Once or twice I have watched Extreme makeover, that show where ordinary people undergo transformations through plastic surgery and dental procedures to make themselves look and feel better. Or, at least, that’s the idea. The thing that has always struck me about the whole “reveal” experience on those shows is that very often the thing that makes the most difference is not the breast enlargements, the liposuction or the face lifts, it’s their new teeth. The teeth alone can make someone look ten years younger, wealthier, healthier- like a completely different person.
My orthodontist seems like a nice guy. He is certainly experienced with Invisalign, is funny, reassuring and seems to know what he is doing. Generally he fills me with confidence. I must confess I wasn’t wild about his lectures to his postgrad students on my teeth being called “A silly thing to try and do with Invisalign” but I took it in fairly good heart. However, when at my latest visit he told me that if what he is trying to do to my teeth with Invisalign works, he will write about it for the medical journals, I really started to get nervous…
I almost decided not to switch to these Invisalign trays on the basis that I have a seriously sore throat. But. But. But. The ever nagging little voice in my head that thinks that my teeth will end up going back 5 stages if I don’t complete this thing properly keeps telling me that I need to follow all the instructions exactly to the letter, so switch I did. I figured that the panadol would probably help my throat too, right?
Having just got my new Invisalign attachments I think my love affair with Invisalign braces may already be starting to wane.
I’m not sure what possessed me, but I scheduled my appointment to get my Invisalign attachments an hour after I was due to drop my 5 year old daughter off for her first ever day at school. By the time I had realised, it was too late to reschedule, unless I wanted to wait another 2 weeks for my next set, which I certainly didn’t.
So, I arrived at my appointment red eyed and sorry for myself after a morning of blubbing and was perhaps feeling a little more fragile than I might otherwise have been. You should probably bear that in mind when reading this account!
My teeth though, were in great shape. I had a quick chat with the ortho about the bleaching which we agreed had been reasonably successful. I mentioned that after 3 consecutive nights of use it had made my gums crack and bleed, which he said noone else had told him before, so maybe that is just me?
He had a quick look at tray 2 in my mouth, and examined the crack (read about that here). He could immediately see the problem, and upon examining the other aligners he had waiting for me we could see that some of them cover my stray lower tooth completely, and some just cover the top of it. He wasn’t able to give me any explanation other than the that the Invisalign robot was having an off day but he decided it was unnecessary to cover that tooth, and took all the future sets away and filed them down. There was also a small area that irritates part of my gum that I have had to file on my last two sets, and he filed that on all the future sets too which was a great relief.
By the time I got to this appointment, 4 weeks into my Invisalign treatment I could get my trays in and out almost without thinking about it. It wasn’t quite at the point where I could pop them out with my tongue as I have read some other people discuss, but it was certainly easy. I told my ortho this, and he chuckled and said “wait until we get these attachments on” with an evil glint in his eye, and what I thought might be a cackle under his breath…
The Invisalign attachments or buttons are small clear ‘blobs” that are fixed to your teeth to give your aligners better grip on the tooth that they are attached to. They are, in my case, all oblong shaped, although apparently there are other possible shapes. Depending on the movement they are designed to help with, they can be put on either vertically or horizontally, and can go on different positions on each tooth to help create different movements. I have 5 attachments in total as you can see on my clincheck.
The process of putting them on began with my ortho showing me 2 sets of my third aligner. One of them was a template set, made of a much finer and softer plastic than the normal aligners, the other was the standard aligner for use after the attachments were fixed. The template aligner was fitted to my teeth to check for fit and was then removed again. The ortho then used some kind of powered drill to ‘rough up’ the surface of my tooth. It was a sensation not unlike sandpapering and not altogether pleasant. He then filled the attachment gaps in the template with some gel and reinserted it on to my teeth. The gel would be what ultimately would form the attachments, and was hardened by him shining a blue light on each one in turn in a way very similar to when you get a white filling.
The next bit was slightly fiddly as he then had to remove the template, which involved lots of pulling and the use of his dentists pick, but eventually it came out without the attachments or any of my teeth!
He then took what sounded like a drill and filed off any excess bits that had become attached to my teeth, and also smoothed around the attachments so that they would not irritate my mouth. This was the part that I REALLY didn’t enjoy. It was very similar to having your tooth drilled in preparation for a filling, and although I knew that they weren’t actually drilling into my tooth, it felt as if they were, and was almost bordering on painful. The only positive was that it was over relatively quickly. If you have a dentist or filling phobia it may be worthwhile having a stiff drink or a valium for this bit, it is the bit I have enjoyed least of the whole process thus far.
I was then ready to go! The orthodontist reinserted the softer template tray and told me to wear that one until the end of the day. His reasoning for this was that it can be extremely difficult to remove the trays the first day after attachments are put on. The template would therefore help to move the teeth a bit whilst still being flexible enough to allow it to be more easily removed. This would give me a chance to practice before inserting the normal one that evening. I’m not sure whether this is standard procedure from Invisalign, if not, all hail my ortho, as it seemed like a great idea!
Of course, when he said that the template would be easier to remove than the normal tray, he meant easier, not easy. It still took me about ten nail-breaking minutes to remove each aligner, and I began to seriously doubt whether I would actually ever be able eat again.
There is a moment when you reach a certain point of frustration trying to remove these things, when your fingers seem too big and clumsy to fit in your mouth, and you just want to scream. I spent most of the day like that with one of the aligners stuck half on and half off my teeth and my fingers down my throat. I was so panicky that I wondered whether I can do this or whether I will need an aligner hook.Apparently a lot of Invisalign patients swear by them although they are hard to get hold of in Australia.
I switched to the standard aligners that evening, and noticed two things. Firstly, that the attachments make them WAY firmer- they certainly do increase the grip- and also that my ortho wasn’t kidding about how much more difficult they are to remove. Even a week on I am still struggling- not as much, but there is no sense of just ‘popping’ them in and out, it really is something of an ordeal. They are also so much tighter than set two, almost to the point of pain. The old cliche of be careful what you wish for certainly applies in this case.
Aesthetically, I am also not a great fan of the attachments. I was prepared to concede that Invisalign braces are fairly invisible when you don’t have attachments, but, I think the attachments effectively double their visibility. The strange bumps on your teeth are way more noticeable than the extra glossiness that you get from the aligner. Of course, that being said, they are still a substantial improvement on even clear standard braces, just not truly invisible.
The only other thing I dislike is that when your aligners are out of your mouth the Invisalign attachments feel very rough inside your cheeks- it gives you sympathy for how people with standard braces must struggle. They also feel like food becomes easily caught on them.
Of course, having said all this, I still on balance feel that they will be worth it- if I do end up with great teeth at the end!
For those of you who might be interested there is a great video on youtube showing the attachment process. I think it was helpful to me to know what to expect.
I’ll let you be the judge of how visible my Invisalign attachments look:
It’s not that I’m a masochist, don’t get me wrong, but I am almost disappointed by the lack of pressure or pain these second aligners have caused me.
I had psyched myself up, if not for pain exactly, then at least a level of discomfort comparable with my first set, but- nothing. Well, perhaps not nothing exactly, but the discomfort has really been minimal, more a too tight pair of trousers than early childbirth. I think the disappointment stems from a fear that if I can’t feel pain then my teeth aren’t moving any closer to their shiny, new, improved postitions, which I’m sure the orthodontist would tell me is simply not the truth.
So, something of an anti climax. On Tuesday morning I excitedly snipped the seal on the Invisalign plastic bag that contained my new set of aligners, and placed them side by side with set 1, scrutinising them, hoping to be able to spot some difference, however small. But, nothing. Nada. To my eyes they look identical in every respect. Every respect except one that is. The section that covers the wayward tooth that grows across the bottom of my mouth (see the pictures of the tooth here, or the clincheck here) is much larger than it was for the first set where it simply slotted over the top part of the tooth. In the second set, it encloses the whole tooth, and horror of horror, on removing it from the pack I could see that the aligner had a small crack up the side of that tooth.
This caused me a minor panic as there was no way I wanted to wait the 4-6 weeks for a new set. I called my orthodontist planning to beg for an immediate solution, but, thankfully no begging required. He was no keener than I on any delays and decided that as the aligner isn’t moving that tooth and won’t interfere with my treatment, as long as it isn’t causing me discomfort, I can just wear it. Yay.
(set 1 are at the top and set 2 are at the bottom in each picture)
Another thing that I noticed about the new set was that they weren’t as clear as set #1, which is a little odd considering I have been wearing set #1 for 2 weeks. I have been absolutely scrupulous about hygiene, so they were looking pretty spotless, but the new set looking so cloudy, even before I had worn them, bothered me. As a precaution I gave them a quick scrub with a soft toothbrush and a rinse and they came up just as clear as the first set. I’m not sure what it was that was making them look cloudy, but I’m glad it went down the plughole rather than in my mouth. I will be cleaning them all in future before inserting them for the first time.
Once clean I put them in with almost no trouble. The stray bottom tooth makes it a little complicated in that I have to insert the lower set and then separately pop that section onto the side tooth. It seems to work ok though despite the split. I am removing them slightly more gingerly than the last set, just in case they are more fragile.
For the first couple of minutes there was some pressure, but nothing when compared to the first set. To what extent it was simply me getting used to the sensation of having a foreign plastic object in my mouth the first time around, however, is hard to say. They were a little difficult to remove for the first day, but again, nothing like at the beginning of the first set, which I’m sure is almost certainly down to improved technique. For the first 12 hours I had very slight root sensitivity on my front teeth, but certainly no pain.
So, all in all a successful beginning to set 2. Would it be tempting fate to hope that the rest of the sets go as smoothly?