners right after the activity is over. Instructing the patient to keep their aligner case in their sports bag (with Chewies to help seat the aligners) will also encourage compliance. 

If you or the patient are concerned about removing the aligners for an extended period of time, you may instruct the patient to wear a mouthguard with their aligners. Companies like Shock Doctor make special mouthguards for patients with orthodontic treatment. Be sure to use an aligner that doesn't need to be worn anymore (or make a "sacrificial" aligner in your practice) when fitting the mouthguard to protect the integrity of the patient's current step.

Remember -- ClearCorrect aligners should never be used in lieu of a sports mouthguard, and the patient's teeth may move slightly during any time they are not wearing their aligners. Please use your best judgment when instructing your patients on treatment.  

How do I accomodate sleep apnea appliances & clear aligners?

One doctor asked us:

I have a patient that wears a nighttime appliance for snoring/sleep apnea. What do I have to do to accommodate both clear aligners and the nighttime appliances while they are in treatment? Do the appliance trays provide adequate retention or do you have to make the appliance fit over the clear aligner?

As you know, clear aligners should be worn for at least 22 hours per day. If your patient removed the clear aligners each night to wear the sleep apnea appliance, not only would it cut into your patient's wear-time, the appliance could actively work against the aligners, pressuring the teeth back into their original positions.

So, tight-fitting custom sleep apnea appliances probably can't be used during clear aligner treatment.

If you use a loose-fitting sleep apnea appliance, it may be less likely to interfere with the aligners. You could also consider a non-fitted device, such as the aveoTSD or a CPAP machine. If you've found something that works for you, please let us know.

Please note, however, that we have not tested ClearCorrect for use with sleep apnea appliances. We cannot guarantee the safety or efficacy of any sleep apnea device when used with clear aligners.

If your patient just stops wearing a sleep apnea appliance during clear aligner therapy, remember that they'll probably need a new sleep apnea appliance at the end of treatment, to fit the new configuration of their teeth.

Dr. Virginia Hughson-Otte wrote in to say:

"There are NO proven, safe, useful OTC apnea devices. I surely would NEVER recommend to my patients to EVER get an OTC device for sleep apnea."

When we talked about a sleep apnea appliance earlier that "fits more loosely (like an over-the-counter sport mouthguard)," that was just an analogy to describe the looseness of the fit. Obviously, an actual OTC sport mouthguard shouldn't be used as a sleep apnea appliance. 

Dr. Hughson-Otte also wrote:

"I'm a fan of the aveoTSD during ClearCorrect therapy... In fact the CPAP machine can actually produce so much anterior pressure you'll end up fighting this with your aligners also and it can prolong TX."

More than one doctor gave us positive feedback about the aveoTSD device. Dr. Marion N. Wilson wrote:

"aveoTSD works great in place of the custom fitted appliances while wearing aligners. It is a good alternative during TX. In fact I use it extensively for my patients who will not use their CPAP machines."

We contacted Glidewell Laboratories, the US distributor of the aveoTSD, to ask them about using the device with clear aligners. Their VP of Sales & Marketing, responded:

"I personally wear clear retainers myself along with the aveoTSD virtually every night. The intra-oral dimension of the aveoTSD is very thin and since your tongue is held between your upper and lower teeth inside the silicone bulb it is completely comfortable and effectively keeps my airway open so I do not snore."

We should point out that, although clinical trials in other countries have found the aveoTSD effective for mild to moderate obstructive sleep apnea, the FDA has only cleared it for use as an anti-snoring device in the United States.

We have no affiliation with Glidewell Laboratories, and we aren't getting any financial compensation from them. We have not tested the aveoTSD ourselves, so we can't recommend for or against using it. We're just passing along the feedback we've received.

Trimming Questions:

Why do your aligners overlap the gumline?

We announced in September 2013, that we trim our aligners with a smooth contour, overlapping the attached gingiva. We made this change from our previous method based on clinical research which demonstrated big improvements to retention using this technique.

Can I make custom trimming requests?

Unfortunately, we are not able to accept custom trimming requests. We trim all aligners using the same standard protocol. If you want to customize your aligners, you can do so fairly easily in your office with a buffing wheel (like the ones available in ourTrimming Kit found in the online store).

What should I look for if my patient complains of sore gums?

ClearCorrect aligners go through a multi-stage polishing process, so actual rough or sharp edges should be quite rare.

It is fairly common, however, to experience some discomfort for the first few days wearing an aligner. This often indicates that the soft tissue is getting used to having foreign material present in the mouth. Changes to the mucosa eventually fade away when the patient stops wearing aligners.

If the gums are being impinged, one possibility is that the gingiva were not captured accurately in the impression. We prefer 4-5 millimeters of gum to be included. Incomplete impressions will affect our production models.

You may also want to look for frenum pulls. These can be difficult to detect because the aligner may feel comfortable at first, but as the patient speaks and moves around, the frenum becomes irritated and ulcerated. Unfortunately this dynamic movement is not captured in the impression. Clear photographs can help to identify these. Gingival frenum pulls are rare, but when they occur, they are typically found in the maxillary premolar and midline areas. If this proves to be a problem, you may want to trim the aligner shorter in the affected areas.

 

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ClearCorrect is a medical device manufacturer and does not practice dentistry. The treating physician is solely responsible for prescribing and administering orthodontic treatment. Clear aligner therapy is unpredictable. ClearCorrect does not guarantee a successful treatment outcome. Individual results will vary.

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