Active Aligners Cheat Sheet

What are Active Aligners?

Active Aligners are clear aligners developed to align teeth in a predictable, smooth, clear and comfortable way. A series of aligners moves the teeth 0.25 to 0.3mm per stage until optimal alignment is reached. They’re made from clear, high-quality, medical-grade dental material, smooth, clear, transparent, and BPA- and gluten-free.

Benefits

• Clear and virtually invisible
• Removable and comfortable
• Predictable, with effective outcomes
• An affordable alternative to traditional braces
• Relatively fast, 6 to 8 month average treatment time

Patient instructions

• Wear aligners 20 to 22 hours a day
• Switch to the next set after 1 to 2 weeks (or as the provider instructs)
• Seat the aligner with the help of chewies
• Proper insertion and removal are important
• Clean the aligners regularly to maintain good oral hygiene
• Every set is delivered to the provider with a comprehensive patient instruction manual

Treatable cases

Open bite · rotated teeth · underbite · spacing / gaps · overbite · crooked / crowded teeth.

FAQs

• Treatment length: 6 to 8 months on average; each case differs and may range from 2 to 12 months.
• Orthodontic principles: aligners correct crowding, gaps or rotation in a planned way, each stage worn ~22 hours a day for two weeks until optimal alignment is reached.
• Manufacture time: once the plan is approved, aligners are ready for collection in approximately 2 weeks.
• Minimum age: 16 by default; exceptions may be made by the provider case-by-case (young teens usually qualify once all adult teeth have fully erupted).
• Eating: no food restrictions, patients remove the aligners to eat, then brush before reinserting.
• Cleaning: clean morning and night with a soft-bristled toothbrush, cold water and a small amount of soap (avoid hot water, which can denature the plastic and alter the fit).
• Lost or damaged: the patient should contact you immediately. Within 7 days of starting the current stage, a replacement should be made; if compliant for the first 7 to 8 days, it may be possible to move to the next stage at the doctor’s discretion (additional costs apply for replacements).
• Can patients remove them? Yes, any time, but they should wear them at least 22 hours a day, removing only to eat, drink, brush and floss.
• Retainers: worn 22 hours a day for 3 months, then switched to night-time wear, to hold the new positions; a fixed lingual retainer can be offered after the 3-month period.

The patient journey

1. Consultation
2. Scan or impression
3. Quality-control images
4. Wishes / instructions
5. If a candidate: automatic treatment plan
6. Treatment plan review and acceptance
7. Manufacture (around 10 working days)
8. Collect aligners and begin treatment (IPR and attachments if needed)
9. Track treatment every 8 to 10 weeks
10. Complete treatment, then retention (for life)

Doctor’s workflow

1. Evaluate overall oral health and candidacy; the patient completes informed consent. Resolve any periodontal disease, caries or oral-health issues before starting.
2. Once cleared, take records and send to the platform: impressions (PVS or Impregum, not alginate), quality-control photographs, and prescription / design instructions.
3. The treatment plan is generated and assessed on the platform, number of aligners, a 3D plan, Smile Summary and QC photos.
4. Once you and the patient accept the plan, the case is manufactured; IPR and attachments may be needed (check the Smile Summary). Each set is worn 22 hours a day for two weeks before the next stage; aligners are removed to eat, drink, brush and floss.
5. Monitor treatment every 8 to 10 weeks, there may be more IPR at later stages; check attachments are engaging and teeth are tracking to plan.
6. Once teeth are in their final position, retainers maintain the result (3 months full-time, then night-time or a fixed retainer).

Treatment protocols

Our movement philosophy is based on being the least invasive, using maximum arch expansion, allowing minimal IPR, and using attachments where necessary for predictable movement. There are three protocols:

• Protocol 1, anterior movement without attachments
• Protocol 2, anterior movement with attachments
• Protocol 3, full-arch movement with attachments

See Case Selection and Movement Protocols, the Guide to IPR and the Guide to Attachments for the detail.

Quality-control photos

Eight photos are required, external: 1) profile repose, 2) frontal repose, 3) frontal smiling; intra-oral (with cheek retractors): 4) lower arch (open mouth), 5) upper arch (open mouth), 6) right buccal (teeth together), 7) anterior (teeth together), 8) left buccal (teeth together).

• Choose a solid, light background and stand in front of the patient
• Centre the face/teeth; keep the patient away from the background to avoid shadows
• Tie long hair back and make sure nothing obscures the teeth
• Check focus, exposure, that all teeth are present, and watch for reflections

Impression guidelines

PVS / Impregum: use the correct tray size (rear molars covered); overflow both ends to capture the distal of the 2nd molars (and 8’s if present); capture 2 to 4mm of gingival tissue; inspect for air bubbles, double impressions, missing anatomy, push-through or blended tooth and gingiva; re-take any with defects. Alginate is not accepted. Digital: capture 2 to 4mm of gingival tissue, follow the manufacturer’s ortho/arch scanning guidelines, take an accurate bite in centric occlusion (not edge-to-edge), and rescan if there’s debris or missing anatomy.

Prioritising Active Aligners in your practice

• Educate and build awareness, train your team to spot orthodontic needs at routine check-ups and to talk to every patient (they may know a candidate); having a staff member in treatment is a great conversation starter
• Market it, run targeted social ads, share informative content and success stories, add dedicated Active Aligners sections to your website with before/after photos and testimonials, and display brochures, posters and videos in your waiting area (contact us for promotional items)
• Use local insight, interest in discreet adult orthodontics is growing; tailor your messaging to that demographic across emails, on-hold messages and word of mouth
• Showcase success stories, encourage reviews and testimonials and maintain a before-and-after gallery online and in-practice
• Partner locally, offer corporate wellness sessions and take part in local health fairs, school programmes and community events