Case Selection Basics

Considerations of complexity, timing, and age

Dr. Alex Molayem avatar
Written by Dr. Alex Molayem
Updated over a week ago

Also See: Treatment Plan Basics and How to Submit a Case


One of the first decisions you, as the prescribing dentist, will have to make is whether the treatment is right for the patient and the practice.

To do this, consider the following:

  1. Assess the patient's understanding of orthodontic treatment and clear aligner therapy. Evaluate and start a discussion with your patient about clear aligner systems and the benefits they provide to their oral health. Discuss patient responsibilities and commitments, during and after treatment. Discuss risks and success stories to help guide their decision.

  2. Can your practice handle the case complexity? Clear aligner cases operate on fundamental orthodontic principles and complexity can be classified as simple, moderate, or complex. It is up to the doctor to decide what classification they think the patient is in order to give some idea of the associated length of treatment and costs.

  3. Will the patient require other treatment before clear aligner treatment? Plan on completing necessary restorative treatment before clear aligner therapy and any cosmetic work after clear aligner therapy.

  4. Is this treatment financially viable? As all oral health services entail, the doctor must understand the patient's readiness to pay for treatment and what type of insurance or financing programs they need to provide, if any, in order to pay for the correct treatment.

Sometimes, you may need to anticipate some risks to treatment, such as patient compliance, if the patient is planning on moving, or an age limitation.

The more complexity a case requires, the more experience is required by the clear aligner provider to deliver a successful result.

The next factor to consider is the patient's age and periodontal health. As long as they are healthy, your patient can be a candidate for Orthosnap clear aligners.

Younger Patients

It is possible to treat younger patients with clear aligners, including those in deciduous and late mixed dentitions. It does, however, take an experienced clinician to manage their care as the child’s smile grows and changes.

Treating younger patients requires a careful approach, as eruptive movements can cause aligner fit issues. Before attempting treatment, the clinician must have a good understanding of how to manage the eruption of permanent teeth and the loss of deciduous teeth.

Older Patients

When treating older patients, you will want to make sure they understand the unique complications they may face. For instance, just as healing and metabolism are slower than with younger patients, tooth movement can be more gradual. Since tooth movement in older patients is unpredictable and can be highly variable, it is much more difficult to anticipate treatment time. They may require a longer aligner wear schedule.

You will want to spend time discussing general and specific challenges with your patient. For example, explaining a tooth with a dental implant will not move. Or that with restorations or veneers, one or more may need repair, replacement, or adjustment to align with the new occlusion.

Treating older patients with clear aligners may require a comprehensive treatment plan to rejuvenate and restore their smile.

When submitting a case, notes regarding possible risks to the treatment plan are important. Furthermore, presenting possible solutions and alternatives to the patient will make the patient feel comfortable knowing a plan is in place to deliver the best results with the least amount of risk.

Still unsure? Our Clinical Support team will be happy to go through case selection with any number of potential cases you have lined up.

Related Topics and Information:

Click to learn more about Treatment Plan Basics and How to Submit a Case.

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