My Invisalign Blog

My Invisalign Braces Experience

Invisalign Refinements- Is This A New World Record?!

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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?


How They Remove Invisalign Attachments Or Buttons…

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Looking for advice on how to remove your Invisalign trays? Click here

This week was another milestone in my treatment as it was time to remove my Invisalign attachments or buttons. 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:

how to remove invisalign attachments

My orthodontist decides to Remove Invisalign Attachments

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 dentist’s 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 dentist’s 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 – if you google remove Invisalign attachments very little shows up, so I had filled in the details myself.

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 changed 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.

how to remove invisalign attachments

Close Up No Attachments

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 and the ugly crown at the front that needs replacing though…

Invisalign- taking a break at Disney World

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OK, first things first. I have an apology to make. You see, I have spent the last month, gallivanting, for want of a better word and have sadly neglected my blog. My only defence is that I have had very limited opportunities to access the internet as I have flitted from Australia to the UK, over to the US, back to the UK for a week and then back to Australia. It’s a hard knock life…

With over 80 hours spent in the air and 28 nights away from my home this has presented me with a fair few challenges when it comes to Invisalign compliance. Challenges that I am sad to say that I have not risen to, exactly.

Don’t get me wrong, I haven’t given up on my Invisalign by any stretch of the imagination, but the difficulties associated with cleaning my aligners whilst travelling, coupled with being in retention for my top arches whilst still in treatment for my bottom has meant that I have been very, very, very lax.

Invisalign on holiday - picture of my family.

Invisalign at Disney World – lots of junk food, not much aligner wearing!

Safe to say that it’s probably easier to tell you what I have done, rather than what I haven’t. I have worn my top aligners every night faithfully. The only exceptions to this have been the two 24 hour flights between Australia and the UK when I simply couldn’t figure out what was night and what was day and so I just wore them for odd random periods whilst I attempted to snatch a little bit of that junk sleep that you get on planes. I don’t think that I have always managed exactly 12 hours on every one of my 28 nights away, sometimes it may have been nearer to 10 and a half, but I have made up for it by forgetting that I am supposed to take my top aligners out on some days and so have worn them for the full 22 hours of my pre refinement days. .

(If my orthodontist is reading this, please, please, for both our sakes, stop here!)

OK, now for the bottom aligners. Regular readers will remember me telling you that I find it much more difficult to remember to wear the bottom aligners only. This is because I really don’t notice them at all; which must be a good thing, right? The downside is that several times I have taken them out at breakfast, merrily popping them into their case and then remembered at lunchtime that I had never put them back in. Oops.

Travelling in itself provides a fair few inconveniences when it comes to Invisalign. Firstly, no sooner had I got onto a plane than I would be offered a drink. This was lovely and with 8 or 10 boring hours ahead I wasn’t ready to decline it but it did require me to take my braces out even before take off. Having finished my drink there was no opportunity to get up and brush my teeth before we lifted off so I opted to leave them out, knowing that another drink would turn up just after take off. No sooner than I had finished that second drink I would see my lunch clattering it’s way down the aisle. Halfway through lunch my 6 year old would decide she was DESPERATE for the toilet and we would try and extricate ourselves from under our tray tables, clambering across seats sending cutlery and drinks flying to get there. Having worked through the balletic complexities of two people in one tiny plane toilet, one of them a 6 year old terrified of the roar that plane toilets make when they flush, then manoeuvred ourselves back through the aisles to the whole clambering, spilling routine again, I had had enough. By the time I had finally sat back down and finished my lunch I could barely be bothered to get up and line up for the toilet again just to brush my teeth.

On one particular flight I simply gave up and left them out altogether for 8 hours. They felt tight afterwards, but I got them in and hopefully no harm done. My appointment with my ortho next week will confirm that one way or another. I may be back here, tail between my legs having been ordered back several stages, but I am cautiously optimistic.

We spent one of our weeks at Disney World in Florida and I found this too a challenge. I figured we walked approximately 70 miles that week, criss crossing backwards and forwards across the parks, chasing rollercoasters and small over exuberant mice, so I reckoned this gave me licence to gorge myself on all the enormous buffets and junk food on offer- which I duly did. My reckoning was right because my waistline didn’t suffer; squeezing myself into my clothes was no more difficult than before. Squeezing my teeth into my trays however was a lot more difficult. I could tell that I had been less compliant than I normally am by the force required to get them properly seated on my teeth..

Of course, being on holiday and more relaxed that normal means that it is remarkably easy to convince yourself that you are actually doing what you are supposed to do. Sitting by the pool on a lounger flicking idly through a trashy mag I would tell myself that my orthodontist had expressly told me that I was not allowed to wear my aligners whilst swimming, so I was actually doing the right thing by not wearing them. I find it alarmingly easy to delude myself!

The good thing about this holiday is that I have come back full of energy and ready to attack things with a renewed vigour. This includes my invisalign wearing which I am now going to be so, so, so much more disciplined about. Well, that’s my story and I’m sticking to it.

Invisalign Braces Update: My teeth Aug 09

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11 days into 16/17 upper and 16/34 lower Invisalign and I must confess that I’m getting nervous. Don’t get me wrong, my teeth have moved. The difference from 6 months ago is almost unbelievable. The thing is though that they aren’t quite there. My uppers, which have only one set after this look great from the front- almost perfect, but from the side there is one particular area that I still don’t like.

My front right tooth that was twisted slightly at the beginning of all this still isn’t quite lined up how I would like it to be and the crown next to it still has a gap. Also, regular readers might remember that there was one area that my ortho and I disagreed on with one of my back molars.

He thought one tooth should come down and I thought another should go up to make them line up. Having almost completed the upper arch I am sticking to my guns! I think that tooth needs to go up, so that will be one of my refinements.

Here are pics of the teeth I am talking about. I’ll let you know if there is any improvement during the last set.

Set 15 Of my Invisalign Braces- and some ugly Pre Invisalign pictures!

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I don’t know whether my orthodontist had in mind George Bernard Shaw’s quote “My way of joking is to tell the truth; that’s the funniest joke in the world” when he handed me the CD of pre Invisalign pictures taken of my teeth at my initial appointment, but if he didn’t, then he should have had. Digitally printed on the front of the CD were the words “Ugly photos” along with a picture of a goat in braces, and never has a title been more apt.Whilst it was kind of him to give them to me, (I think!), I’m not at all sure that it is kind of me to put them on here, but I will, with the proviso that if you have just eaten, please, please, don’t look at them. They are alarmingly, distastefully, graphic and ugly.

As well as giving me the photos, we spent a large part of my appointment talking about retainment and refinements, things that seemed so distant in the early days, but now look so promisingly close. I’m excited even to be thinking about such things let alone talking about them.
After the next couple of aligners I can get moulds for any refinements that I want on my top arch and then switch to retainment mode for the top arches until they arrive. I will continue to wear each of the remaining 17 sets of lower aligners as usual but only my last set of top aligners at night. I had to double check this with him twice, but apparently that is the case; nighttime wear only will be fine. He reiterated that I have three attempts at refinement included in his price so I am happy to use one up in fiddling with the top arch whilst the bottom completes it’s first run. I’m not sure exactly what I’ll want to change yet, but I already have a few ideas of things that I’d like to tweak, so no doubt I’ll have a long, perfectionist, type A list by the time we make the new moulds in a few weeks!
My orthodontist has said that I can also get my new crown to replace the ugly old one that is really showing it’s age lately and that we’ll do refinements around it. Initially, this was definitely what I wanted, however, one of my two front teeth is not quite in the position that I want it to be yet, and unless it moves fairly significantly in the next two aligners I think it will need to be worked on during refinements. As the new crown will be right next to it, I have the feeling that I might be better off leaving it until the end of the whole process and getting the crown made then to perfectly fit the shape of the final gap. I’ll make a decision on this in the next few weeks, but please,let me know what you think. Bear in mind that a new crown costs $1500. Gulp. I really don’t want to have to do it twice.
My orthodontist is a lovely guy and I usually enjoy the banter that his visits entail but I have to say that I enjoyed this one a lot less than previous ones. Not the fault of my orthodontist, rather that I had an attack of heart palpitations in his office. The last few months I have been having these a lot, when I bend down and stand up too suddenly, when I twist into certain positions, and also I now know, when I get tipped upside down, head above my feet, in a dentists chair.
My heart, for some strange, electrical reason goes into a crazy irregular pattern for 30 seconds -2 minutes. I have seen two cardiologists, one of whom specialises in electrical problems, and had numerous tests and they have assured me that it is nothing serious, but still it is unnerving and extremely unpleasant. Luckily, my orthodontist has had some experience of this and he and his assistant were very calm about it and just kept my head above my feet for the rest of my
appointment, meaning that it quickly stopped, but it was a little scary nonetheless. I plan to do all the rest of my appointments in a more upright position: I’m prepared to put up with a lot for my new teeth, but heart arrhythmias weren’t something I had planned for!
Set 15 has been going very smoothly, no pain, little discomfort and no other problems. There is a tiny gap between my tooth and the aligner along the bottom of one of my front teeth, but I showed my orthodontist and he was happy that it was normal so I think all is well. I must confess that I haven’t been wearing them the full 22 hours of late so whether this is my comeuppance only time will tell. I will try to be more disciplined over the next two sets. No really, I will.
Here are the hideous photos. Can I just point out in my defence that the water on them is from the things that hold your mouth back, whose name entirely eludes me. It’s not my saliva! Honestly.