Dr. Amy E Buchler is a successful orthodontist with two offices in the Modesto, CA area. She’s been involved with SureSmile® since 2012, using it for a handful of cases each year. Last year Dr. Buchler accepted the SureSmile conversion challenge in which she agreed to use the SureSmile digital treatment platform for all of her cases for a full year. We recently sat down with Dr. Buchler to discuss how the challenge has gone.
How long have you been using SureSmile?
I started using SureSmile in 2012 and used it occasionally over the years. The last year they issued me a “conversion challenge” in which they said “convert to SureSmile digital treatment for one year and see if you notice a difference in how your cases progress and finish.”
In the past SureSmile was only available in a case volume-based price structure. I would purchase 100 cases to improve my pricing. As a result, I would kind of save it for cases when I wanted the benefit of their technology. But with the conversion challenge, they also introduced a fixed monthly payment—one price no matter how many cases I use it for. So, I gave it a shot.
Did you see a noticeable difference?
Yes. I now use SureSmile for my wire-based cases and the SureSmile Aligner for those seeking an esthetic, aligner-based option. I have a few Invisalign® cases finishing up. But my practice is 100% SureSmile now.
What do you think about the treatment planning software?
I’m a big fan of it. I love the DIY option where I can do the treatment planning. This means the case never goes to the digital lab. I use the software to set everything up, and then I just order the case. It’s perfect for most of the minor movements that I treat. But not all. On more complex cases, I can enter my prescription and treatment plan, they do the rest. They will go as far as staging it for me. I can still check and change the plan however I want. And then I have three years to finish that patient.
It sounds like there’s a lot of flexibility?
There is. For example, when I’m starting an adult patient, I know that person’s teeth haven’t moved in a long time and it takes a couple of months to get their teeth ready to move. So I change the velocity on how fast the case progresses. I slow down movement for the first few trays as a patient is getting used to it. Then we ramp it up later on. The software lets me adjust it to exactly how I want it.
Of course for the real “techy” types, you can also export the STL file and do the aligners yourself. If you want to print and produce everything in house, you can do that too.
What’s it like working with the SureSmile Digital lab?
It’s been great. Most of my cases are DIY. That way I can set up the teeth myself. Then I just hit order and the aligners show up at my door in two weeks. So it’s about three weeks from digital impression until the aligners are here.
What do you think about hybrid treatment?
Well that’s often the ideal. Sometimes I’ll be dealing with smiles where the teeth are really rotated and I will move them with braces first. Or sometimes I say to a patient ‘if you can give me three or four months with braces on the lower arches and then I can make it so your uppers and lowers finish at the same time’. Patients don’t want to have a mismatched number of trays for the upper and lower arches. So this helps keep it simple.
What do you do if someone comes in and requests Invisalign by name?
Good question. If someone comes in and requests Invisalign by name, I explain that there are a number of different aligner options available. I tell them the one that I prefer is SureSmile. It’s the clearest option out there.
I also tell them I prefer this one because the trim line is a little bit higher, which allows me to put less attachments on. And I tell them it’s just as effective in my hands. I also let them know that Invisalign is the “big-name” because they were first. But they’re kind of like Kleenex in that the name has come to include the entire category. The patients understand that analogy and I’ve never had a patient insist they want Invisalign over SureSmile. They always say ‘whatever you think is best’.
With the proliferation of direct-to-consumer companies like Candid® and SmileDirectClub® what sort of impact do you think these companies are having on the orthodontic communities?
Becoming a next-level orthodontist in today’s world means becoming comfortable with technologies like digital treatment planning and 3D modeling. So upgrading to that level of technology can certainly feel intimidating. SureSmile has guided me 100% of the way. With training and getting proficient at the aligner type treatment.
I think the deeper impact that these companies are delivering is awareness. Everyone has seen the Smile Direct ads on Facebook. They see the ads on TV. So it definitely brings awareness.
But at the end of the day, I think patients still want someone who is proficient and knowledgeable to guide them. Not everyone wants to build their own house or fix their own car. Many times, they want to trust a professional. Yes, there are a lot of aligner companies. But it’s a situation of quality in, quality out. You need the treatment planning, you need the professional analysis, to get the end results you want.