We need to keep things in perspective. In the early 80’s, the percentage of adults in an orthodontic practice was at most, 20%. Nowadays, adults can be anywhere from 40 to 60% of the patient base of any given practice throughout the United States. It’s very important, or at least, it was very important for us to be able to cater to the needs of those adult patients, which in some events are different from the needs of a patient that is in his or her teens. For instance, some adult patients may have bruxism problems. They wear down their teeth a lot faster than younger patients, just because they have that ailment, which can also lead to problems of your joint, which is also known as TMJ.
We’ve been able to incorporate the features of our retainer for a patient that has just finished orthodontic treatment with the features of a splint appliance. The splint is basically a sign so that you do not load up your TMJ, and it also helps you to protect against early attrition of your dental enamel. That has been a huge hit for our adult patients. Moreover, some of these patients may also have rehab work done to their arches, so they may have crowns, they may have implants, and they may have bone grafts. Having this splint that protects their teeth is pretty much insurance for their investment. When you think about, if you add things up from a orthodontic treatment, to a dental implant, to a crown, young adults, or adults in general do have a sizable investment in the way they want their teeth to look, and we want to be able to give them the tools to protect that investment on the long term.
That’s how we cater to our adult patients. Also, we make appliances more aesthetic, if you will. A dreaded feature of a regular retainer is the labial bow across your teeth, so when you smile, when you grin, people are able to see that wire coming across your teeth, so we are able to give, or manufacture retainers for these patients that have a labial bow that you can barely see, because it’s made out of a very high quality plastic. Also, the color combinations, the way we finish the acrylic, everything is geared toward giving patients a more aesthetic look, while also meeting the function the appliance is going to have. That’s how we cater to our growing number of adult patients.
There are a few instances that are very common here at the lab when we get broken retainers in. Retainers can usually get crushed if you put them in your back pocket, so it is always advisable to carry your retainer case. Also, when people do not have a retainer case and are about to have dinner or eat in a social setting, they might wrap their retainer in a napkin to keep it safe from the elements, but that napkin may end up at the dumpster and their retainer may not be found after that. It’s always advisable to keep a retainer case with you at all times and perhaps at multiple places. See, all of our retainers are shipped to our practices with retainer cases. Most practices will also provide you their own retainer cases. At the very least, you have two retainer cases that you can put at strategic places so that you’re never without one.
It is also advisable to keep your retainer as clean as possible. We tell our patients not to use toothpaste. You can use your toothbrush, but not your toothpaste because that actually creates more buildup than what it removes. It is always a good idea to get advice from your orthodontist and get access to cleaning tablets for retainers. They will allow for the buildup to be broken up so you can keep your retainers clean and lasting
for a long time.
Another source of pain for patients is how they remove their retainer from the mouth or put it into the mouth. Their retainers do have retention clasps, which are usually on the back part of their retainer. Those tend to be the most sturdy pieces of wire that you can have on a retainer and it is advisable to remove the retainer or put it on using those. For convenience of course, patients do sometimes pull their retainer from the anterior piece of wire called the labial bow. The problem is that that labial bow, because it is a greater expanse of wire, tends to be more flexible, so as you pull it in and out the mouth, the wire starts to flex, it creates stress on the wire, and the wire breaks.
Those I will say will be the biggest pieces of advice I will have for patients. Of course, we see that happening all the time here at the lab.
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Traditionally, retainers have been clear pink or clear; however, there has been a huge trend that has taken place in changing that tradition of clear and clear and pink. The reason is simple, patients nowadays need to have a little bit more other than, “You need to wear this,” in order to do something. Having the ability to personalize one’s retainer increases the likelihood of the patient wearing the retainer because now there is a connection, there is a bond. “I helped create this. I’m having it in the color I like. I have it with my pet’s picture embedded into the retainer. I have my jersey number,” or, “I have the karate school’s logo in it and it’s black because I’m a black belt.” Those are the connections that patients make with their retainers, which make them far more likely to
wear their retainer.
When a patient undergoes orthodontic treatment, during the entire course of the treatment the orthodontist is on the driver’s seat because the orthodontist, whether the patient wants or not … The braces are fixed to your teeth, so things are going to happen regardless. Compliance is not really a factor unless you need for the patient to wear elastics, or things of that nature, but all that changes when the patient finishes treatment and you give the patient a retainer, because now the orthodontist is relying 100% on the willingness of the patient to wear that retainer. Sure, traditional wisdom will say, “Well, he underwent two years of treatment. It has been a huge sacrifice for the patient and their parents to get this treatment. He or she is going to wear their retainer.” Not so in some cases. Having the ability to customize that retainer, to personalize the color, really increases the likelihood for the patient to wear their retainer.
The inspiration comes from many places. A lot of times, it is our own technicians. For instance, we have a design called Florida, and it’s pretty much like a landscape, if you will, of the sun coming down at the beach, with birds and all that. Who would have thought that all of that could be clustered into a little retainer? A lot of times, inspiration comes from patients themselves. They say, “Hey, I want the picture of my pet in the retainer,” or, “Hey, I have this cool picture of a galaxy. Can you put it in there?” Or, “Hey, my favorite album is Pink Floyd’s Prism. Can you put it in there?” So, it goes.
The options are endless and we cater to any request, from any patient. Having such a wide variety of colors to start with, and allowing patients latitude to create their own, has really given us a powerful tool to elicit compliance from patients. That’s why colors, nowadays, are very important when manufacturing orthodontic appliances.
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Over the years OrthoDenco has seen an optic on the demand for splint appliances because more adult patients are entering or seeking dental treatment. We’ve been able to expand our offering when it comes to splints, we now specialize our plans based on the specific need of the patient, whether it is grinding of the teeth or if we want to level the bite or position the jaw in a certain place or not allow the patient to load up the joint. It’s very very specialized and over the years we’ve been able to develop an entire line of appliances that caters to that.
It’s not only how it’s finished, it’s also the material. We now have access to special materials that increase the level of performance of these appliances. The chief complaint for patients wearing the splints in years past was that they couldn’t tolerate a splint over two hours because the appliance is so rigid. You can imagine just having something really stiff on your teeth is going to tire you very quickly. The materials we use now are more benign that way and allow the patient to really use it over extended periods of time, which of course allow them to really see the benefits of undergoing treatment with such appliance.
That’s the splints. Now, the night guards also have allowed us to cater to that specific segment of patients that just want relief while they’re sleeping. The night guards do not necessarily will position your jaw or seek certain specific things but the main purpose for those is to achieve comfort and to avoid early attrition of the teeth. On both of those aspects, we’ve come a long way in understanding what the needs are in catering to those at the highest level of performance.
What keeps OrthoDenco up at Night?
For many industries, outsourcing makes a lot of sense because you send work to other places where it can be done faster, or cheaper or with higher quality. However, when you outsource, you lose control of quality and your processes. We’re very proud to say that here at OrthoDenco we do not outsource any of our appliances. Everything we deliver to our partner in practices is made by us, from our technicians here in house. That’s very important because it allows us to have air tight control over quality. Which is one of the major paint points of our clients.
If OrthoDenco delivers a case to one a client and that appliance does not have the quality required, the orthodontist is not going to deliver that case to that patient. We owe it to our orthodontists but we also owe it to the patient, to always have the utmost level of quality. That is what not outsourcing anything allows us to have. Full control of quality and the guarantee that not only the appliance is going to be there on time, but also, again, have the highest standards of quality. At the same time, it’s a source of price to be able to say, “Listen, this is made by us, with our hands, from our folks, 100%.
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