Aisling Byrne's latest article, published in May Clinical Dentistry, features her top ten tips for orthodontists. Her insights include many gems that improve her clinical practice. For instance, choosing coated short ties improves aesthetics for her patients wearing ceramic brackets. She also explains how sending an extra email has increased patient uptake, what Ixion Instruments she wouldn't be without, plus many more tips and tricks. How many of Aisling's tips do you use? What would be your top ten tips?
1. Ceramic brackets.
One of the main complaints with ceramic brackets is discolouration of modules between adjustment appointments. They can turn a yellow or brown colour, and look unsightly, defeating the purpose of a ‘discreet’ appliance. To maintain between-visit aesthetics, I always use coated short ties anteriorly (canine to canine) in the aesthetic zone, so patients don’t experience this issue. Before going ahead with ceramic fixed appliances, many patients ask if they will stain, and I can reassure them they won’t if I use coated ligature ties.
2. Metal braces.
Crowded lower incisors teeth, particularly in adults, can be stubborn and harder to align. Using push coil to open small spaces between the contacts can speed up the alignment process.
3. Follow-up letter.
Following a new patient consultation, I send a follow-up letter a week or two later, outlining what was discussed at the consultation, the treatment options and summary of the payment plans. My patients appreciate this personal touch, which includes all the salient information from the appointment. Patients only recall a small percentage of what is said to them, and this provides them with all the information they need to make a decision. Since sending these letters, my treatment uptake has increased.
My dental nurses are fantastic and are so vital in the clinic – particularly with nervous patients. Often, my patients gravitate towards my dental nurses for support. They also do all my scanning, take all my photos and provide postoperative advice. They are an asset to my workflow and really help
make things run smoothly.
5. Ixion instruments.
I love Ixion instruments and use them for all my fixed brace and aligner work; I would not be without them. One of my favourites is the lxion long handled distal end cutter, which provides me with better vision when I am cutting arch wire ends because the hand is further away from the mouth. When it comes to aligners, the Hole Punch plier and the Tear Drop plier make cutting hooks for elastics and space for buttons so much easier.
6. Patient motivation.
At the bond-up appointment, I provide all new patients with a brace care pack, which contains everything they need in a handy pouch; they love it. They can brush their teeth on the go, and it reminds them to clean interdentally too.
7. Wire cutting.
When I am using 019/025 steel archwire, I will always cut it at an angle. This means the wire can be slotted straight in easily instead of thinning out the wire with a stone, which is time consuming.
8. At the end of treatment.
Patients, particularly adult patients, often have tooth wear (such as on the incisor edges). Enamel recontouring is a must with many of these patients to given them the most aesthetic finish. Removal of the smallest amounts of enamel can significantly enhance the aesthetics. I also offer Autograph whitening treatment for all my adult patients, should they be suitable. This can be done in their last aligner or their retainers, removing the need to make additional whitening trays.
9. Smile simulations.
I have an Itero scanner and provide all my new patients with a smile simulation at the initial consultation. I believe it is important for patients to be able to see what their teeth will look like when they are straight. Not only does this help sell the treatment, but it also manages patient expectations and can be used as a teaching aid when explaining features of the malocclusion to the patient. Also, as it gets emailed to the patient, it can be shared with family and friends.
10. Share experiences.
Even as a consultant, I still encounter challenging cases that I like to discuss with my peers. No one is ever too experienced to stop learning, and it is a great way to pick up new tips and ideas.
About Aisling Byrne
Aisling graduated from Bristol Dental School in 2000 achieving first place in her year. She was awarded both the prestigious Gold Medal as well as the British Dental Association Medal for her academic and clinical successes.
After gaining experience in a number of different dental specialties, she joined the Orthodontic Specialist Registrar Training Programme at the Birmingham Dental Hospital. During this time she undertook a Masters in Philosophy research degree. She completed her training in 2007 and gained her Membership in Orthodontics from the Royal College of Surgeons. At this examination she was awarded the distinguished British Orthodontic Society Cases Medal for her outstanding quality of orthodontic treatment.
Aisling undertook additional higher training in orthodontics, centred on the treatment of the most complex cases. She was awarded her Intercollegiate Speciality Fellowship of the Royal College of Surgeons to gain Consultant status. Aisling is a registered Orthodontic Specialist on the GDC Register and has been working as a Consultant Orthodontist at Walsall Manor Hospital since 2010. She also works in Private Practice in Birmingham.
She is an Educational Supervisor and is responsible for training and mentoring trainee orthodontists. She is an invited lecturer on the West Midlands Deanery Orthodontic Training Programme. She has lectured both regionally and nationally and has presented her research at conferences.
About DB Orthodontics
It is our company mission to become a global leader in orthodontic and laboratory supplies. With over 45 years of experience in orthodontics, we recognise the importance of quality, service and innovation. Working to ISO13485 standards we strive for perfection in all that we do, from unique product design to the excellent service provided by our dedicated customer service and sales teams. We are continually developing our product range, designing innovative products through consultation with leading orthodontists from the world, to ensure that our products meet the high standards expected by today’s practitioners.