reducing refinements

Top 8 Tips for Reducing Refinements

For clear aligner treatment, experts advise keeping your refinement rate under 30%. Reducing the number of refinements per patient not only makes your treatments more efficient and creates more revenue for you, it also makes patients happier. The longer their aligner treatment lasts, the less likely they’ll refer other aligner patients to you. Get those referrals up with minimum refinements.

To keep everyone happy, reduce your refinements with these tips:

Case Selection 

Choose your cases carefully. If you are a GP and a case needs an orthodontist, you can either refer it out or bring them on as a consultant. Wait until you’ve got aligner experience before you take the more challenging cases. When you do take those cases, check those patients more often.

However, this does have to mean bringing them into the office repeatedly. If you use a remote monitoring app, checking progress can take place quickly and easily. Similarly, if you use a remote monitoring app that allows you to have a 3rd party consultant view your cases, that can be a cost effective and easy way to have a more experienced doctor partner with you as a consultant.

Treatment Plan 

Use more trays so your patients can change them every 7 days. This makes the plan more predictable and reduces the chances the patient will go off track. If you are not seeing them as much in the office, have them save their aligners in case you have to backtrack. 


Set expectations: let your patient know from the very first appointment that the only way aligner systems work is if they’re worn until they’re passive, meaning the trays are no longer moving teeth and it’s okay to proceed on to the next set. Make sure they understand exactly what compliance means and have a strong accountability loop in place. The aligners can’t do their job if they are sitting in their trays for half the day–and that type of behavior will ultimately lead to refinements. 

Accountability Loop 

Compliance is huge, but can be easily controlled with digital dentistry. Reduce refinements with an accountability loop that has patients checking in regularly. Your patience checks their phones countless times throughout the day, so performing a daily check in on their aligner treatment should be an easy thing for them to accomplish. 

FYI: you can make this fun for them. For example, if they check in 30/30 days of the month, enter them into a raffle to win a gift card!

Munchies and Chewies

Insist that they use their munchies and/or chewies to make sure the aligners are seated correctly. Munchies have slots to seat canines while chewies are just smooth pieces of rubber.

IPR (interproximal reduction)

Always underdo your IPR. The more IPR, the more likely you’ll need refinements.

No attachmentless aligners

Attachmentless aligners make things more unpredictable. Don’t use them if you want to avoid refinements or hiccups in your treatment.


Overcorrect rotations to make sure they end up where they belong. This is possible because teeth don’t end up exactly where the aligners are. There’s always space between the teeth and the aligners. You might even put patients in braces or partial braces first and then switch to clear aligners.

Posterior Open Bite 

This is common. If it’s a half millimeter and no other correction is needed, you don’t need a refinement. Just add 15 hrs/day of wear time and let teeth set themselves. 4-8 weeks later, the teeth will be touching. 

Residual Spaces 

Sometimes there are small spaces that need to be tightened up. Use C-chain aligners for the final weeks.

From choosing to take a case to getting all the details right all the way to the end, you can reduce your number of aligner refinements and get better results and happier patients. 

Then don’t forget to ask for reviews so patients can tell others how efficient your treatment is!

With all the help and guidance you need in the In Hand Dental app, why would you pass up the aligner business that’s coming our way? 

Want to learn more about In Hand Dental and how your practice can benefit from reducing refinements? Go to our Contact Page and set up a time to book a free demo today!