Today, a convenient orthodontic patient experience is paramount, and in return, the demand for clear aligners is growing. Many doctors offering this modality are concerned about predictability, efficiency, profitability, and compliance. For more than 12 years, we have provided clear aligners to our patients and have worked to overcome those concerns. At this point, 99% of our adult patients are in Invisalign® clear aligners.
It did not take long to discover that compliance was a key factor in a successful clear aligner treatment result. However, over time we realized several other important issues that kept some of our patients from finishing treatment on time or having less than ideal results. One of the main issues was that patients did not want to come to the office 10 to 14 times over the course of treatment. The need to take time off work or school proved to be an inconvenience for our patients and parents.
As the numbers of adults and teens in aligners increased, and the number of non-compliant patients grew simultaneously, my team and I began to pose some questions:
- How can we reduce the number of appointments and get better results?
- How can we get patients wearing Invisalign clear aligners to finish treatment faster?
- How can we get patients with Invisalign clear aligners to “track” better?
- How can we reduce or eliminate the discomfort on weekly aligner changes?
- Can we stop the “inquisition” at each visit?
- Is there a way to add value to our services?
- Is there an adjunct appliance we could use that would solve these problems?
Is this appliance easy to use, takes minimal effort or time, and is affordable for the patient and the practice?
After some research and testing of several devices to help address these issues, we decided to incorporate Propel VPro™ vibration device, as it is the only high-frequency device proven to be successful not only as an aligner seater, but it also accelerates tooth movement while decreasing discomfort. We include it in our treatment plans because it resolved many of our questions and concerns while providing an affordable option for our patients.
Initially, for an additional fee, we offered adult patients VPro as a tool to help decrease teeth soreness and allow them to easily change their aligners weekly. We found that patients who opted for the VPro experienced minimal discomfort throughout treatment and finishing on schedule. An area that it really shined for us was its ability to reduce the number of appointments we scheduled per case. Interestingly, initially saving visits was not a huge priority for our office. Still, once we saw that patients were able to advance through treatment in roughly half the visits with predictable tooth movement, we saw a way to competitively promote a more enjoyable, convenient experience for our patients.
We adapted quickly and began giving every adult patient a VPro to enhance their experience and results with Invisalign treatment. We included the cost of the VPro into the inclusive treatment fee so that no patient would say they did not want it or could not afford it.
My chairside “inquisition” about how much patients were wearing their aligners every day transformed into to “are you using your VPro every day?” I began to hear my patients’ excitement in their feedback when describing their experiences with responses such as, “oh yes, it is like a massage for my teeth!”, “Sometimes, I use it 2 or 3 times a day when I change to a new aligner to help with soreness,” and “definitely helps me seat the aligners fully each day.” We found the solution for our adult patients who wanted to have Invisalign treatment but often had trouble wearing aligners full time or were experiencing some discomfort. We can also hand out more trays and see the patient less frequently with confidence that their treatment will track. In cases where we need refinement, it is often fewer trays than our cases without the vibration.
Here are a few case studies to illustrate just how well VPro works with Invisalign clear aligners:
Case 1: Michael, Age 38 (Figures 1a-1c)
Michael, age 38, had a chief complaint of not wanting to smile. He presented as a class 1 deep bite with excessive wear and a history of bruxing. He presented with some lower upper and lower crowding and narrow arches. He underwent Invisalign treatment and completed treatment in 9 months of our estimated 10 to 12 months. This included 1 refinement. We recommended the VPro for 5 minutes each day. Michael was in treatment for 9 months, and estimated time was 12 months.
Case 2: Ben, Age 20 (Figures 2a-2c)
Ben, age 20, came to our office with the need for quick treatment because he was being deployed to the Middle East in 9 months. His chief complaint was his upper front teeth. We started him on Invisalign clear aligners and VPro. The aligners were worn 22 hours a day and changed every 7 days.
We recommended he use the VPro twice a day, at 5 minutes a session, for the first 3 days of each aligner and 1 time a day for the remainder. Ben was in treatment for 7 months, and estimated time was 9 to 10 months.
1b. Michael progress at month 5
2c. Ben initial and final at month 7
3. Scott initial and final at month 18
4. Brittany initial and final at month 5
5. Molly initial and final at month 9
Case 3: Scott, Age 42 (Figure 3)
Scott was concerned about his edge-to-edge bite. He had previous orthodontic treatment as a teenager that included 4 premolar extractions. We treated with Invisalign and VPro. He had 1 refinement. We encouraged him to wear the aligners 22 hours a day, along with daily use of VPro at 5 mins per day. He was in treatment for 18 months, with an estimated time of 18 to 20 months. He had difficulty scheduling visits due to working out of town during the week, so aligner deliveries and refinement scans were delayed.
Case 4: Brittany (Figure 4)
Brittany’s chief complaint was about her open bite and position of her canines. We treated Brittany with Invisalign and VPro. She had 1 refinement. We instructed her to wear aligners 22 hours a day and use VPro 5 minutes per day. She was in treatment for 5 months, and estimated time was 10 to 12 months.
Case 5: Molly, Age 28 (Figure 5)
Molly was concerned about her bite and upper spacing. We treated Molly with Invisalign and VPro. She had 1 refinement. We encouraged her to wear her aligners 22 hours a day and use VPro at 5 mins per day. She was in treatment for 9 months, and estimated time was 12 months.
My 4 Success Strategies for efficient aligners treatment with VPro:
- All patients change aligners every 5-7 days – including advanced Blue/Black movements
- Every adult patient receives a VPro inclusive with Orthodontic treatment fee
- VPro is prescribed 5-min daily (2x/day for first 2-3 days of a new aligner)
- Patients are seen every 12 weeks in the first set of aligners and every 16 weeks in the additional aligner stage.
In summary, my results are:
- Added value to our treatment and differentiates our practice
- Improved tracking even for patients wearing less than 22 hrs/day
- Eliminated the cooperation “inquisition” and improved patient experience
- Reduced need for more refinement and extensive treatment time
Now, more than ever, there is a demand for fewer office visits. Fewer visits are what the patients want and make us more profitable. We found that providing all our adult and some teen patients a VPro throughout their treatment enabled them to change their aligners every 5 to 7 days for all types of cases—not just the easy ones.
Because their cases tracked extremely well, we eliminated many office visits, which has been greatly appreciated by our patients and has been smoother for our practice. Patients want to get results safely and with minimal discomfort, and VPro helps us meet those goals.