By Digital Smile Design
⋅ min read
⋅ 14 Nov 2019
At DSD, we are huge advocates of the power of intraoral scanners, such as iTero. There are many reasons for this and we explain a lot about this at our DSD courses.
But, in this blog post, I want to highlight iTero's TimeLapse feature.
This tool is, very simply, a way to overlap two patient scans that were taken at different moments, with one simple goal - diagnostics.
Using this overlapping technology and creating storylines with TimeLapse can enable us to really understand and explain what is happening over time in a patient’s mouth.
Below I will explore how you can use iTero scans to create great stories for your patients, and how often you should be scanning them.
iTero Scans are low radiation so you can scan a patient every time
At our DSD courses, we explain that we believe the future of dentistry will include scanning every patient at every appointment.
This is something that you can start now – with low radiation it is safe to scan a patient during every appointment – whether this is a hygiene appointment, maintenance, a check-up or to start a course of restorative treatment.
Imagine you have had an iTero scanner in your practice for three years and have been scanning every patient at every appointment – by this stage you will have built up a solid record of that patient’s smile over time.
With this, you can create a timeline that you can analyse, overlapping two scans to see any differences.
I want to highlight the power of this for patient communication, using a few real stories from our clinic.
1. Utilising TimeLapse to enable patients to see the value of aligning the teeth
The first story is about when a patient came in considering aligning their teeth, but they shared the common misconception that the only reason for adult orthodontics is aesthetics.
As we know, crowding or misalignment can generate problems such as bad load distribution, bad teeth positioning in the jaw, recession, increased risk of cracks in the teeth and failure in restorations. Bad alignment can also lead to the need for more aggressive prep before treatment.
Aligning the teeth with minimally invasive dentistry can leave us with a prep-less situation, improve intercuspation, bite, load distribution, the placement of teeth in the jaw and periodontal health around the tooth.
It also enables better oral hygiene, with easier brushing and flossing, reducing the risk of decay. There are many advantages to aligning teeth!
Sometimes we want the patient to better understand and value the many advantages to aligning teeth in order to get over the challenge of adult patients embracing adult orthodontics.
That’s where iTero comes in – we need to understand how to create powerful stories that make patients see the value in treatment. But how can TimeLapse do this?
Storytelling: nothing talks like pictures
When we use iTero TimeLapse in our clinic for this situation, we may have a patient that has had veneers on their upper teeth but needs their lower teeth aligned.
However, the patient may not feel like it is necessary, or a priority, for this treatment. This is because the patient can't see the consequence of not getting the treatment.
This is an important way to show a patient the value of treatment; and how it could get worse without treatment.
It isn’t enough to explain verbally how a patient’s teeth could get worse over time, and we need to visually communicate this.
This is also about explaining to a patient that treatment will never get easier or cheaper, and in fact, over time, it could actually become a more complicated problem that costs more to fix.
Patients may still say no to treatment, but it is an educated ‘no’.
I often say to patients, you need to “own your no” and by that I mean, fully understand the consequences of not having treatment and how it could become worse in the future.
With TimeLapse we can show that five years ago the crowding looked a certain way, three years ago it was worse… all the way up until today. Patients can visually see how the situation is actually getting worse and why treatment is needed.
2. Using TimeLapse for patients with abrasion or erosion
The second story is of a dentist giving a patient a night guard, such as an appliance or retainer, but the patient not using it. Why does this happen? It could be a lack of motivation, but it is really about a lack of understanding the consequences of not using the night guard.
The Power of Visual Communication
If you have the iTero in use at your clinic, scanning patients regularly over a period of years will give you a strong record of scans.
You can sit down with the patient when they come back for an appointment, and you can see they are not using the night guard, even if the patient may say they have.
You can activate TimeLapse and show them over a period of years volumetrically how much erosion, abrasion and abfraction there has been, and how these issues are getting worse over time. They can visually see the amount of tooth structure that has been lost.
You can use TimeLapse to create a storyline for the patient, which will help them to see the trend and how their teeth will deteriorate without using the night guard.
3. Using TimeLapse to track and highlight soft tissue recession
This is an interesting story because it is my own.
I am predisposed to posterior soft tissue recession and I have a very thin biotype. I know from experience that TimeLapse is a great tool to be able to show patients the loss of gum volumetrically and the amount of recession over time.
I remember my father ten years ago telling me I had recession and needed to protect my gums.
He suggested grafts for those areas to improve the aesthetic and function of my smile. However as I didn't show my posteriors when I smiled, the need for treatment wasn’t emotionally strong in my mind – which may sound strange, as a dentist who teaches others to improve case acceptance!
So for ten years my father wasn’t able to convince me to have the graft treatment, even though it would improve my biotype and reduce the risk of more recession. Every year he offered the treatment and every year I would find a reason why not to do it...
What changed? We happened to use my case in one of our DSD courses three years ago. We scanned my smile to do a demonstration and then a year later we scanned my smile again for another course. I was curious to see my 3D mouth on a big screen (which is a great reason to connect iTero to a big flat screen TV in your clinical and presentation room, so the patient can see clearly and in high quality)!
I saw the recession in my own mouth and decided to compare the two scans.
I thought my gums were stable, but actually I saw how that wasn’t the case at all. There was a visible worsening and it played on my mind after seeing this. I needed to take action – and I did, a week after seeing the TimeLapse. That’s the power of visual storytelling with iTero.
Using the iTero for 3D patient communication and emotional storytelling
There is so much power in visual 3D communication and storytelling. It is the best way to enable patients to understand the consequences of not acting on how their teeth have changed over time.
The iTero scanner is a great ally in motivating and educating patients, using TimeLapse.
See an iTero scanner in a DSD context
If you are considering investing in an iTero scanner but aren’t sure how it would work in your clinic, watch this video with DSD Clinic owner Dr Peggy Bown explaining why dentists should use iTero scanners in their clinics.
Want to see more? Watch this short video of the iTero Element 5D up close.