My Invisalign braces and I have been through a lot lately!

Whilst I have largely adjusted back to the rigors of full time Invisalign wear and the brush/floss/no snack lifestyle that that entails, the rest of me has been slightly under the weather. So under the weather in fact, that I was tripped off to hospital so that they could put a few cameras in my stomach and work out what was going on.

Luckily enough, the answer was nothing that can’t be fixed with time and medication- phew! -but in the meantime I must confess that I somehow “forgot” to remove my braces when I was knocked out- whoops!

I don’t know about you but I am an absolute baby when it comes to all things medical or dental. Show me a white coat and I’ll show you a racing heart and blood pressure through the roof. So as I sat in my hospital bed, bottom lip trembling, mentally composing goodbye notes to my loved ones and waiting for them to come and knock me out I wasn’t about to win any bravery awards.

The very, very sweet nurses, being used to cowardly patients like myself spotted that I was on the verge of tears and got the very kind and very competent anesthetist to come and offer me some comforting words-words which worked a treat at helping me steady my nerves. Somehow though, in the midst of my self absorbed terror I forgot to mention to him that I wear Invisalign – oops.

So it wasn’t until I was in recovery, in the kind of after surgery bliss that only strong opiates and the joy of having actually made it through the anesthetic can induce, that I suddenly realised that my braces were in. I mentioned it to the nurse looking after me, who winked at me, told me to keep it to myself and said “no harm done”.

What is amazing though is despite that fact that my doctor had me knocked out, had put a camera down my throat and had various breathing and other apparatus near my mouth over the course of the afternoon, no one noticed that my teeth looked any different. I suppose that is a great advert for Invisalign invisibility if nothing else although I’m not convinced it’s recommend practice to keep your braces in during anaesthesia. Don’t try this at home folks!

Anyway, aside from the dramatics my teeth are continuing to improve. As you can see from the comparison pictures below, the molars on the right hand side upper are now starting to appear from behind the front teeth, so I no longer appear to have half a mouthful of teeth in pictures. The bottom teeth changes are less visible, but judging by the amount of pressure on them something is certainly happening… One thing I would say is that close up pictures like this tend to highlight every flaw. In real life my teeth look much better than in these pictures- or I think so at least!

Before Invisalign:

Latest Front picture (as usual please ignore the ugly old upper crown, it will be changed after treatment finishes):

Profile Before Invisalign:

Profile July 2010:

Alternate View July 2010:

As usual thanks for all your comments and for reading, I love to hear about your experiences too. For prospective invisalign braces wearers you might find my Invisalign FAQs helpful..

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.

Here’s the thing. I loved my time of wearing Invisalign only at night. Loved it. I didn’t miss them one bit in the day, and would trot happily from my computer to the cookie jar and back without a single thought about brushing or flossing or flouride mouthwashes.

The only problem was that I got just a little too friendly with the cookie jar. Whilst in my last post I called this extra weight that I’m currently humping around my “Christmas weight” the truth is that I started putting a bit extra on at Christmas and then piled a WHOLE lot more on during my break from Invisalign. Nine pounds extra to be exact, and a nine pounds that I need to lose if I want to get my jeans back on before winter is over. (Australian winter is June, July and August)

The good news is that now I am back in invisalign I have a feeling that that weight will come off reasonably quickly. The bad news is that the reason I think that is because I am starving. There hasn’t been a moment in the last week since I got these new trays that I haven’t been sat at my desk, watching the clock and counting the hours until my next meal.

There was a point last year (2009) when my mum came over to visit from the UK and I remember her declaring that I looked thin and that I had lost loads of weight. At the time I thought it was because of some medication I had been taking for my crohns disease, it didn’t occur to me until I stopped wearing the Invisalign that it was my braces that were keeping my weight down.

In past years I have tried Atkins, CSIRO, low GI; you name a diet, I’ve tried it. What I hadn’t tried before last year was the Invisalign diet. The funny thing is, that long term it’s turned out to be the most effective one of all of them. (Until you stop wearing them and make friends with the cookie jar!)

In three months my brother is getting married in the UK and every relative and friend that I have known since childhood will be there. Vain though it is, I would really like it if I could be both slim(ish) and have great teeth for that day. Let’s hope Invisalign can deliver on both fronts!

Other than the near starvation, the aligners aren’t giving me too many problems. The lower ones are very hard to get in and out because of the area with the gap and the wonky tooth. (see pic below) I am terrified of breaking my trays again so I now have to remove the lower ones very gingerly. I was contemplating an aligner hook, but as they aren’t readily available in Australia I’m not sure whether it is worth actually importing one all the way from the US. My fingernails are capable of doing the job, it just takes a little while.

Other than that everything is going well. I keep forgetting to take my little washbag with toothbrush, paste and case out with me, but that just means I can’t eat whilst I’m out so is almost certainly a good thing.

I also keep forgetting to put them back in quickly enough after eating- something I need to improve upon if I am to keep up the 22 hours a day wear. I expected difficulties with Invisalign – all of the cleaning and brushing and having to remove them to eat. Whilst all of those have actually turned out to be easier than anticipated it is the compliance that has been the hardest thing. For people thinking about Invisalign that is probably the thing that you should consider. I would never be put off by fear of pain or how they look- I haven’t found these things to be issues at all. I would, however, say to think very carefully before getting Invisalign if you don’t trust yourself to wear them properly, because although that isn’t such a problem at the beginning, it gets harder and harder to discipline yourself as time goes on. As the potential world record holder for the most aligners ever that is something I am really struggling with.

Still, it’s worth it for great teeth and a skinny butt, right?!

My eldest daughter, being something of a geek like her mother, has a copy of the Guinness Book Of Records that she likes to leaf through every now and then. Nothing gives her more joy than the knowledge of who can eat the most doughnuts in two minutes, or which is the largest island in the world (Greenland, incidentally.) So, imagine how thrilled she will be next year when she sees my new entry as the person with the most Invisalign aligners EVER!

Longtime readers will know that my first run of Invisalign were 17 Uppers and 34 Lowers, which I breezed through with very little actual trouble despite my frequent whining. The last few weeks I have been patiently awaiting the arrival of my refinements, enjoying the newfound freedom to snack myself out of being able to do up my favourite jeans.

Whilst my upper teeth are almost perfectly straight now and just need a couple of tiny tweaks with these refinements, my lower teeth still have a long, long way to go. In particular there is one tooth that is growing across the bottom of my mouth that I have always known will be a problem to move. My orthodontist reminded me again today that there are no guarantees that it will move at all, it may in fact be somehow fused to the bone which could be the reason that it proved impossible to remove when my dentist tried to pull it out. I have a good feeling about it though. Call me an optimist, or feel free to call me a fool if you prefer, but I think it will move with the Invisalign. I have included a picture of it below in all its revolting glory. The squeamish amongst you should look away now.

At the beginning of my treatment my orthodontist explained to me that the plan for my teeth is that we should open up a gap in the bottom row to make room for my stray tooth with the first run of aligners, then with a set of refinements (another series of aligners), or if necessary some metal braces, pull it up into the gap.

Having completed my first run of 34 lower aligners to open the gap I thought that I would have a similar number or slightly less aligners to pull the wayward tooth into line. I imagined that the hard bit was over, and from here on it it would just be a case of gently nudging the stray tooth into its shiny new space.

Lord, was I wrong.

Not only do I have more aligners than on the first run, I have 54 new lower aligners, something that my orthodontist tells me is a new record, for his practice at least! Adding those to my original 34 means that my lower teeth will take 88 Invisalign aligners in total- presuming I don’t need another refinement!!

At this point, just for the new readers amongst you I would like to make one thing clear. I have an extremely complex Invisalign case. I knew that from the outset; my orthodontist made it very clear from the beginning of my Invisalign treatment that my case wouldn’t be easy and that if it all worked as he hoped that he would write a paper on it for the Invisalign medical journals. By contrast I believe the average Invisalign case takes a year or less, some people with very simple cases taking well under six months. To give this thing perspective I was quoted 2-3 years in metal braces by other orthodontists that I saw, which probably means that my Invisalign will work out to about the same timeframe when all is said and done. So please, don’t let the length of my Invisalign treatment put you off, if anything I think my teeth just go to show how much can be achieved with Invisalign even in such complex cases.

Of course, as with anything there is good news and bad news here. The great news is that my top teeth need only 6 more aligners and I’m pretty certain given where we now are that they will be pretty perfect at the end of that time. Realistically, these teeth are all I care about. In six aligners time (or less than three months) I will have great teeth to all intents and purposes, as the things going on with my lower teeth are things that aren’t actually visible and will not have much impact on how good or otherwise my teeth look to the casual observer. Below is a picture of my upper teeth before Invisalign in Dec 2008(on the left) and as they are now before my second refinements June 2010 (on the right). After these six aligners I will also change the ugly discoloured crown that you can see on the left next to my upper front teeth. I think at the moment that crown is actually one of the things preventing my upper teeth from looking as good as they can do, changing it for a new, whiter better fitting one should make a huge difference.

Fortunately I can say in all truthfulness that the number of extra aligners really doesn’t bother me too much. My orthodontist told me not to even ask how many more I have so fearful was he of my reaction. Still, there was a definite look of relief that washed over his face when I burst into peals of laughter as I peered intently at the little plastic bags that hold your Invisalign and tell you how many aligners are included in your treatment. The truth is I would much rather wear Invisalign for a bit longer and get a good result than wear them for less time and the final result not be so good. Of course, the bad news for my orthodontist is that he now has to put up with me for a lot longer, so maybe it wasn’t relief washing over his face after all!

After six more aligners I will have to wear only the bottom trays anyway, which as far as I am concerned are almost completely invisible. As I have said before wearing only lower aligners is really not very different than wearing no aligners. I tend to forget that I have them rather than be bothered by them.

One thing that I have realised however is that with a run of 54 aligners I will have to be fastidious about wearing them 22 hours a day if I want to keep them fitting perfectly right up until the end. I have struggled in the past to be as diligent as I should be as those of you that have read my post about a typical day with Invisalign are probably aware. This has meant that occasionally there have been tiny gaps between my aligners and my teeth -although fortunately they have never been enough to worry about or to impact on my treatment. My new resolution therefore is that not only will I wear them 22 hours a day I will no longer pop them in and out of my mouth all day to feast on diet coke and mini muffins as I have been wont to do in the past.. That way I not only will I have great teeth but I might also finally lose the “Christmas weight” that I have been carrying around for the last six months! Perfect teeth and perfectly fitting jeans? My husband might not recognise me!

Incidentally, if you actually have more aligners than me please let me know via the comments form. You can get to it by clicking on the the little black speech bubble at the top of this entry that tells you how many comments there are. I would love to know who the person with the ACTUAL record for the most aligners is. Is can’t really be me, can it?

Woohoo! After 15 months I have finally finished paying off my Invisalign. Whilst the Invisalign have been almost completely pain free the bills have not been, so I am more than happy to see the back of them. Having said that I can tell you quite categorically that it has been worth every single cent I’ve paid -and I haven’t even seen the final result yet!

I have mentioned before that my Invisalign cost $6100, plus $200 for the taking of records and impressions. That amounts to approximately $5300 US or 3600 British Pounds at todays conversion rates (3rd June 2010). I paid $1500 at the time of the first impressions, $1550 at the first fitting and then made 15 monthly payments of $220. I did however get around $2000 back from MBF, my health fund here in Australia. Still, even with that refund the bills HURT.

I didn’t choose the cheapest Invisalign orthodontist that I saw. That isn’t because I am too rich for the cost to bother me; with two children, two cats and a husband with a penchant for expensive gadgets, FAR from it in fact. It was just that when I was paying so much already I sure as hell didn’t want to have to pay it twice. Also, I am a perfectionist. So although I told my orthodontist that I was happy for my teeth to be better without being absolutely perfect, I really wanted them to be as perfect as they could be.

Given that Invisalign are expensive – and I know that I have written about some of this before, long time readers might want to skip the rest of this post!- I just wanted to say a few things about the costs of Invisalign for those that have not yet chosen their orthodontist or dentist. When you are considering spending several thousand dollars you want to get the best deal possible. Nobody wants to spend more than they have to. However, as I have repeated several times on this blog, if there is any way you can avoid it please don’t choose your Invisalign provider just based on price.

Some people getting Invisalign will have only very simple cases. For them, it may not matter whether they look for their provider based on price alone. For anybody with a more complex orthodontic problem like myself, choosing the right provider could be vital. It can honestly mean the difference between good teeth and great teeth. Given that whichever orthodontist you choose will be rearranging your teeth, filling your mouth with moulding gunk, and even possibly filing away parts of teeth occasionally, it’s important to choose the right person for the job.

Having said that cost is something that most of us can’t afford to ignore altogether, so I thought I would run through the things that influence how much your Invisalign are likely to cost.

The first thing that determines Invisalign cost is which Invisalign system your orthodontist uses. Invisalign Express is a system of Invisalign used for only the simplest Invisalign cases. Generally Invisalign Express cases take less than 10 aligners and are for minor spacing issues. Full Invisalign is used for cases other than the very simplest cases where more aligners, more complex movements and possible refinements are required. Invisalign Teen is an Invisalign system aimed at teens who may still have erupting teeth or who may have issues with Invisalign compliance.

Where you live will also have an impact on the cost of your Invisalign. In areas where the dentist or orthodontist will have higher staff and rent costs Invisalign will obviously cost more. Also, in areas where there are not many Invisalign providers there is likely to be less price competition and therefore more expensive Invisalign.

Another factor is whether you choose an Invisalign dentist or Orthodontist. Orthodontists in most countries are more specialised in tooth movement than general dentists, often having completed several more years of training at university than general dentists. This means that orthodontists sometimes (but not always) charge more for Invisalign.

Invisalign dentists and orthodontists sometimes also vary their prices according to their Invisalign experience. Some providers offer lower prices when they first start out with Invisalign, increasing their prices when they become highly experienced. This isn’t always the case though- please don’t take higher prices as a definite indicator of more experience. If you need to know which are the most experienced Invisalign providers where you live, the Invisalign website for your country ranks their providers by experience level. (Look for providers with platinum elite or premier provider elite next to their name for the most experienced provider)

Finally, you should check what your Invisalign costs include. Find out whether the cost that you are quoted includes everything- including any refinements that you might need if you are not happy with your teeth after the first run of aligners. My orthodontist offers three runs of refinements, but some providers offer less than three included in the price. Some providers also offer whitening and other extras whilst others charge for it. Make sure you know exactly what you are paying for and exactly what extra costs could crop up during treatment.

Finally, I would suggest seeing several Invisalign doctors to get quotes and opinions before choosing who to go with. In my experience they can have very different ideas as to what to do with your teeth and how complex and costly the treatment needs to be. You will also get a feel for their personality and whether they are somebody that you would feel comfortable talking to and asking questions of during your treatment. Also, check with any orthodontist or dentist that you choose that they have completed cases like yours before and ask to see before and after pictures too if they have them.

If you are concerned about whether the quotes you have are reasonable for your area of the world have a look at the realself website. It shows the prices paid by people all over the world, often with reviews of their doctors too. I found this site invaluable whilst looking for my Invisalign orthodontist.

In the meantime, I am off to enjoy my final few days of night time only braces wear. My new aligners are due in this week at which point I will be back to 22 hours a day wear. I’ll post an update and some pictures when I get them…but for now I’m off for a leisurely coffee and some very sticky chocolate cake whist I still can!

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.

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…

As you can see from the Invisalign before and after pictures in the right sidebar, my teeth before Invisalign were horrible. Not just slightly wonky, or slightly yellow, or even just slightly English, neglected teeth; rather, my teeth were of the kind that induce nightmares in small children. Ok, so I wasn’t quite Shane McGowan of The Pogues, but I could have been his long lost cousin- the one without any singing talent.

Part of the reason for my terrible teeth was years (I can’t tell you how many, there are some things even I am not willing to share with the world- suffice to say it was many, many years) of thumb sucking. The other reason was simply bad genes. Everyone in my family has bad teeth, to some extent or another. Unfortunately for me, mine were the worst of this bad lot and it was only as a result of a minor miracle that I was still able to model despite my teeth.  In nine years of modeling I only ever smiled in two shoots, and even then it was only because they were paying me handsomely to do so. The Colgate girl I was not.

Knowing the agonies I went through as a teenager- trying to hide my teeth behind a half cupped hand and peering out through a haze of self consciousness, I want to do everything that I can to ensure that my own children don’t have to spend their time cultivating a tight, closed mouth smile. So, buoyed by how happy I am with my own Invisalign experience, I recently took my nine year old for a check up with my orthodontist to assess whether she yet needs braces or is likely to do so in the future.

My 9 year old daughter is beautiful. Really, really beautiful – and I am not in any way biased as her mother, of course. As my husband often says to me “Isn’t it funny how everyone in the world thinks their daughter is the most beautiful girl in the world, and ours actually is?” So I think she’s lovely. You get the picture.

Luckily for her, she also has GREAT teeth. I don’t know where they came from but I can only give thanks that not only are they strong and healthy, but they are regularly shaped and almost all in line too. I want to do everything in my power to keep them that way.

The orthodontist took some x-rays, examined her teeth and her bite and told us that her teeth are fine at the moment, she certainly doesn’t need braces now. I watched her face as he told her this, and know that for a fleeting moment  in her nine year old mind she was slightly disappointed by this news. There is a certain cachet amongst nine year olds when it comes to getting braces, she felt that she might be missing out on something slightly glamorous.

However, what my orthodontist did tell us was that he thinks that in the future she may need some minor orthodontic work, probably at around the age of 14 or 15. Nothing major, but when her molars come through, she might need some minor straightening. My daughter took this on board, nodded sagely at my orthodontist and declared “That’s fine, I’ll just get Invisalign like mummy”

It was at that moment that it hit me. Although I love that fact that my braces are transparent and virtually unnoticeable, do I actually want that for my teenaged daughter?

Lets get something straight here. I wasn’t a perfect teenager myself. I wasn’t a deliquent, but I am young enough that I remember exactly what teenage girls are like, and more importantly, I remember only too well what teenage boys are like, particularly when in the presence of a girl as lovely as my daughter. Call me overprotective, (and plenty of people do) but I have always quite liked the idea of my teenage daughters wearing large unsightly metal braces; the orthodontic opposite of a boy magnet, if you will.

With this in mind, I pleaded with my orthodontist for several minutes about the necessity of my daughter wearing large, metal braces from about the age of 14 and preferably for a minimum of four years. Sadly he is far too ethical to apply unnecessary orthodontic devices at the behest of overvigilant mothers and is also of the belief, as a parent himself, that braces aren’t as much of a boy deflector as I might think.

So therein lies my dilemma. The things that I love about Invisalign; how inconspicuous it is, how easily removable it is, how you can still appear attractive whilst wearing it, are the very things that make me hesitate about allowing my own daughter to have it. I want her to have the ease and convenience of Invisalign, I want her to avoid the pain of metal braces, but my visions of my keeping my daughter away from boys as a teenager by making her wear an ugly school uniform, black lace up shoes, no make up and large metal braces are fading fast.

Luckily it seems that I have several years to mull over this decision; let’s just hope in the meantime that the good people at Invisalign come up with something a little less attractive for the Teen market. If they absolutely must insist on offering teenagers clear plastic aligners, I wonder whether they couldn’t at least make large black attachments on every tooth standard issue with their Invisalign Teen system? They might just make a few mothers like myself very, very happy.
[youtube]http://www.youtube.com/watch?v=fl45mNqiCaA[/youtube]

For the last week or so I have been wearing set 9 of my Invisalign upper refinements – the last set! I’m thrilled to report that not only have my teeth improved over these nine sets, they have improved in all the places that didn’t improve with the first run of 17 aligners. The molar on the right hand side which was out of line and too long has now moved into place perfectly. The front left tooth that was still twisted and out of line is 99% straight now- although I would like to get that last 1% corrected too as it is a front tooth. One thing I’m not sure of is whether at this point that is still an orthodontic issue or something that will be fixed by getting my new crown on the tooth next to it (yes, the ugly old crown on the front left tooth is still hanging in there, and still horribly discolored – see pics below)

However, having corrected those problems another one has arisen. My upper left molars now look to be in shadow compared to the front teeth. In fact they looked substantially better at set 23 of my Invisalign than they do now. I’m not sure whether this is because my eye tooth has moved outwards during my refinements and thrown them into shadow (you can see that it was programmed to move out on the refinements clincheck) or because the molars need to move out more. I notice that on the clincheck the front few teeth move out, but the molars don’t move with them, hence the problem. I mentioned this to my orthodontist at my last appointment and he hummed and haaahd and was a little noncommittal, however I am certain I want to fix this. I know that I said that I didn’t want perfect teeth, but it turns out that I am not as laissez faire as I first imagined and I do want them more perfect than this! Judging by how things have gone so far, and how well my Invisalign have worked up to this point,  I imagine that it would be a very simple refinement to get them where I want them,

In another week or so I have a long appointment with my orthodontist where we will remove the upper attachments (joy!) look at my upper teeth and decide what to do with them. He seems quite keen on leaving them as they are- I am much, much less keen on that idea! Fortunately he is the kind of orthodontist that really seems to take your opinions into account, so I’ll report back after my appointment as to what we decide.

My lower teeth are now on set 29 and I am thrilled with how they are progressing. If you look at my original pre Invisalign pictures below you can see that they were really, really straggly, for want of a better word. They are not perfect yet by a long way; but they are so, so much better.

Anyway, I’ll leave you with the pictures and let you judge for yourself. Please feel free to leave a comment letting me know what you think. Clicking the “leave a comment” link at the bottom of this page will take you to the comments form. As always, thanks for reading.

Before Invisalign:

After 29 sets of Invisalign braces on my lower arch and 17 original plus 9 refinements sets on my upper arch. See how much the bottom teeth have improved:

This picture below shows how the left side upper molars are thrown into shadow behind the eye teeth now. In both pictures and in person those teeth almost look “missing” now:

Whereas in this picture below taken at set 23, before the eye tooth moved outwards, the molars looked much, much better and were visible when I smiled.

I will be taking a copy of these images to show my orthodontist and see what he says- Watch this space!