What to expect with ClinCheck appointment?

Discussions about treatment with invisible braces that use clear aligners, such as Invisalign, OrthoClear, the Red White and Blue system, etc.

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chinglnc
Posts: 82
Joined: Sun May 21, 2017 9:35 am

What to expect with ClinCheck appointment?

#1 Post by chinglnc » Fri Jul 07, 2017 10:49 am

Hello everyone

Had my first time with the invisalign process, took all pictures and scans.

My question is:

1. What should I expect during the next ClinCheck appointment?
2. How do I know whether the treatment plan is 'good'?

I was a bit surprised to find out my orthodontist pointed out I can do the ClinCheck appointment without him? I have requested to have him around though.

It's making me wondering how much a orthodontist is involved in the treatment plan? Do they usually just follow the advice from the Invisalign technicians?

Beemur
Posts: 62
Joined: Sun Mar 26, 2017 10:11 pm

Re: What to expect with ClinCheck appointment?

#2 Post by Beemur » Tue Jul 11, 2017 7:23 am

In my clincheck appointment, my orthodontist had to be present only because he wanted to discuss my extraction with me, so he was going through all the options but was showing me how that option was the best. I think if it's pretty straight forward, they would show you the video that has been compiled and I think if you say yep looks good, they click the approve button and the Invisalign lab starts making your aligners.
From what I remember my treatment coordinator telling me (I could be a bit off because it was a few months back now) I think the only thing the invisalign techs at the factory do is make the 3D video image thing. So like when you go in for your scan/mold, that gets sent away to invisalign and all they do is make a really intricate 3D image of mouth that can be altered. Then they send that back to the orthodontist and the orthodontist adjusts it in stages until they get the straightness they desire of the teeth. So the ortho actually does all the treatment plan work except for making the 3D image itself.
I think if you look at the clincheck and your teeth don't look quite straight or there's something that you don't like the look of, ask a lot of questions. But most of the time if there is something that doesn't end up perfect, it's corrected in the refinement stage :D
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chinglnc
Posts: 82
Joined: Sun May 21, 2017 9:35 am

Re: What to expect with ClinCheck appointment?

#3 Post by chinglnc » Tue Jul 11, 2017 9:01 am

Thank you! I have read a lot of 'refinement stage'.

I am confused of what this really means- Surely the 'refinement' should be part of the treatment process until it's perfect?

Is this just a tactic that used by orthodontist that the treatment takes xx months + xx months of refinement?

Beemur
Posts: 62
Joined: Sun Mar 26, 2017 10:11 pm

Re: What to expect with ClinCheck appointment?

#4 Post by Beemur » Tue Jul 11, 2017 12:05 pm

Yes I was also a bit confused about refinements! I remember my orthodontist talking about them and saying '99% chance you'll need refinements' and I didn't really take much notice but then got curious so I asked him. The treatment time he gave me was 2 years, but he said my initial sets of aligners are due to end after 11 months. He gave me a 2 year treatment quote because he has included refinement stage time in it because he isn't 100% sure that two particular teeth of mine will move how they are supposed to because they seem like they would be stubborn with how extremely crooked they are. He said ideally, all my teeth will move exactly how they are supposed to and then I won't need any refinements and be done with treatment in 11 months, but he said he would rather be safe and quote me longer so that I'm prepared for how long it could take. So I think refinements mostly happen because either some teeth are just much more stubborn than they're predicted to be or some people get a bit relaxed with wearing them and leave them out a bit too long so their teeth don't track as well as they would have. I'm pretty sure a lot of orthodontists include 3 refinement stages in their treatments but I know a lot of orthodontists don't properly talk about the refinements or include them in initial treatment time so people get a bit shocked by them :)
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chinglnc
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Joined: Sun May 21, 2017 9:35 am

Re: What to expect with ClinCheck appointment?

#5 Post by chinglnc » Wed Jul 12, 2017 11:21 am

Thanks for sharing. My orthodontist definitely hasn't talked about refinement stage so I am quite clueless what it means. It sounds really strange to me that there are three refinement stages!!

Another question: Once we 'happy' and 'agree' with the ClinChek, does it mean it's too late if we change our mind about how we want the teeth to look like?

For me, one downside of using invisalign is that the 'prediction' doesn't really show how your face would like when the treatment is completed.

Beemur
Posts: 62
Joined: Sun Mar 26, 2017 10:11 pm

Re: What to expect with ClinCheck appointment?

#6 Post by Beemur » Wed Jul 12, 2017 12:05 pm

That's okay, lots of people are very unsure about refinement stages. I don't think most people end up using all three refinement stages though anyway, most people go through one refinement and are very happy with the outcome by then so they leave it at that :)

Yes, once the Clincheck gets the 'okay', the invisalign lab gets the order and starts making all the aligners so there is no going back. But if something goes wrong somewhere mid-treatment and the teeth are looking like they aren't tracking properly, they can do a 'mid-course correction' and take new impressions of the teeth and get new aligners made, I think most treatment plans include one mid-course correction just in case something isn't going right. One lady from my work had just one tooth that wasn't tracking properly and her aligners stopped fitting so they had to rescan her mouth and get new aligners for her remaining aligners.

Yes it is a bit scary not knowing what the face will end up looking like! I look at my Clincheck and see straight teeth and I have to wonder how those straight teeth will look on my face, I was very worried at first that my face shape would change but my orthodontist said not to worry at all so hopefully he's right haha
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drleonsu
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Joined: Fri Mar 10, 2017 3:18 pm

Re: What to expect with ClinCheck appointment?

#7 Post by drleonsu » Wed Jul 12, 2017 8:20 pm

Before Invisalign aligners are manufactured, doctors review and approve the tooth movements on the ClinCheck. So the ClinCheck is what the doctor considers will deliver the best outcome for the patient. Some doctors like to show the clincheck to patients, some don't. I personally don't because the clincheck doesn't always show a perfect set of teeth at the end, and evaluating the process of moving the teeth requires professional knowledge to comprehend. Keep in mind that the Invisalign trays are manufactured from these ClinChecks, so the ClinCheck actually shows what the trays will look like, not precisely how your teeth will move. Some ClinChecks may show an exaggerated tooth movement, and it will show a crazy bite, but that is what's required to get the appropriate tooth movement.

To use an analogy from a famous Invisalign speaker Willy Dayan. Think of Invislaign as playing golf. You need to swing big to get to the green first, and then you putt into the hole. The first series of trays tackles the major issues. Once that's resolved, we often get a second set of trays to refine the teeth position (Hence refinement). That's the putting area. How many refinements depends on the difficulty of the case, how an orthodontist carries out his treatment plan, and how skillful the orthodontist is.

I always advise my patients not to look at how many trays, or how many refinements they have to go through, but look at how long it takes to complete the treatment. If the doctor quotes 18 to 20 months, just trust the doctor and follow his directions, regardless of what needs to be done. If there is any questions or issues, I would certainly recommend to discuss your concerns with your doctor. Pick a doctor you trust and
believe that he/she has capable hands. If you don't trust the doctor, then don't even start your treatment there.
Leon Su, DDS, MDS
Board Certified Orthodontist
Serving New York and North New Jersey

My posts are strictly personal opinion based on my education and experience. I try to provide objective and unbiased responses in an effort to benefit the public.

chinglnc
Posts: 82
Joined: Sun May 21, 2017 9:35 am

Re: What to expect with ClinCheck appointment?

#8 Post by chinglnc » Thu Jul 13, 2017 11:58 am

That's really useful. Thank you both.

Am I correct to think that the trays come in several sets...

Set 1 (treatment plan) - if everything going according to plan, there won't be additional sets
Set 2 and onward - are all 'refinement' sets

Have I understood it correctly?

As a patient, what are the signs when we know the 'aligners' stop working properly? Do we rely on doctor's advice during the routine appointment?

I feel invisalign appointments are a lot less frequent compared to other braces treatment- I wonder how do the patients know their treatment plan is according to plan, or they should seek immediate advice?

drleonsu
Posts: 12
Joined: Fri Mar 10, 2017 3:18 pm

Re: What to expect with ClinCheck appointment?

#9 Post by drleonsu » Tue Jul 18, 2017 8:31 pm

As a patient, make sure the tray is "tracking", meaning that the trays fit over the teeth intimately. There will be attachments that we place on the teeth to enable better control over teeth. You will see them as tooth colored bumps on your teeth. Make sure that these attachments are all there and the trays fit over the bumps as well. Some times it takes a trained eye to see that. Some of my patients thinks that it's tracking well but it actually isn't. That's the basic of how your treatment is doing. If your doctor is doing something that's out of the norm, there must be a reason and it's okay to communicate with your doctor.
Leon Su, DDS, MDS
Board Certified Orthodontist
Serving New York and North New Jersey

My posts are strictly personal opinion based on my education and experience. I try to provide objective and unbiased responses in an effort to benefit the public.

chinglnc
Posts: 82
Joined: Sun May 21, 2017 9:35 am

Re: What to expect with ClinCheck appointment?

#10 Post by chinglnc » Wed Jul 19, 2017 11:46 am

drleonsu wrote:As a patient, make sure the tray is "tracking", meaning that the trays fit over the teeth intimately. There will be attachments that we place on the teeth to enable better control over teeth. You will see them as tooth colored bumps on your teeth. Make sure that these attachments are all there and the trays fit over the bumps as well. Some times it takes a trained eye to see that. Some of my patients thinks that it's tracking well but it actually isn't. That's the basic of how your treatment is doing. If your doctor is doing something that's out of the norm, there must be a reason and it's okay to communicate with your doctor.
Thank you!!

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