Table of Contents

Einstein Series
Cover Story
Practice Building
Roundtable
Continuing Education
Restorative

Inside Dentistry

April 2012, Volume 8, Issue 4
Published by AEGIS Communications

The Six Month Smiles System

Creating dramatic changes in tooth position and smile symmetry with a novel orthodontic system.

By Ryan B. Swain, DMD

Patients tend to function well despite malpositioned teeth and non-ideal occlusal schemes. Even though most adults desire an attractive smile, few pursue comprehensive orthodontic treatment because they are unwilling to wear braces for the length of time typically associated with traditional braces. Most patients do not experience any negative ramifications from their crooked teeth beyond the far-ranging psychological impacts of an asymmetrical and cosmetically hindered smile. If the desire for change reaches the point where these adults are willing to undergo traditional orthodontics and the time and cost usually associated with it, some will proceed, but most will not.1

The Six Month Smiles System is a reasonable approach for adults who want to straighten their teeth not because they cannot chew or because their crooked teeth are causing functional problems, but simply because they want straight teeth and crave the benefits associated with an attractive smile.2,3 While highly trained and skilled orthodontists provide the profession with an invaluable service for achieving ideal, comprehensive results, the Six Month Smiles System enables general dentists to correct specific patient-focused problems and treat a large pool of potential adult patients who want the cosmetic and quality of life enhancements that a straight smile can offer.4

Of course there are some cases in which a patient’s malocclusion is severe (eg, skeletal open bites, arch discrepancies, etc). In such instances, traditional orthodontics would provide a tangible functional benefit for these patients. However, when a patient’s motivation for straightening their teeth is cosmetically driven, Six Month Smiles is the short-term orthodontic and systematic cosmetic braces solution.

Six Month Smiles System

The Six Month Smiles System is a practical and turnkey solution specifically for general dentists that incorporates highly specialized materials uniquely designed to effectively and efficiently treat cosmetic cases. The one-step bracket seating system—which enables dentists to seat an entire arch in just minutes—combines the ease of use and scope of treatment typically associated with aligners but with the reliability of braces.5,6 As a practice builder, the Six Month Smiles System makes it easy for general dentists to give their patients the smile they always wanted, usually in an average of 6 months.7,8 The return on investment is immediate because general dentists, regardless of orthodontic experience, can quickly learn how to use the system and start treating patients immediately after training.

For example, dentists who attend a Six Month Smiles 2-day hands-on seminar can return to their practices the following week, begin treating adult patients with the system, and see revenue coming in from that care. Fees for training are minimal, as are the costs for the instruments and supplies associated with the system.

It is important to note that a general dentist does not require any orthodontic experience to get involved with using the Six Month Smiles System, which validates its ease of use. The unique Six Month Smiles brackets are expertly pre-positioned in custom bonding trays, ready for easy and one-step seating. The unique shape-memory wires work in conjunction with the pre-positioned brackets to achieve the desired results. This allows dentists to attend a training program, quickly learn the process, and treat appropriate cases with confidence.

A wide range of tooth movements can be predictably achieved with Six Month Smiles, including extrusions, rotations, intrusions, and various types of tipping.8 Careful case selection and successful treatment is predicated on understanding the patient’s expectations, what they want to achieve with braces, and what is possible to accomplish with the system. Most adults with malpositioned teeth are candidates.

To initiate a case, dentists take impressions of the patient’s teeth, for which there is support available through the Six Month Smiles Forum to help ensure that accurate and detailed impression-taking techniques are followed. The Forum includes mentors and instructors who help guide dentists in all aspects of the system, including case selection and treatment planning.

After impressions are taken, the models or impressions are sent to the Six Month Smiles Case Processing Center, where a Six Month Smiles bracket specialist/technician sets up the case. Set-up involves positioning the Six Month Smiles clear brackets on models of the patient’s teeth, then fabricating the custom bonding trays used for precise intraoral bracket placement. The trays are a part of the Six Month Smiles Patient Tray Kit (PTK), a custom kit created for each patient that is then sent to the dentist for initiation of treatment.

The Six Month Smiles bonding trays are the most valuable component of the Patient Tray Kit (PTK) because they are the cornerstone of the easy and efficient one-step seating process, which also is delegable. The brackets are precisely positioned within the tray according to where on the patient’s teeth they should be located to achieve the desired treatment results. Therefore, the dentist or assistant needs only to etch the teeth, apply the adhesive included in the PTK, and seat the trays intraorally. Once the brackets are secure, the unique tooth-colored wires and ties included in the PTK can be attached and adjusted accordingly.

The Six Month Smiles short-term orthodontic wires have shape memory that works in conjunction with the brackets to guide the teeth to the pre-set and desired position.9 No wire bending is required. Patients return monthly for adjustments and placement of different sized wires that also are included in the PTK. When the patient’s desired changes have been achieved and the improved occlusal scheme has been established, the brackets and wires are removed and appropriate retention is provided.

Six Month Smiles Providers are afforded an array of support materials, advanced-level training opportunities, and marketing materials. The process is honed and focused, incorporating one-step seating. This allows busy general dentists to add orthodontics, a field considered mysterious by most, to provide a life-changing option to adult patients in their practices and communities.

Case Presentation

A 19-year-old male adolescent who was accompanied to the office by his mother presented with very noticeably crooked (ie, “snaggletooth”) teeth (Figure 1). Quiet and shy, he barely said two words and demonstrated no facial expressions, having to force a smile to show his teeth for preoperative photographs. A thorough examination was performed, records were obtained, and an in-depth conversation with the patient revealed what he specifically did not like about his smile. As is common, it was generalized crowding.

Orthodontically speaking, the patient’s diagnosis was Angle Class I, canine right and left, although he had a Class III tendency (Figure 2). He demonstrated 50% overbite and ideal overjet. Tooth No. 11 was apically positioned, and he retained tooth H . The patient also exhibited generalized crowding in both arches, as well as crossbites at teeth Nos. 7 and 10, among other findings (Figure 3).

Traditional orthodontics is always discussed as an option. But, based on the diagnosis and the patient’s desires, Six Month Smiles short-term orthodontic cosmetic treatment was indicated and preferred by the patient. Despite the complex appearance of this case (eg, crowding and crossbite, and the position of tooth No. 7), it was expected that the patient’s anticipated results could be accomplished in approximately 5 to 8 months.

Impressions were taken and forwarded to the Six Month Smiles Case Processing Facility for case set-up and fabrication of the customized bonding trays used to place the brackets intraorally. The trays were placed in the Six Month Smiles PTK, along with the other needed materials, and returned for initiation of treatment (Figure 4).

At the dentist’s office, the adhesive included in the PTK was applied to the teeth (Figure 5), and the bonding trays were used to precisely and easily position the brackets on the patient’s teeth. Once the brackets were secure (Figure 6), the unique wires included in the PTK were engaged and tooth movement was initiated. The Six Month Smiles brackets and wires work together to gently move the teeth into the desired position during the short treatment time. The forces are light, and root resorption is no more of a concern than it would be for other type of orthodontic treatments.

The patient returned to the office every 4 weeks, each time accompanied by his mother, at which time minor changes and adjustments were made, including increasing the wire size when appropriate (Figure 7). Conservative and focused interproximal reduction was provided as long as crowding existed with the arches. After 2 months, tooth No. 11 was already brought down into better position, and the patient already showed positive social changes as a result of an enhanced smile. As treatment progressed, he became less shy, came out of his shell, and began smiling for photographs—even with the Six Month Smiles braces in place.

After 6.5 months, the Six Month Smiles braces were removed and, when the patient viewed his new smile in the mirror for the first time, the moment was magical for him (Figure 8). As with any tooth movement, retention is important, and a robust retention protocol is essential for long-term success.

Conclusion

This case demonstrates the life-changing effects that Six Month Smiles treatment can provide for patients and their family members, too. The results after 6.5 months produced a significantly straighter smile and enhanced cosmetic appearance (Figure 9 and Figure 10). When his mother saw his new smile for the first time, she cried tears of joy and guilt for not being able to give him a nicer smile earlier in life. She felt proud being able to send her son to serve his country in Afghanistan with a great-looking smile, only a few weeks after completion of treatment.

Disclosure

The author is the CEO and founder of Six Month Smiles, Inc.

References

1. Ren Y, Boxum C, Sandham A. Patients’ perceptions, treatment need, and complexity of orthodontic re-treatment. Eur J Orthod. 2009;31(2):189-195.

2. Oland J, Jensen J, Elklit A, Melsen B. Motives for surgical-orthodontic treatment and effect of treatment on psychosocial well-being and satisfaction: a prospective study of 118 patients. J Oral Maxillofac Surg. 2011;69(1):104-113.

3. de Paula Júnior DF, Santos NC, da Silva ET, et al. Psychosocial impact of dental esthetics on quality of life in adolescents. Angle Orthod. 2009;79(6):1188-1193.

4. Gazit-Rappaport T, Haisraeli-Shalish M, Gazit E. Psychosocial reward of orthodontic treatment in adult patients. Eur J Orthod. 2010;32(4):441-446.

5. Kravitz ND, Kusnoto B, BeGole E, et al. How well does Invisalign work? A prospective clinical study evaluating the efficacy of tooth movement with Invisalgn. Am J Orthod Dentofacial Orthop. 2009;135(1):
27-35.

6. Proffit William R, Fields Henry W. Contemporary Orthodontics. 3rd ed. St. Louis, Missouri: Mosby; 2000:616.

7. Franchi L, Baccetti T, Camporesi M, Lupoli M. Maxillary arch changes during leveling and aligning with fixed appliances and low-friction ligatures. Am J Dent Orthod Dentofacial Orthop. 2006;130(1):88-91.

8. Skidmore KJ, Brook KJ, Thomson WM, Harding WJ. Factors influencing treatment time in orthodontic patients. Am J Orthod Dentofacial Orthop. 2006;129(2):230-238.

9. Mullins WS, Bagby MD, Norman TL. Mechanical behavior of thermo-responsive orthodontic archwires. Dent Mater. 1996;12(5):308-314.

About the Author

Ryan B. Swain, DMD
CEO & Founder
Six Month Smiles, Inc.
Scottsville, New York

Private Practice
Scottsville, New York