When you are already falling – who’s pulling the ripcord?

Every practice should support the provision for the figurative “ripcord” so that you can halt an ongoing process and resort to switching treatment procedures, should you be faced with the need. Figuring out who should be responsible for pulling the ripcord helps you develop a surefire formula that actually works.

Of course, it is not only the leader who is entrusted with pulling the ripcord. The assistants should very well be offered the opportunity as well. This requires a clear description of the signals for pulling the ripcord. Here I present some of the “red flags” that warrant a crisis pulling of the ripcord.

1. Your patient last wore stainless steel archwires, a power chain to close the gap, and class II elastics to adjust to the Class I. Unfortunately a bracket came loose and the power chain moved some of the teeth out of position so the steel wire cannot be ligated anymore. Ripcord 1!
   1. Your assistant asks if you want to use a power chain from molar to molar (6-6) again: Red traffic light and ripcord!
   2. Now they ask if the rubber bands can be carried on: Red traffic light number two. Ripcord.
      In this way, you help your assistant think along and understand the concept of Lean Orthodontics®.
2. Another example is the use of multiband for deep bites. If your patient bites on their lower brackets, let your assistant pull the ripcord. They recognize the problem and aim to solve it themselves with bite blocks (whether on the molars or rather frontal bite turbos in the upper jaw is up to you, but I prefer posterior bites for various reasons).
3. This is a perfect example of when you should let your assistants pull the ripcord. Luisa has fixed braces and now they are to be removed. The assistant immediately recognizes that two brackets have come loose and the teeth have shifted again. In order to standardize the workflow, it is important for your assistant to know what to do: she pulls the ripcord and informs you, the dentist.

The recognition of the right red traffic lights is an extremely valuable skill that makes its place in Lean Orthodontics®.