My Invisalign Blog

The Creation Of My Hollywood Smile

Invisalign, straight teeth and opposable thumbs

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After two years in Invisalign I can safely say that I thought I was pretty much the world expert in swiftly removing my braces. Not only could I whip them out one handed, I could do it with my eyes shut, upside down and with my left hand tied behind my back… or so I thought.

Not for me one of the Outie Tools, rubber gloves, paper towels or any of the other methods that help newcomers struggling with their Invisalign.

The last few days though, I have discovered that there is one tool that I have been using; one that I took entirely for granted and without which, removing your Invisalign is a fraught, tear stained, frustrating, frantic, claustrophobia inducing ordeal.

Ladies and gentlemen… I give you… the opposable thumb….

That sorry mess you see in the picture? That my dear readers is the thumb of my right hand. Sore, infected, inflamed, impossible to bend and therefore entirely useless as an Invisalign removing tool. Thanks to a course of very strong antibiotics it is starting to improve…but it still hurts. A lot.

I’d like to tell you that it was a snake bite, wrestling a crocodile, or some other such adventure that many outside Australia assume form the fabric of our daily lives. Sadly, the truth is somewhat less exotic. My sore thumb is, in reality, a consequence of  ‘a terrible cheese grater incident ‘ Need I say more? Devilishly dangerous things, cheese graters….

I know, I know, I have another thumb. But here’s the thing. It turns out that although I am a fiend at removing my aligners with my right hand, with my left, I am entirely useless. Whatever the little action is that I have so painstakingly perfected with my right hand, I simply can’t do it with the left.

The good news is, however, for those of you that have just started wearing Invisalign, that I can share that the key to quick and easy removal is all in the thumb. I believe, judging by the amount of pain when I try and do it at the moment, that my technique has been based entirely on hooking my right thumbnail under the edge of the aligner and flicking it up before grasping it with my hand and pulling it off.

On a much happier note, my teeth are looking good. I still haven’t had the top crown replaced. Primarily for the want of the (deep breaths) $3500 that the first dentist I found wanted to charge me. For one crown. However, I have now found another dentist whose quote is “only” $1600 and who my orthodontist recommends so I am currently steeling myself to put myself through that. You’ll be the first to know.

As you can probably tell from the pictures below my teeth are still improving, little by little. The gap into which my funky lower tooth will hopefully slide is getting closer and closer to being ready- not long to go now until we can start trying to move it in. After two years I’m so used to my Invisalign that I really don’t notice them any more; the difficulty that I face now is that because my teeth already look good from the front and all the action is at the back, it’s harder to find the motivation to wear them as many hours as I should. The photo of my teeth pre Invisalign, and the fear of going back there helps though. It really helps.

Mar ’11

2008 – Before Invisalign

 

On a final note, I’m sorry that it has been so long since my last post. What with Christmas, and then the huge floods we had in Brisbane in January (my house wasn’t flooded thankfully, although my neighbours weren’t so lucky) as well as the fact that I am currently studying full time as well as doing the usual parenting stuff means that I have been a little overstretched. I have lots to share with you though, so I promise to be far more profilic over the next few months! It’s nice to be back….

Compliance, Compliance, Compliance. Why Invisalign Compliance Is Key!

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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 don’t take my lack of Invisalign compliance as a sign it won’t hurt your teeth to wear them a bit less either.

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. Invisalign compliance is everything and the difference between and average and great result with Invisalign braces. 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.

Invisalign complaince - picture of Anthony wiggle with over-White teeth

Invisalign compliance won’t make your teeth look like these, luckily!

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.
Invisalign Compliance - image of teeth

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.

Invisalign Braces Before and After Pictures – update

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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.

Invisalign braces before and after pictures

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 Invisalign braces before and after 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..

A Cracked Invisalign Tray…

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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!
invisalign aligner set 32

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..

Invisalign Dentist Or Orthodontist? Which Is The Best Invisalign Provider?

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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.

How To Remove Invisalign Image of Invisalign dentist or orthodontist

Invisalign dentist or orthodontist. Does it matter?

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 inInvisalign 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 she took a two day course to qualify in Invisalign and 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 and you should keep this foremost in your mind when choosing an Invisaling dentist or orthodontist. 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.