Orthotown April 2020 - 60
4
Establish good habits
Consistent, long-term wear of
removable retainers is required for
lasting results. The challenge for
orthodontists is that many children
are reluctant to wear their retainers
at school, and parents who fear the
cost of lost retainers choose to condone
this behavior. As a result, the children
never develop good retainer habits, and
their nighttime-only wear soon turns
into full noncompliance. This problem
is exacerbated as offices get busier and
start reducing the number of retainer
check appointments.
The fourth law of retention is
about parental and patient obligation.
Parents may be in shock at the notion
that retention is a lifetime commitment
for their children. This reaction often
causes orthodontists to acquiesce to
a nighttime-only protocol from the
get-go, but this is doomed to fail.
Parents and patients alike need to
understand the importance of good
retainer habits. These habits need to
be instilled with full-time wear in the
beginning, then reinforced with more
than one retainer check appointment.
60
5
Retention is practice
management
In the controversial book
Straighter: The Rules of Orthodontics by
Drs. Ben Burris and Marc Ackerman,
Ackerman writes, "Orthodontic
retention is imperfect and how you
deal with relapse is a critical practice
management decision." In other words,
physiological rebound is inevitable,
and your retention protocol will have a
profound impact on patient satisfaction.
According to Ackerman, showing
unhappy patients with relapse their
signed consent form and then charging
them for re-treatment is practice
reputation hara-kiri.
The fifth law of retention is about
the orthodontist's obligation. Relapse
will certainly happen if retainers are
lost, broken or worn inadequately, but
sometimes it occurs even with great
compliance. At this moment, will you
heed Ackerman's advice, or charge for
the proverbial Phase III? Personally,
I never charge for re-treatment or
replacement retainers, no matter the
reason. And I often see areas where my
diagnosis and technique could have
been improved the first time around.
APRIL 2020 // orthotown.com
OT0420_KravitzRetention_AG_V3.indd 60
3/26/20 1:08 PM
http://www.orthotown.com
Orthotown April 2020
Table of Contents for the Digital Edition of Orthotown April 2020
Orthotown April 2020 - Intro
Orthotown April 2020 - Cover1
Orthotown April 2020 - Cover2
Orthotown April 2020 - 1
Orthotown April 2020 - 2
Orthotown April 2020 - 3
Orthotown April 2020 - 4
Orthotown April 2020 - 5
Orthotown April 2020 - 6
Orthotown April 2020 - 7
Orthotown April 2020 - 8
Orthotown April 2020 - 9
Orthotown April 2020 - 10
Orthotown April 2020 - 11
Orthotown April 2020 - 12
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Orthotown April 2020 - 15
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Orthotown April 2020 - 18
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Orthotown April 2020 - 30
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Orthotown April 2020 - Cover3
Orthotown April 2020 - Cover4
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