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Thread: Sure smile?

  1. #1
    Rangers Guest

    Sure smile?

    Hi - Looking for anyone who has been offered or experienced what is called "Sure Smile"? VERY few dentists seem to offer it and I must admit I am skeptical. I called one office in my area - - and I was told they will ONLY see me for a consult at either 10AM or 11:30AM. This means I need to take a 2-hour lunch. I was told that xrays are complimentary and my consult will be one hour.

    This particular office is run by an ortho who has been in practice for 30 years and it seems he offers ALL varieties of braces - lingual, invisalign, ceramic, metal, self-ligating, sure smile.

    I agreed to the consult but then I asked how often they were in the office located closest to me and she said 1 day a week -sometimes 2, the rest of the practice takes place at another office which is too far from me.

    So I said that is a concern for me - so she said "OH we only see you once every EIGHT weeks". That turned me off. I said - - - well I am an adult patient and I already know that I want my ligatures changed onc every 4 weeks due to staining. She then said she is not clinical and said what are ligatures? I explained and went on to say if he uses self ligating then that is not an issue - - but I still want to be watched and followed more often then once every 8 weeks. She then asked if i was familiar with sure smile and basically - she lost me from there.

    My time (and everyones) is limited, I don't want to take the time from work and a 2 hour lunch to meet with someone who doesn't sound as tho they are for me. And going once every 8 weeks would be worrisome to me not to mention how hard it would be to see him in an emergency.

    Still I'm curious if anyone has experienced Sure smile?

  2. #2
    Rangers, eight weeks is a very typical call-back frequency for adults and kids alike. (And it's not even a given that the brackets you have will require ligatures - as you say, your brackets may be self-ligating.) Basically though, you'd really just be spinning your wheels heading in for an appointment every four weeks. There are some stages of treatment where it is more appropriate to head in more frequently, but six to eight weeks, and even as long as 10 or 12 is not uncommon, is no indicator of bad treatment, and causes no issues or delays to treatment. As you say, your time is limited, so why waste it on entirely unnecessary extra orthodontic appointments?

    I do agree that only having access to your doc one day per week is something of a concern, as it may cause problems should any little unforeseen issues arise. Only you can decide how much of a concern this is to you.

    SureSmile is one of a number of computer assisted treatment planning systems that are on the market today. Instead of the treatment planning being done by just examining the records and making tracings on paper, or by cutting up plaster models, tooth movements are planned out using a detailed 3D computer model. The brackets are bonded to the teeth all at once (by placing them into an impression of the teeth - this is called indirect bonding) to the precise positions indicated by the computerised plan, and the archwires are custom made for each individual patient. This means that for most of the treatment time, the teeth can potentially be moved more efficiently - it's not that they are moved faster, but rather that the particular movements that are made are optimised. The results using a system like SureSmile are no better than those from a conventional treatment, and the types of brackets and wires are the same (excepting that the wires are shaped just for you); you still depend on the expertise of your orthodontist. But you may experience a significantly reduced treatment time with this method. Of course, you'll also generally pay a premium price for this (I believe typically around 10% over and above conventional treatment). I did not have SureSmile myself, but do know people who have, and they have been very happy with their outcomes.
    Last edited by Zoso; 01-16-2009 at 03:15 PM.

  3. #3
    Rangers Guest
    Wow - I must say that I have never heard of adult patients (in the USA that is) going as long as eight weeks between visits. And I've spoken to and read many a story. The most I've heard is 4-6 - some even go every 3, and again this is often to change ligatures. IF Suer Smile is self-ligating and does not require ligature change, then I suppose 8 weeks is okay, but I still prefer touching base to ensure everything is going smoothly more often then that, as I know all too well how fast teeth can move.

    Thks for your feedback, it has helped me to determine that that particular ortho as well as SureSmile is definitely not for me.

    Regards! :)

  4. #4
    Join Date
    Jan 2008
    Blog Entries
    Rangers the modern archwires are designed to keep working until your teeth are in the shape the archwire was in when it was put in your mouth. This means that you can have long periods between appointments, as these archwires will continue working.

    Were I work appointments vary depending on what the ortho is trying to achieve, but on average they are 8-12 week aparts. Our ortho's do not want people (children or adults) coming in, if the appointment will be no more than a reasurance. Sometimes that still happens at 12 weeks apart ... but not so often.

    We also have available, lig change appointments between adjustment appointments. Ligs only take seconds to change, and these appointments are completed by the assistants, and you don't see the your ortho, just leave with a fresh smile!

    Good luck with your consultations! :)
    After 5 years, 11 months and two days of stainless steel brackets ... my teeth now have upper and lower bonded, gold wire, retainers and removable clear retainers!

  5. #5
    Rangers Guest
    I don't mean to play Devils advocate but if Sure Smile is so great why don't more dentists offer it? Orthos grow on trees around me - - and no one offers SS accept this individual.

    Does Sure Smile use ligatures? If so all the more reason for me to not use this ortho - because with the infrequency he is in the office near me, it will be hard for me to get in to see them for a change.

    I just see the whole Sure Smile 'thing' as a big gimic. No offense - just haven't seen it offered enough by the many orthos in my area to really buy into it - I do see it as an enormous money maker!

    Thks again for your input!

  6. #6
    I'd not say that SureSmile is a gimmick - as I noted, it is generally expected to trim a significant proportion from your treatment time. These systems though are relatively new to the market, and there is an up-front cost to the orthodontist (hardware and software) who wants to start using them, as well as a learning curve once they do. (So, if you did consider choosing this orthodontist, I'd ask first if he has treated many cases using SureSmile. I know everyone needs to get their initial experience with someone as the patient, but I am selfish enough that I don't want that "guinea pig" to be me!) I believe that SureSmile is currently being used by somewhere between 250 and 300 orthodontists in North America and most have been using it less than three years. I don't think the low numbers of providers implies it is a gimmick any more than I would brand the use of (any one particular brand of) lingual braces a gimmick, but comparitively few orthodontists offer linguals (even though they have been around far longer)

    As to the brackets, SureSmile is not tied to any particular one system. I've browsed case studies that use a variety of different bracket brands, both self-ligating and traditionally tied (for example In-Ovation, Damon 3, Clarity, or Mystique) so only this doctor's office can tell you which he prefers.

    But you pays your money and you takes your choice. If you do not feel this is the ortho for you, you have to go with what you feel.

  7. #7
    Rangers Guest
    Thanks again for the feedback! :)

    I haven't even met with that particular ortho - he will only schedule patient consults at 10AM or 11:30AM - he is half an hour from where I work, i thought about taking a 2 hour lunch to see what he has to say - - - but I am concerned about his limited hours for future visits if I were to become his patient.

    Do you know on average how much more Sure Smile costs then 'traditional' braces? For instance if 18 months in traditional braces were to cost about $6,000 how much more on average would Sure Smile run?

    I can't say for sure - but it would appear as though this particular ortho does indeed have quite a bit of experience with Sure Smile. He is actually feature on the Science Channel's documentary of the technology.

    I hope I can find someone i am pleased with!

  8. #8
    I've heard around 10% extra, and wouldn't expect to see the extra be any less than $500 and would not be surprised by anything up to $1k. But I really don't have much solid info to back that up.

    Anyway, good luck finding the right doc for you. Even though self-ligating brackets and high tech archwires allow for much less frequent call-backs, I know that some docs out there do like to keep the patient coming in more frequently (though generally not as frequently as every four weeks) since they realise that this is necessary for many of us to feel a sense of progress, and a sense of our treatment being actively monitored. So with any luck you can find one whom you like who has this sort of philosophy. For what it's worth, I do understand how you feel to some extent - whenever I was given a timeframe of (say) six to eight weeks, you can bet your bottom dollar that unless there was something going on to prevent it (such as being away that week) I'd pick the short end of the interval ;)

  9. I am about to start my braces and im using suresmile. im supposed to have them on for twelve to fourteen months and mine are going to cost me all together a little over $5,000. my insurance is covering $1,100. So they would end up being between six and seven thousand dollars.

  10. #10
    Join Date
    Jan 2008
    Blog Entries
    It's great you're soon to begin your orthodontic treatment Pamela! :)

    Hope it all goes well for you! :thumb:
    After 5 years, 11 months and two days of stainless steel brackets ... my teeth now have upper and lower bonded, gold wire, retainers and removable clear retainers!

  11. #11
    aba424 Guest
    Suresmile is a relatively new technology. I say if it costs the same as another orthodontist who does not use it, go with the Suresmile guy =D

  12. #12
    I'll say one thing about SureSmile that impresses me - it should take ortho error out of the equation. That should be a benefit to the ortho and the patient. SS makes complete sense. If the tooth needs to be moved A to B and the computer/wires can do 1 degree of torque and precisely shape that wire, it's just common sense the benefit.

  13. #13
    I'm sorry, but I must disagree. Any "computerised" orthodontic system, be it SureSmile, Invisalign, or whatever still relies upon the skill of the orthodontist at the very outset, to specify a suitable treatment plan. Also, no machine can predict exactly what will happen in the human body - there are simply too many variables that are impossible to predict with complete accuracy, so the clinician's skill and expertise remain important throughout treatment. Even people I know who have been treated with SureSmile have still found, at the end of treatment, that the final tweaks are carried out by hand.
    I am not a dental professional.

    As it says on the main Bracesreview.com page, always consult a qualified orthodontist, dentist, or medical professional with questions you may have.

  14. #14
    Join Date
    Jan 2008
    Blog Entries
    Supo there's no way that a computer program could take away from the need for the treating ortho to have the necessary skill and understanding to ensure that teeth are moved correctly.

    It's possible that a computer may be able to make bends in a wire with more detail, but these bends still have to be controlled and refined.
    After 5 years, 11 months and two days of stainless steel brackets ... my teeth now have upper and lower bonded, gold wire, retainers and removable clear retainers!

  15. SureSmile

    Based on my experience, I would not recommend paying the extra money for SureSmile technology. This technology does not shorten the treatment time for wearing braces at all. I believe coventional braces that require manual adjustments by a professional is better.



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