For all patients with malpositioned teeth, comprehensive orthodontics are the first recommendation to conservatively correct and enhance the appearance of their smile. Unfortunately, the large majority of adults aren’t willing to undergo the lengthy treatment that’s usually involved. For patients who refuse comprehensive orthodontic treatment, general dentists are finding clear aligners to be a solution that isn’t always as predictable or as cost effective as they had hoped. For older teens and adults, the Six Month Smiles® short-term orthodontic system (Six Month Smiles Inc.; Scottsville, N.Y.) may be an option.
The Six Month Smiles system is a practical, turnkey cosmetic braces system specifically designed for general dentists. As a practice builder, the system enables practices to treat a large pool of potential patients who aren’t interested in comprehensive orthodontic treatment, but who want the cosmetic and quality of life enhancements that a straight smile can offer. The system enables general dentists to provide this treatment in a very short time, and the return on investment is immediate.
For example, dentists who attend Six Month Smiles training seminars can return to their practices the following week, treat patients previously unaware of this option and generate revenue from that care. General dentists don’t require orthodontic experience to begin implementing the system, which validates its ease of use. Dentists can attend a two-day hands-on training seminar, quickly learn the process, avail themselves of mentors and support specialists, and treat appropriate, life-changing cases when they return to their practices.
Figure 1: Consult with patient to determine specific cosmetic concerns.
Figure 2: Etch the teeth prior to seating the bonding trays.
Figure 3: Apply the adhesive bonding agent provided in the kit.
Figure 4: Bonding agent is placed on the brackets in the bonding trays.
About the System
The Six Month Smiles short-term orthodontic system incorporates a patient-focused approach to treatment planning and case selection, and a practical system for simplified bracket and wire placement. It combines the reliability of braces with the ease of use and general practitioner-friendly nature of clear aligners. Key components of the system are the hands-on training seminars, the specific brackets, the Six Month Smiles case processing facility and the Six Month Smiles Patient Tray Kit™ (PTK), which includes case-specific bonding trays.
One of the most valuable features of the PTK is that the bonding trays are custom-fabricated based on models of the patient’s teeth. The brackets are uniquely positioned in the bonding trays by bracket technicians, and the trays enable dentists to easily and precisely place brackets on the patient’s teeth. Tooth-by-tooth chairside bracket application is eliminated, saving dentists and their patients significant chairtime. Once the brackets are secure, shape-memory wires (also included in the PTK) are attached. The shape-memory wires work with the prepositioned brackets to easily move the teeth to the desired positions.
A wide range of tooth movement can be predictably achieved using the system, including extrusions, rotations, intrusions and various types of tipping. However, careful case selection and successful treatment is predicated on a good understanding of patient expectations, what they want to achieve with braces and what is possible with the system. The treatment approach involves correcting the patient’s chief cosmetic complaints and not making significant changes to the posterior occlusal scheme. The short treatment times are due to cosmetically focused treatment goals and materials that are designed to efficiently achieve these results.
Figure 5: OrthoFlow® cement (Six Month Smiles Inc.) is placed on the brackets in the bonding trays.
Figure 6: The upper-arch bonding tray with brackets in place while the lower arch is etched.
Figure 7: The bonding trays with brackets are cured into place.
Figure 8: The bonding trays are removed.
Examine the patient and discuss what he specifically dislikes about his smile and what he wants to change (Fig. 1). If the patient’s concerns are primarily cosmetic and don’t involve changes that are outside the realm of short-term orthodontics (i.e., changes to angle class, significant buccolingual root movement, significant midline changes), continue with an examination to confirm that Six Month Smiles is a viable option.
Take impressions of the patient’s teeth. Support is available through the Six Month Smiles online forum to help ensure that accurate and detailed impression-taking techniques are followed. The online forum includes mentors and instructors who are experts in providing guidance when treating patients with specific cosmetic concerns. Send impressions or models to the Six Month Smiles case processing facility.
A Six Month Smiles bracket specialist/technician sets up the case by positioning the brackets on the models, after which the bonding trays used for precise intraoral bracket placement are fabricated. The trays are placed in the PTK with the other necessary materials and returned to the dentist.
Etch the teeth (Fig. 2), then apply the adhesive included in the PTK (Figs. 3, 4) and seat the bonding trays (Figs. 5–8). Attach the appropriate wires included in the PTK to the brackets and adjust accordingly (Figs. 9, 10). Dismiss the patient.
See the patient every four weeks for adjustments. A three-wire sequence is typically followed throughout treatment. The appropriate wires are included in the PTK. Treatment ranges from four to nine months, depending on the case.
When treatment is complete, the teeth are straight and an acceptable occlusal scheme has been achieved. Remove the wires and brackets. Because a robust retention protocol is important for long-term orthodontic success of any kind, determine and provide appropriate retention.
Figure 9: The bonding trays are removed by peeling them away.
Figure 10: Attach the shape-memory wires to the brackets.
Figure 11: A typical case before treatment.
Figure 12: A typical case six months after treatment.
The Six Month Smiles short-term orthodontic system is a patient-focused, lifestyle-friendly approach to orthodontics and a simplified, general dentist-friendly means to treat adult patients who previously were stuck with malpositioned teeth (Figs. 11, 12). General dentists don’t require orthodontic experience to incorporate the system into their practices. Mentors and support specialists are available to answer questions and supplement the thorough training provided during the initial seminar.
For patients with crooked teeth who aren’t willing to undergo comprehensive orthodontics, the system is a practical, cosmetic braces option for general dentists to provide the quality of life enhancements for their patients that a straight smile can offer.