A Quick Video Update

Well, it’s been a long time again, so rather than just update with pictures I thought in keeping with the way the world is moving I’d upload a quick video to show you my teeth. You can photoshop photographs or change the colour/alignment so it’s always hard to tell what people’s teeth really look like and whether their pictures are an honest portrayal- hopefully a video update gives a slightly different view.

I’m a nervous youtuber- I’m not the usual age demographic for these kinds of videos and they aren’t particularly forgiving of wrinkles, double chins etc, so please, be gentle. I feel a little exposed doing it, particularly with the before pictures- I had forgotten how truly, stupendously, awful they are. At the same time, I hated my teeth and am so glad that I got Invisalign, so hopefully this might encourage other people, even those, like me,  who are a bit older than the usual orthodontic patient, to give Invisalign a try.

If you’re new to this blog you can read the whole tale by starting here– but do feel free to skip through, I do tend to go on a bit!

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The journey continues… A new crown and a new gumline.

Where was I? All those months ago when I last filled you in on how my teeth were progressing I felt like I was almost at the end of this momentous tooth journey, but things have changed a lot since then. So much so that I feel I need to write a few posts to help you catch up with everything that has happened.
As you may or may not remember, my top teeth, as far as Invisalign were concerned, were essentially finished. There was just one problem though. However technically straight they were I still had that revolting front crown that had moved during treatment and which spoiled the effect of all the treatment. You can see it clearly in this picture here.

Teeth with ugly old crown

So, after a lot of nervous procrastination I took a very big gulp and a large dose of valium and headed off to a prosthedontist to try and get my crown fixed. In case that word is new to you- it was to me- a prosthedontist is to crowns, what an orthodontist is to braces. Crowns, posts, implants and all that scary stuff are pretty much all they do. I asked around for the best prosthedontist in Brisbane, but in the end it came down to who was available- some of these specialists have months and months of waiting list.

Also, let me tell you these people are not cheap. I can’t remember the final bill exactly, but there wasn’t a lot of change from $4000. Gulp. So I really wanted someone who would do a great job, as at that price, I would only be doing it once.

Before I went I had several fears. First, that they wouldn’t be able to get the old crown off… it had been there since I was 18, I felt like almost twenty years later it must be well and truly stuck. I had visions of my tooth being pulled out, and being left with a bloody, unfixable hole in my gum.

My second fear was that the prosthedontist would find a secret abcess hidden on the root of the tooth. I knew that before I had the original crown, some hideous procedure had happened that involved drilling through the root and putting a metal post in. It was all spectacularly vile, especially for someone as afraid of dentists as I am. Now, I had visions of him removing the crown only to find some hidden horror that would make my whole head cave in… ok, well not exactly, but something terrible.

Thirdly, I was terrified, truly terrified, that he would say I needed a dental implant. The kind that are drilled into your jawbone. Somehow, this seemed more terrifying than anything. Teeth are one thing, but messing with a jaw bone that is part of your skull- that’s horror movie style.

So, to say that I was nervous, would be the understatement of the year. Fortunately, the doctor I chose, whether the best or not, did have a fantastic bedside manner. I explained my fears at his insistence (the shaking gave me away) and one by one he explained why none of them would be a disaster. He then took lots of photos of my face and took me to his office where he pulled them all up on screen.

It was at that point that he explained to me that giving me a new crown would be easy, but that it would never look right as my gum line was not right. In order for teeth to look symmetrical the gums have to be right. You can do whatever you want to the teeth, but great teeth always have a great gum line. I sat there hyperventilating for a moment, then plucked up the courage to ask whether that meant… that I would need my gum lasered to give it the right shape. He frowned looking at the screen, and said “No, your gumline is too bad for that, to fix yours I really need to drill away a bit of the jawbone before I can reshape the gum.”

I let it hang for a moment before having a full blown (internal) panic attack. He gave me a few minutes to think about it and left me there whilst he went to get a coffee.

It took me five minutes of standing in front of the mirror in the bathroom splashing my face with icy water to keep myself from passing out before making my decision. I was going to do it. After all the time and money I had spent on my teeth, I wasn’t going to let one rogue gumline muck it all up. So, I walked back to the chair and asked him to do it as quickly as he could before I could change my mind.

The first part was numbing. This was horrible, purely as I am one of those people that truly believes that local anaesthetic (along with many, many other things)is likely to kill me. So as my mouth went numb, and part of my throat too, I was convinced I would die, and twice had to sit up in the chair to make sure I could breathe. Unlike a filling, when they will drill your bone you have to be very numb… so there were a lot of injections involved.

Once I was numb, breathing, and heart still beating in my chest, we moved on to removing the crown. This was really fairly simple. The prosthedontist simply drilled away the old crown, leaving what I’m afraid I can only describe as a stump.

Next came the scary part- the gum line alteration. Having my head lower than my feet and a mouth full of tools I’m not exactly sure what happened, but I am certain that it involved the cutting away of some gum with a scalpel,  then the peeling back of the gum and the drilling of bone. Actually, if you could get it out of your mind that someone was at that moment drilling your jawbone, it really wasn’t any worse than a large filling. It just felt like when one of the larger drills vibrates through your head, no more. I suppose this part lasted ten to twenty minutes, although judging time when you are as panicked as I was is not easy.

Then came the stitching up, which was fine-the numbness took care of that, and the shaping of the “stump” with drills etc. Finally a temporary crown was fitted. Surprisingly this looked pretty good already, and despite my abject terror during the procedure I walked out of the room happy that I had done it. This is what I looked like when I walked out. (The squeamish amongst you should look away now)



It was then a waiting game. The orthodontist wanted me to wait at least three months for the gum to settle. Gum heals quickly, but it also regrows to an extent. If you fit a new crown too soon, it can grow back, or recede and leave a black line along the edge of the tooth, meaning it needs to be redone. So, I waited five months (it’s good to be sure about these things, right!) During which time the temporary crown fell off once – horror story time and on a Thursday too, when the prosthedontist office wasn’t open again till the following Monday… you can imagine.

Ultimately though, I am very happy with the end result which you can see below. The difference was worth the fear, slight pain and the money. I think!


Before The New Crown

After New Crown








After Invisalign….Essix Retainers, Vivera or Fixed?

When I first started Invisalign, the time when I would finally be wearing retainers seemed like such a distant prospect that I barely even allowed myself to give it a second thought. In my imagination, a day when I would have good teeth was a day that I dreamt about, but not one that I ever REALLY thought might come.

My friends, that day is here.

As I mentioned in my last post, my upper teeth have now been happily ensconsed in retainers for some time, and I thought those of you still on your journey to get that to that point, might like to see what the different retainers look like.

My orthodontist has chosen Essix retainers for me, and ever one to question his professional judgement, I did a fair amount of research as to what I think the most comfortable and unnoticeable retainers are, ready to fight battle if need be.

Essentially there are two main options when it comes to retention following adult braces. The bad news is that either way, you need to wear retainers forever. Not forever, as in, for ten years and then your teeth will grudgingly conform and stay elegantly upright in their new, more attractive positions. Nope, this kind of forever is really the forever kind. The kind of forever where fifty years of wearing retainers, followed by a week long slip up will still mean that your unobliging teeth will start to dance back to the position they were in before you trussed them up in Invisalign.

So, retainers fall into two main camps. Permanent retainers and removable retainers, both of them forever retainers.

When I first did my trawl around the various orthodontists seeking an opinion about my teeth, retention was something that was often mentioned to me. I was shown various pictures of retainers, and the types that different orthodontists preferred, and quickly came to a realisation.

Just as I’m not a fixed braces kind of a gal, I’m really not a fixed retainers kind of a girl either. I suspect that many Invisalign wearers feel the same. So an orthodontist that insisted on fixed retainers was never going to be an orthodontist that I could love, a preference that did influence my choice of ortho from the start.

The fixed retainers that I was shown were mainly along the lines of those shown below and were of a permanent wire connected to the back of the teeth that holds the teeth firmly in place, not allowing them to shift :

The benefits of these retainers, according to the orthodontists that I saw, are that they are a set and forget kind of a deal. Once they are on, you don’t have to worry about lost or forgotten retainers, and your teeth stay in place as long as the retainer is correctly attached. The downside of such retainers is that they are fiendishly difficult to keep clean, and obviously, they ain’t that pretty when you open your mouth wide.

The good news, for someone as averse to metal in their mouth as I am, is that there is also the option of removable braces, which are worn only at night. These are divided into the type that your orthodontist (or dentist) can make for you, and those that come from Invisalign themselves, known as Vivera. Both look, to all intents and purposes, very similar to an Invisalign aligner.

My orthodontist, when enduring his regular eight weekly grilling of a thousand of my stupid questions, told me that there are two reasons why he doesn’t use Vivera. Firstly, they simply weren’t available here in Australia at the time of asking and very similar ones could be made more cheaply and easily here. (A pretty good reason, I’ll have to concede) Secondly, he says that once you order your Vivera retainers from Invisalign your case is seen as effectively closed. He often has patients who decide not to proceed with a refinement or final tweak and then, several months later, change their minds. Using Vivera would remove from him the option of ordering another refinement free of charge, as they would be treated as a new case, with a correspondingly large new bill.

For those who are certain that their treatment is complete though, Vivera certainly sound like a great option. As long as you keep up your subscription to them you receive a nice shiny new set of retainers every three months. These can be made either in the shape of your last set of Invisalign, or, if you weren’t an Invisalign patient or if your teeth have been crowned or filled, can be made from a new molding. This gives you the reassurance that as long as the retainer still fits your retainer isn’t changing shape and that your teeth are actually stable and in the position that they were at the end of your orthodontic treatment. There is an interesting review of an orthodontist wearing Vivera here for those that are interested in this system.

In my case, my orthodontist favours another alternative, an Essix retainer.

Whilst this might look fairly similar to an Invisalign aligner, in truth they feel quite different to wear. Whereas Invisalign seem finely crafted and take in the shape of every tooth and gum line, these seem more like Invisalign would be were they crafted by a five year old. The shape and the general appearance are the same, but the execution looks and feels altogether more clumsy. Peering closely at my retainer I can see that it does have the individual shape of my teeth molded into it, but that they are not as distinct as they would be on an Invisalign aligner and cover part of my gum as well as my teeth.

Whereas Invisalign feel that they fit very closely to the teeth, these feel larger and thicker in the mouth. However, that isn’t to say they aren’t comfortable. I would equate the putting in of my retainer each night as similar to putting on a pair of comfy old bed socks. Not the most attractive thing in the world, but comfortable and somehow comforting. Comforting too to know that these retainers can be made cheaply (well, relatively- this is orthodontics after all) and easily by any general dentist in a couple of days so losing them isn’t the issue that losing an Invisalign aligner might be. Also, they are doing a fantastic job of keeping my teeth exactly where they were when I completed my treatment, which has to be a good feature in a retainer.

In reality the right retainers will be down to personal preference, but as someone who loves the fact that Invisalign are removable, and just can’t face the prospect of a metal wire permanently fixed to my teeth, Essix retainers are perfect for me.

Which is a good job given the amount of time we’ll be spending together.

Which retainers will you be using or have you worn, and how did you find them?

The Most Experienced Invisalign Wearer In The World™?

Two and a half years in, I think I must be close to being the world expert on wearing Invisalign.

I was undoubtedly the most complicated case that my orthodontist had ever taken on when I started, and I believe I’m still his longest running case. Most of his patients swan in and out of his offices every few weeks, visiting him for six months to a year, and then wander off again, retainers in hand, to carry on their lives the same as before; just a little bit better looking.

Not me. As I amble into the surgery, apologies in hand about whatever the current month’s misdemeanour is (forgetting to change the aligners on the right day, mostly) he sighs resignedly. It isn’t that I want to make my treatment longer than it is, or that I can’t bear to end our six weekly visits, it’s just that after all this time the thrill of changing to the next set is almost gone and some weeks when I’m supposed to change aligners, I simply forget.

The good news about this, I suppose, is that it goes to show exactly how comfortable Invisalign really are. I don’t think about them at all these days, my mouth is as comfortable with them as without, in fact, sometimes when I’m not wearing them my mouth almost feels strangely empty. And therein lies the problem really. I need to think about them just a little bit.

This visit, as I confessed that I had again slipped an aligner behind, so that I only needed two, not three new aligners to take me through to my next appointment, my orthodontist shook his head and said “You’d have been finished if you were in metal braces, you know.”

The truth is though, as I told him, that I would rather wear Invisalign for 10 years than wear metal braces for one- a sentiment with which he heartily agreed. To me, there is simply no contest.

And whilst I sometimes forget to change, and wear my Invisalign sets for three weeks instead of two, I take comfort from the fact that at least I wear them too much, and not too little.

Of course, there’s a very good reason why my treatment has taken so long; we always knew that it would. My orthodontist made it very clear from the beginning that I was right on the boundary of being suitable for Invisalign treatment. You can see the offending tooth that has meant that I have been pushing at the limits of Invisalign’s capabilities on my original clincheck:
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Whilst my upper teeth are now in retainers, and my lower teeth look almost perfectly straight from the front, that wayward tooth on the lower arch is still there, strewn across the bottom of my mouth. I’m currently about five aligners short of the gap being large enough to start moving it into place, and I can’t wait to try.

My orthodontist is not by any means convinced it will ever move, he fears it is somehow fused to my jaw bone or in some other way completely stuck, and that ultimately I may have to simply remove it. I however remain deliriously optimistic; my treatment has gone so well and so easily this far that I’m simply not ready to concede that anything could go seriously wrong at this point.

Let’s hope I’m right!

An Invisalign Braces Update- More Invisalign Before and After Pictures..

Those of you who are long time readers will know that my top teeth are finished…kind of. I am wearing a retainer only at night these days on my upper arch, waiting until my bottom teeth are finished. At that point we will tweak anything on the top that needs it at the same time as we do any tweaks or refinements on the bottom arch. I have also decided to wait until all of the bottom teeth are finished before I get my upper crown sorted. This is partly due to financial constraints (nearly $2,000 for a new crown means I want it done only once) and partly me putting it off because I’m terrified! If you don’t know my full crown saga, suffice to say it is the ugly yellow looking tooth, right next to my top front teeth. The scariest thing is that before I whitened my teeth earlier in my Invisalign treatment it matched my other teeth perfectly!

For my bottom arch I am now on aligner #2,734. I kid, but it sometimes feels like it… In reality I am now on #21 of my 54 lower Invisalign refinements. There were also 34 in my original run that I wore before I started on these refinements. That means of the 88 lower aligners that make up my treatment in total, I am on #55… unless I lost count. Whichever way you look at it, that’s a LOT of Invisalign. (Although I should point out here for new readers that my teeth were essentially a jumble sale before I started Invisalign. A misaligned, misshapen, discoloured mess of a mouth…)

Take a look for yourselves at the differences….

My teeth don’t actually change that much visually these days, all the action is at the back where we are opening up a gap for a tooth to move into. My orthodontist warned me from the start that this would take a long time, and he was right. Looking back at where I started from though I think that every one of those 55 aligners has been worth it…

Before Invisalign

Teeth July 2011

Overjet before Invisalign

Overjet July 2011

Incidentally, apologies for the colour on these photos. You’ll have to take my word for it that my teeth really aren’t that yellow in reality. Honestly!

How many Invisalign do you have? Can anyone beat my record of 88?