There’s a little rigmarole I have gone through with every dentist I have ever visited. After they have completed my numerous fillings (there always seems to be something that needs fixing up in my mouth…) they ask me the dreaded question about “how often I floss.”

In most of my life I pride myself on being a truthful and honest person. I would rather eat my own arm than steal, I never ever lie to my husband (except maybe a teeny, tiny one about the price of my shoes, but that doesn’t count, right?!) and I am generally truthful and honest in everything I do. But somehow, before Invisalign, I was terrified to admit the truth to my dentist, that I rarely, if ever, flossed.

So I would cast my eyes down, feigning a quick mental calculation, and come up with a hesitant “once a week, maybe?” whilst he would consider my face with a dubious expression and tell me how I needed to floss every day without fail. I would look concerned and nod my agreement and then go home to continue on my merry path of rarely flossing.

That is, until Invisalign. The moment I started wearing Invisalign, my ticket to a new, improved me, I diligently followed my orthodontist’s instructions to floss, if not every time I ate, then at least two or three times a day. So much so, that my ten year old daughter, in all her tween wit, has dubbed me a “flossing freakazoid”

All of this flossing has had it’s benefits. Since getting Invisalign I have had the least fillings of any two year period of my life. Namely none. My teeth look whiter and healthier and when my (very happy) dentist puts his camera in my mouth and shows me my teeth up on the screen I can literally see the difference. In fact, last time I saw him he asked me to thank my orthodontist for getting me to do what he had never been able to.

So my failure to floss has been cured, and everyone is happy.

That is until the other night.

There I was, virtuously flossing, smug and safe in the knowledge of my superior oral hygiene, when I felt a small crack and a tug, and felt something on my tongue. Fishing the ‘something’ from my mouth with the tip of my finger I could see not only that it wasn’t a piece of food, but that it was actually, gulp, a piece of my tooth. Not a large piece, more of a small sliver of one of my back molars. Fatter than a fish bone and worryingly black on one side.

One of the best things about Invisalign is that it is uniquely molded to the shape of your teeth. However, at times, like when you are foolish enough to break a tooth with over vigorous flossing, that can be a disadvantage too. I was filled with terror that fixing my tooth would mean that my upper aligner would no longer fit. I didn’t know how long it would take to mold and fit a new one and had visions that before it could be done my teeth would happily rearrange themselves

from this:

Mar '11

2008 - Before Invisalign

It was Friday night when this happened, and with my husband out of town and my children safe in bed I thought that there was nothing I could do until Monday. Except that by the next morning it hurt.

So it was with a little fear that I walked gingerly into an emergency dental clinic first thing Saturday morning, two children in tow, each of them a little more thrilled than the other at the idea of watching the dentist giving me a “huge” injection in my mouth. I was also, truth be told, more than a little afraid of the cost; crowns aren’t cheap, and I was dreading being given bad news.

So imagine my joy when the dentist told me that although the ‘something’ (which I handed him, carefully wrapped in tissue paper, and secreted inside an Invisalign case) was a piece of my tooth as I feared, he thought he could fix it with a filling and that he hoped he could do it in such a way that my Invisalign would still fit.

Twenty minutes later, face numb and with my mouth vaguely dribbling, it was time to try and refit my upper Invisalign. The dentist offered to do it for me and after 30 seconds of his rubber gloved fingers vainly scurrying around my mouth, pushing and pulling at my aligner he handed it to me in defeat. Vaguely panicked and without a mirror or any sensation in my numbed cheek I immediately and joyfully popped it into my mouth, slotting it into place at the first attempt. Bingo.

So, all is not lost if you need a filling during Invisalign, and to the joy of my dentist, the flossing can continue. Just a little more gently this time….

Phew!

After all of the turmoil from losing my Invisalign when on holiday I was absolutely terrified about going to see my orthodontist. Not because he is particularly fearsome or because I thought he would lecture me- he’s a pretty laid back kind of guy fortunately, but because I thought he would tell me that I had done irreparable damage to my treatment.

The good news is that after a quick five minute check around my mouth he told me that actually, everything is perfectly on track!… Now, the thing is, don’t try this at home kids. That title you just read? It isn’t me nagging you. It’s me nagging myself. The only thing that stands between you and great teeth if you have Invisalign is compliance, and whilst I have generally been reasonably compliant with the need to wear my braces 22 hours a day, the holiday episode was not good. Not good at all.

So, in the interests of doing the right thing I would like to point out here that losing your Invisalign braces and having to skip two aligners isn’t just stupid, it’s really really stupid. I could easily have messed up much of the good work that has so far been done with my teeth. Compliance is everything with Invisalign braces and according to my orthodontist I am very fortunate not to have caused myself a lot more problems and put my treatment back by months. I think what saved me is that fact that although I skipped directly from set 5 to set 8 on my lower teeth, I actually wore set 8 full time for over a month whilst on holiday, only whipping them out occasionally to overindulge in red wine and other holiday extravagances. That month of enforced wear without being able to change my aligner seems to be what really gave my teeth time to settle down into their shiny, new, much shifted positions. Nonetheless, don’t do it!

As for my upper arch, regular readers may remember that I had just finished treatment on my upper teeth and was wearing my upper 6 aligner (before I lost it…) as a retainer. Having moved back to aligner number 5 as a substitute to the lost number 6 my orthodontist says that there is little point in re-ordering #6. Apparently, the movement from one aligner will be only 0.1mm whereas the cost to replace the lost tray will be the rather grand sum of $150. I’m trusting his judgement on this one and as far as I can tell my teeth still look as good as they did….

At this point I am free to get my crown done and finish my upper teeth. Having spent so much time and effort getting to this point I really want to find the best dentist possible to complete my smile, so I have been on the hunt for a great cosmetic dentist to do the job. If you know of one in Brisbane, Australia please let me know via the comments form. I am looking for someone that can make natural looking crowns that will match my other teeth perfectly, who will reshape my gum to make my gumline more symmetrical and someone that will put up with my endless questions and abject terror. Not much to ask is it?

Meanwhile, whilst I hunt for the right dentist I am planning to use nitewhite again now that my upper attachments have been taken off. I want my teeth to be as white as possible before I get the crown as once it’s in place I can’t whiten again or my teeth won’t match.

Longtime readers will remember that I whitened my teeth very successfully at the start of my treatment, but after almost two years they are looking a little yellow again and really need a touch up. ( I was naive enough to think that whitening was permanent, but apparently not) Whitening is so addictive that I’m hoping I won’t be tempted to overdo it and end up looking like Anthony Wiggle!

(Apologies to those of you without children- suffice to say he’s a toddler superstar with highly over bleached glow in the dark teeth)

I’ll leave you with a picture of my teeth as they are today. Hopefully this is the last time they will be photographed with the ugly crown to the left of my front upper teeth still in place. Despite how terrified I am about the process of renewing it I am really looking forward to seeing how my teeth look with a new, natural looking crown.

Anyway, thanks for reading, and thank you to everyone that leaves me such encouraging comments. It really does help to have all the comments and advice from everyone else going through the same process.

Throughout my life people have always accused me of pouting in photos. As a model in the nineties I could get away with that. With Kate Moss as the poster girl that all of us lesser models attempted to emulate, looking haughty and indifferent was all part of the program. In family photos though, you look a little, well, tragic, if you pout too much and never smile.

The thing is though, that I wasn’t pouting, honestly. (Well, not in the family photos anyway) What I was actually trying to achieve was a closed mouth smile; one that still made me look friendly and approachable, but never, ever showed my higgledy, piggledy teeth. I might have looked like I was pouting, but what I was really doing was going through a thousand inner turmoils, each of which started with me mentally begging the photographer not to utter the words “let’s see some teeth”

Obviously though, whatever I was doing wasn’t working. When I look back at those photos now I can see that not only did I not look very happy, I did indeed look self conscious and well, just a little bit pouty. A little too much like trying to look cool, and not enough like I was enjoying the moment.

So, getting my pictures back from my latest holiday, I was thrilled to see that not only am I not pouting, I am grinning from ear to ear! I actually look happy.

I know my teeth aren’t finished yet, and aren’t yet as perfect as I would like them to be, but what I realised, looking at my holiday pictures, is that when all of these photos were taken I wasn’t thinking for a moment about my teeth. I could just smile, naturally and enjoy the moment….. and honestly, that lack of self consciousness is worth the price of the braces alone.

So, I will leave you today with a picture of me at my brother’s wedding last month.

I’m smiling!….

I used to have beautiful fingernails. They weren’t long and glamorous exactly, but they were long enough, healthy enough and manicured enough to look feminine and as if I at least took a little care of myself. (When the sad truth is that with two children the time I get to spend taking care of myself is minimal at best)

No more. Since I transferred back to full time wear of Invisalign removing my aligners has transformed my previously healthy looking nails into broken, torn, ragged shadows of their former selves. It ain’t pretty.

I must confess that over the last week things have got easier, but my first week back in full time aligners reminded me just how difficult it can be to remove aligners at the beginning of Invisalign. I remember the claustrophobic feeling of terror as I clawed at my mouth in a restaurant bathroom the very first week I ever wore them. Fortunately, having been through all of this before I know that in a couple of weeks removing these things will be as easy as taking off a t shirt, so there isn’t quite the same level of fear this time around. However, being reminded just how hard it can be I thought it might be helpful to new users to compile a list of tips for removing aligners. These are my top ten tips. Please, please feel free to add more via the comments form- you can see it below or reach it by clicking on the little black comments flag at the top of this posting. Alternatively, if you think I’ve got them wrong, please set me straight!

1. Make sure your mouth is warm. Trying to remove Invisalign after a very cold drink is harder. Don’t ask me why, but it’s true! Somehow the plastic feels less pliable. It also helps if your fingers and the inside of your mouth are drier. If possible, open your mouth for a few seconds before attempting to remove them. Yes you’ll look odd, but it’s worth it.
2. Start at the back. Lift the aligners off the molars on each side first, then gradually work towards the front. Alternatively some people find that it is easier to work from one side of the mouth to the other.The wonkier the tooth, the harder that section of Invisalign are to remove. Start by lifting off the easier bits and get to those bits last. The same is true of areas with a lot of attachments. Tackle those bits last. In those areas hook your fingernails under the edge of the aligner and lift it up and over the attachment or difficult area.
3. Try a paper towel. Lots of people find that thick paper towels increase the grip on the aligner. Taking either a paper towel or a piece of kitchen paper in your hand place it over the tooth, grasp the aligner firmly and pull off the molars. Do this also for the opposite side and finally the front section. The increase in grip can sometimes make a huge difference.
4. Try surgical gloves. Many Invisalign patients report that surgical gloves work the same way as paper towels to increase grip on aligners. Many dental assistants also swear by them apparently. In this case the thick rubber gloves that you use for cleaning your house won’t do the trick (urgh!) what you need is the very fine type that you buy in boxes of 50 or 100. These allow you to feel what you are doing, but still increase grip.
5. Use an aligner hook. Some lucky patients get these given to them by their Invisalign provider. However they are also available on Amazon and are known as an outie.  Looking similar to a crochet hook but designed specifically for removing clear braces they hook under the edge of the aligner and lift it away from the tooth. They are especially helpful for people with attachments.
6. Another implement: Before I even get started in this one I would like to point out that it is certainly not Invisalign approved and might well result in damage to your aligners. Other Invisalign users have however reported success with other implements such as crochet hooks and even the edge of a pair of tweezers. Bearing in mind that your Invisalign are expensive I would personally probably skip this method, but each to their own.
7. Give it time: One thing that people tell you constantly when you first get Invisalign is that removing them gets easier with time. Of course, when people told me this I used to secretly believe that I would be the one exception to this and my aligners would be difficult to remove forever. Of course, what I soon realised is that quite literally every hour counts. If you try to remove your new aligners very soon after they are inserted for the first time it will be very difficult. Waiting even an additional hour could make it much easier. If you are ravenous and desperate to eat I can understand that you may be cursing me on reading this tip, but if there is any way that you can, stopping and waiting a while could make your aligners much easier to remove.
8. Change aligners in the evening: similar to tip 7, inserting your new aligners at night has two benefits. Firstly it means that you get to sleep through the stage when they feel tightest and most uncomfortable. Secondly, by morning your teeth will already have shifted and the aligners will therefore be easier to move. Popping them in last thing at night, accompanied by a mild painkiller is probably the way to go if you think they will cause you trouble.
9. Speak to your orthodontist: Some orthodontists don’t put on the attachments until the third aligner. This allows you four weeks of perfecting your removal technique before the attachments are fitted. Once they go on it does become a lot harder, so this period of practice can be really helpful. Also, when your attachments go on ask whether you can wear the template for a day or two to get used to removing it before changing to the proper aligners. The template is softer and much, much easier to remove than a normal aligner. Also, I thought that it shifted the teeth a tiny bit too, so that also helps to make it easier when it comes to time to remove the actual aligners.
10. Relax: Remembering my first day in Invisalign I know that relaxing was a long way down a very long list of things that I wanted to do; a list that started with ‘Get these aligners out of my mouth and never, ever put them in again’. The truth is though that the feelings of panic and claustrophobia make the aligners much, much harder to remove. Taking a deep breath and trying to relax, even giving up and taking ten minutes before starting again can be the difference between success and failure.

Hopefully these tips will be helpful to someone. As I said above if you have any others please feel free to share them via the comments section and I’ll update this page as and when necessary- thanks.

What a relief!

I had been dreading my latest appointment with my orthodontist. After the terminal crack in my 31st Invisalign aligner his assistant had told me on the phone that he had some “new ideas” for my teeth that he would talk to me about at my next appointment. I’m not sure exactly what I had thought those new ideas might involve, but I was certainly fearful that it might be metal braces, elastics, possibly even headgear and all manner of torturous orthodontics- my imagination is a wonderful thing!

I know, I know, metal braces aren’t torture devices. The trouble is though that I am horribly, horribly vain, (hence the braces in the first place) and I find Invisalign so easy and so invisible that I can’t even bear considering the possibility of a mouth full of metal. I know that I agreed at the start of treatment that I would wear metal braces on three of the teeth on my lower arch for a short period, just to pull one tooth into line but I really don’t want to go beyond that.

Fortunately, my orthodontist didn’t even mention metal braces. Instead, he took new moulds for a second set of Invisalign refinements which should completely finish my upper arch and get us a lot closer to finishing the lower one.

Before I had my first moulds taken 18 months ago I had read on an Invisalign forum about the horrors of the impressions process: the gagging, the vomiting, the residual taste left in your mouth afterwards- all manner of terrors. I know that getting moulds taken is a part of the process that a lot of patients work themselves into a frenzy about- I know I did the first time- but in my experience it really is nothing to be fearful about. My post about taking moulds for Invisalign has a full length description of the process for anyone that has yet to go through it, but if you have neither the time nor the inclination to read it I am happy to report that it is a remarkably painless experience.

For the sake of a balanced viewpoint I did question my orthodontist this time about whether there really are patients that vomit when they get their moulds taken or whether the people writing on Invisalign forums are just getting a kick out of terrifying the uninitiated. He assured me that he doesn’t get actual vomiters as a rule, but that he does get the odd patient who feels like they might gag. In his opinion it is largely psychological- in other words some people are very fearful about the impressions process and it then becomes self fulfilling- their panic makes them feel like they can’t breathe, which combined with the moulding material in their mouth makes them feel that they might vomit. He was happy to reassure me though that the vast majority of his patients cope with impressions quite happily. He did offer the tip that it was best to avoid getting moulds taken when you have a cold though as this can make it harder to breathe and increase your gag reflex.

The moulds made, I now just have to wait until the next sets of aligners are ready which should be in about 4 weeks. In the meantime I have to wear my Invisalign for only 12 hours a day. My orthodontist told me this and then added “if you can manage that”

I was a little surprised by this last comment; I have after all been wearing them 22 (ahem) hours a day quite successfully for the last 16 months; twelve hours a day would be a synch. However it then dawned on me that what he was saying was I could wear them 12 hours a day if I could bear to wear them that little.
Apparently, (and of all the things that he has told me about orthodontics this is the hardest to believe) some people get so used to the feeling of their aligners that they can’t bear to be without them!

What is wrong with these people!! I love my Invisalign as much as the next person, but I love them because they are doing a fine job of coaxing my bedraggled teeth into a cosmetically enhanced order. I don’t literally love wearing them. Apparently though, some people do. Their mouths have become so accustomed to the feeling of wearing the aligners that they can’t bear to wear them only 12 hours a day. Like thumb suckers they have become almost dependent on them. I’m happy to report that although I talked about my need to cultivate a few more vices earlier in this blog, aligner addiction wasn’t what I had in mind. Something tells me that I’ll cope admirably with the need to wear them only 12 hours a day.

Disaster strikes!

I don’t know whether it was because of a little over exuberance in removing my latest aligner, brought on by the thrill of being so close to the end of treatment (tray 31/34), or if it was the result of a few too many “adjustments” to my tray with a nail file, but I have managed to crack my #31 Invisalign tray.

Long time readers will remember that there have been a couple of occasions, particularly earlier in my treatment, where I had very slightly cracked one of my Invisalign aligners. Fortunately after a quick consultation with my Orthodontist it was decided that there was no harm done and I could keep wearing them. This time things were just a little more spectacular. Rather than a hairline crack as my previous ones have been, this aligner is split so that one part of it hangs limply from the other like a floppy, broken limb.

At the moment all the focus of my bottom tray is on opening up a gap sufficiently wide to allow my wayward tooth to move into it. This means that each tray shows a big change from the last one and it has been a struggle to get each new aligner in over the teeth that are moving the most. The aligner also has a slim piece of plastic now at this point rather than a tooth hole, and it is here that it cracked.

As it was number 31 that cracked and I am so close to the end of treatment, my immediate hope was that I could put in tray 32, perhaps wear it for a little longer, and still complete treatment as scheduled. My teeth had other ideas.

A cursory examination of set 32 showed that it was significantly different from set 31- so much so that it was hard to believe the change from one to another. So I knew that it would be a struggle- particularly as I had cracked #31 the first time that I wore it. Still, I was determined, and fairly sure I could get the tray in, one way or another.

Set 32- the unbroken aligner!

After about 2 frustrating minutes of huffing, puffing, wriggling and generally trying to jam my teeth into set 32 I realised that it wasn’t going to be easy. A closer inspection showed that there was a fundamental problem. One of the movements that set 31 must have been designed to achieve was to rotate the lower tooth next to the gap. Whilst this might have not made much difference if the tooth in question did not have an attachment, with an Invisalign button in place it meant that the bubble on the aligner to fit on the attachment was nowhere near the attachment itself. There was simply no way of fitting the aligner onto my tooth.

To cut a long story and a little telephone tag short, after a rather frantic call on my part, my orthodontist called me back to tell me that he has decided that rather than ordering a new #31 aligner- which could take some time given that we are in Australia- he will simply do a refinement to get my teeth to where we want them to be. We are so close to almost finishing this run, and he already knew that refinements would be necessary, that he has decided on balance that this is the best course. This will also allow him to look at the problem of widening both my arches further and so will hopefully solve two issues in one fell swoop.

The only delay now is that I need to wait for my orthodontist to have a long appointment free so that he can take more impressions of my teeth as they are now. He doesn’t have any for two weeks which means that in the meantime I need to wear set #30 lower for 22 hours a day and set #9 upper of my refinements as a retainer at night. This is fine, other than that sometimes it is hard to remember to put the lower one back in after eating, without the upper one needed too.

Nonetheless, I am happy to say that after my initial angst I am not too concerned about this temporary hiccup. I think it may turn out not to delay my treatment too much in the end, and might actually move me towards getting my upper arch perfect more quickly. No doubt it is all part of life’s rich Invisalign journey! Onwards and upwards..

This week was another milestone in my treatment. I have now reached 30/34 on my first run of lower Invisalign braces (only 4 more to go!) and set 9/9 of my first run of Invisalign refinements on my upper arch- in other words, the first run of my upper refinements are now finished! To mark this momentous occasion I had a long appointment with my orthodontist to evaluate how my upper teeth are now looking, and also, joy of joy, to remove my upper Invisalign attachments.

For those of you as yet unfamiliar with all the details of Invisalign, attachments are small tooth coloured blobs of material that are glued or cemented onto teeth during Invisalign treatment. Their purpose is to provide additional “grip” for the aligners so that more difficult or complex tooth movements are possible. They can be used on any number of teeth, depending on the preferences of your Invisalign provider and what movements the teeth need to make. Some lucky people have none, some have a large number, I have 5. You can see some of mine in the picture below:

Throughout my treatment, whilst I haven’t enjoyed having attachments exactly, I have easily tolerated them to the point that not only didn’t I feel them in my mouth any more, I didn’t see them when I looked in the mirror either. So I was fairly relaxed about having them removed- I was happy to do it, but I wasn’t yearning for it exactly. In fact, given that they have been solidly attached to my teeth for the last 15 months and have endured all manner of brushing, tugging and scraping and still stayed resolutely attached, I was afraid that getting them off might be a minor ordeal.

So it was with a certain amount of trepidation that let I let my orthodontist lower me back in his dentist’s chair, one hand adjusting his medical face mask, the other brandishing a large, sinister looking dentists drill. My fear wasn’t allayed by him telling me, with only a little relish in his voice, that this was going to be noisy.

I don’t know whether you have ever had any fillings, but my teeth are riddled with them. So I am pretty familiar with the feeling of the dentists drill and the vibrations that go through your head as they buzz and scrape noisily through your teeth. This was what I was expecting with the removal of my attachments.

I am relieved and excited to report however, that it is really not that bad. Yes, there is a little of the same sensation of vibration as the attachment is drilled, but because it is on the outside of your tooth and the drill is not contacting with any of your tooth’s own structure, the vibrations do not travel through your head in the same way. Also, the removal of each attachment seemed to take no more that 15-20 seconds of drilling, compared to the 30 minutes to an hour that I have endured with some of my larger fillings, so although there was some vibration it had barely started before it finished. After the initial drilling was completed, my orthodontist switched to a smaller polisher and ran it across the tooth’s surface where the attachment had been, just to remove any last traces of the cement- and it was finished! The whole process of removing my attachments was over in less than five minutes start to finish.

As my orthodontist adjusted my chair back into the upright position and told me to rinse my mouth I was so surprised that it was over that I told him “well THAT was remarkably painless” to which he looked at me bemused, and replied “Well what did you expect?”
I didn’t really like to run him through the scenarios that had been coursing through my head prior to my appointment.

The attachments removed and my teeth in all their naked glory we were able to get onto the important business of discussing how my teeth look. Removing the attachments has altered the way they appear (see pics below) but hasn’t changd how I feel about what needs to be done. I told him all of my concerns (explained with pictures in my previous post about set 29 before and after pictures) about how the front tooth needed to rotate a little more and how I think the molars have been thrown into shadow.

He listened patiently, had a very thorough examination of my teeth from every angle, and then told me that he could see what I was talking about, that he agreed that my arch could be widened a little more by moving out my molars, and that we could look at it in the next refinement. He did caution that as my teeth have already moved so much that there was a limit to what could be done whilst still keeping my teeth in the jaw bone, but that he would do his best. One of the things (other than experience) that I think is so important to look for in an orthodontist is their willingness to listen to your opinion. I think I have been very, very fortunate with mine that not only is he willing to listen, he will happily rethink his approach if you tell him that you would prefer to do it another way.

Within my Invisalign contract I have the original run of aligners included, plus three runs of refinements. I have used one refinement correcting my upper arch whilst the bottoms were still completing their first run, so my orthodontist and I agreed that we would wait until I have finished my lower arch first run of aligners before we start the next set of refinements. That means that both arches can be tackled simultaneously in the same series of refinements. In the meantime, over the next eight weeks I will be wearing my upper aligner only at night whilst wearing the lower one for the usual 22 (ahem) hours a day for the next 10 weeks. According to my orthodontist this is the best compromise between keeping the upper aligner intact and still wearable whilst not letting my teeth relapse too much until the next series of aligners. All in all I am thrilled with how my teeth are now looking and excited to get them finished off. Roll on 10 weeks time.

Look no upper attachments- shame about the molars in shadow though…

One of the topics that I get more questions about than any other on this blog is finding an Invisalign dentist or orthodontist. My own search for an Invisalign dentist or orthodontist took visits to several providers before I was able to find someone that I liked that was willing and able to treat me.

One of the things that surprises me the most when I am asked this is that many people don’t understand the difference between a dentist and an orthodontist. The easiest way to explain it is to compare it to doctors. A dentist is the equivalent of a GP. They do general dentistry; sometimes this includes some orthodontics. In many countries they aren’t allowed to call themselves orthodontists but get around this by using the word “orthodontics” or similar in their advertising. By comparison an orthodontist is like a specialist doctor such as a cardiologist, except that they specialise in the movement of teeth. In most countries orthodontists have done substantial additional study at university (often several years) and generally do nothing but orthodontic work in their practices.

Invisalign is available through both dentists and orthodontists. Rather than having substantial orthodontic training, Invisalign providers are required to do an Invisalign course before they can offer Invisalign. It had never occurred to me to wonder exactly how extensive or otherwise this Invisalign training was.

Recently however, I was having a quick google to find some piece of Invisalign information or another and came across the following post from a dentist who is no longer offering Invisalign. To be honest, it terrified me.

As an avid reader of Invisalign forums I had known that Align (the makers of Invisalign) had been tightening up their systems to ensure that only more experienced providers of Invisalign kept offering it, but frankly what I read on the dentists blog terrified me.

For instance her assertion that:

“I graduated Temple dental in 2001 with little clue how to successfully and orthodontically move a tooth.Like most clinicians, I  learned little about orthodontics in dental school. Sure I bent some wires, took a gazillion alginates, uprighted some molars, and occasionally made an active or passive appliance. Requirements, however, were minimal and Ortho at Temple was always the ‘easy A.’”

must surely be a worry for people that are considering Invisalign through a general dentist.

Similarly I don’t know whether there is any truth in her statement:

“Invisalign approved nearly any case you sent. Even with unpredictable movements like extrusions, intrusions, rotations and difficult cases like open bites and cross-bites, Invisalign provided a successful clincheck. This of course was nonsense and after a few poor results, I quickly learned Invisalign’s limitations.”

but it certainly makes me glad that Align are tightening their policies. (incidentally, I wonder whether this blanket approval theory is still true; my orthodontist who is VERY experienced tells me that he gets cases refused regularly that he thinks he could treat)

All in all I think anyone who is interested in Invisalign should read this dentists post to make sure that they ask the right questions before choosing their provider.

As someone with a very complex case my preference for me is an orthodontist to do my treatment. However, I know that many, many people have had dentists do their Invisalign and they have done a fantastic job. The key to it seems to be that you absolutely have to ensure that your provider has experience of using Invisalign and lots of it. Fortunately the Invisalign website ranks providers according to the number of cases they have undertaken recently. Still, it never hurts to ask the question yourself. I saw one provider who had not finished a single Invisalign case but was happy to take on my very complex issue. I would also point out that I think it is important to ask not only how many cases have been treated but also whether any cases similar to yours have been completed and how successful the results were. Ask to see before and after pictures where possible as these will tell you whether you would have been happy with the treatment.

Also, I think when deciding who to go with that it’s important to not just base your decision on what Invisalign costs from each provider. Certainly, if you have a very straightforward simple orthodontic issue you will probably find that you get a great result whoever does your treatment. If however you have anything more complex you really need to consider who will be the best person to treat you. I know that many patients ring around hoping to get the best price- who doesn’t want to pay as little as possible? In more complex cases though, I think it is also vital that you take into account whether the cheapest provider is actually the best one for you in experience terms. Of course, that isn’t to say that more expensive means more experience- I often found the reverse to be true. Rather I just mean that experience should be just as, if not more, important than price in complex cases.

Something occurred to me today- My husband has been very worried that my lips will look smaller after Invisalign as my teeth move back and I have just been more generally concerned that I might not like my new look. 

However in a moment of enlightenment I realised that Invisalign have one other great advantage over traditional braces-if I don’t like my teeth at the end of my treatment,  I can simply wear all 34 aligners in reverse order and put them back exactly how they started!