Addressing Parents’ Concerns with Invisalign Treatment

Compliance is King

When treating adolescents with Invisalign clear aligners, one of the biggest concerns among both parents and orthodontists is the fear that kids aren’t going to wear the aligners and that they lack the responsibility. The irony though is that we often have better leverage over compliance in Invisalign treatment as compared to fixed appliances. With our non-compliant Invisalign patients, there is always the threat of transitioning to braces. However, in teens with braces who fail to adequately brush and who won’t wear their rubber bands, at some point the only thing we have left to bargain with is removing appliances, which to them isn’t much of a threat at all.

Orthodontists who are concerned with teenagers’ compliance feel this way mainly as a result of limited experience versus having actual compliance issues with teens in aligners. Poor compliance leads to a poor outcome no matter how you decide to treat a case. Therefore, it is essential that we anticipate potential stress points that will ultimately have a negative impact on patient motivation, and work to minimize these obstacles by actively steering the family towards the treatment option with the best fit for the patient’s lifestyle. This comes with special emphasis on the patient because the parents’ motivation has not been shown to correlate with the child’s level of cooperation. When the adolescent has bought into the idea of orthodontics, and into the idea of clear aligners, we know compliance will be excellent so we need to make sure the parents’ are on board with the ideal approach.

When parents do have hesitations, they come in a few different flavors:

1. They think braces are less responsibility. Many parents fail to understand that braces require just as much work as Invisalign treatment, but that the required tasks are just different. This sort of objection opens the door to an important discussion about the patient’s role in treatment. Difficulty with hygiene around braces, the dietary restrictions, the need to wear elastics, potential discomfort, etc. can be substantial challenges for patients, so they will really need to be up to the task if we are going to deliver the best outcome. Providing much needed perspective and putting your recommendation within the context of patient motivation and it’s importance to treatment is the best approach to allay these concerns.
2. “What ifs.” Some parents find it hard to trust their child with the investment they are making and get hung up on the “what ifs” of Invisalign treatment. Offering a no cost transition into braces is the easiest way to take this concern off the table and gives you a nice, uncomplicated bargaining when if the patient isn’t living up to their end of the deal.
3. Does it really work? Every now and again you’ll encounter a parent who scratches their head about plastic aligners, and you’ll need to provide reassurance. Some may have even been told by their dentist, a friend, or a less experienced orthodontist that “Invisalign treatment doesn’t work.” A simple explanation that both braces and Invisalign clear aligners do the same things (i.e. straightening teeth) and that the teeth cannot tell the difference puts these concerns to bed.
4. Differences in price. If we know Invisalign treatment is a better fit for that patient, why are you then charging more to make everyone’s life easier? Since we are providing a service and not a product, treatment fees should be based on the complexity of treatment and treatment goals.

Understand Your Patients

When we fail to adequately engage the patient in the decision making process, we see less motivation, poor cooperation, extended treatment times, and compromised results, yet I still see many orthodontists taking patients’ stated desires for “braces” or “colors” at face value instead of looking at the bigger picture. Unless the patient or a sibling has already had treatment, most people don’t have much perspective on what orthodontic treatment will be like and it is up to you to show them what is possible. Don’t abdicate your responsibility to your patients. Be proactive and really listen to what they are telling you about themselves so you can help them make the right choice.