My Invisalign Blog

My Invisalign Braces Experience

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.

Platinum Elite Invisalign Orthodontists in Australia (Premier Provider Elite in the US)

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When I originally went looking for an orthodontist (read about the whole sorry saga here) one of my prerequisites was that my dentist should be an Invisalign Platinum Provider (Invisalign Premier provider in the US). At the time I was looking this seemed to be the blue chip of Invisalign orthodontics, a sign that the Doctor in question was one of the most experienced orthodontists or dentists in using the Invisalign system.

Then the other day whilst at my orthodontists I noticed a new plaque on his wall. This one congratulated him on being a Platinum Elite Invisalign provider. I was intrigued. Was this just another name for platinum providers, or had the fine people at Invisalign created a whole new tier for our goodly orthodontists to aspire to?
Well a quick search on the Invisalign website has enlightened me. Apparently a platinum provider is the name given for “Doctors who have a high level of Invisalign experience based on the number of patients treated” whilst Platinum Elite providers (Invisalign premier provider elite) are “Doctors who have the highest level of Invisalign experience based on the number of patients treated”
The receptionists at my orthodontists office also told me that Elite status is reassesssed regularly and only those orthodontists that complete enough cases on an ongoing basis retain the Elite title.
As a post script I have just found out that there are silver, gold, platinum and platinum elite providers in the Uk and some other countries!

Invisalign Headache & A Quick Update On The Invisalign Crack

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Thanks to everyone for all your recent comments, it is great to see that people are actually reading this.

As I wrote in my last post I have a small crack in tray number 6, but had decided to ignore it. To cut a long story short, this morning I gave in to my conscience and called the orthodontist. I am paying so much that I really don’t want to compromise this process.
Invisalign Headache

Invisalign Headache

The good news is that he said that as long as the tray is still wearable and hasn’t completely broken I can just wear it. I think this is probably because I am in Australia, and all my trays are sent from the Invisalign production factory in the US. Consequently if we waited for a new one it might take weeks to arrive. I’m not sure the advice would be the same if I were a patient in the US, for example.
Anyway, I am happy to wear it, I feel that it is still doing it’s job as there is significant pressure on the teeth in question and the crack is very small. If it breaks I have to call him again. So, for the next 2 weeks I will be removing that tray very gingerly. I feel better however just for having called.
As an aside, 48 hours in, the trays are still very tight- so much so that I have had a mild headache for the last 2 days. I have noticed this Invisalign headache several times. It seems that when the trays are tight they give me a headache, particularly on the first day. The painkillers help, but I think it’s similar to when you clench your jaw and give yourself a tension headache, the Invisalign replicates that by putting pressure on your jaw. The aligners are gradually loosening, but still feel significantly tighter than other trays have at this point. Hopefully that means my teeth are really working hard this set and will soon be nicely aligned and straight.

6th Set of Invisalign braces- A Silly Thing To Try And Treat With Invisalign!

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I chose my Orthodontist after a long and arduous search for the right Invisalign doctor. One of the factors that helped me to choose him was that he is a lecturer in orthodontics at a prestigious Australian University. It never crossed my mind though that I might become the basis for one of his lectures.

Invisalign Orthodontist Dr Brett Kerr

My Invisalign Orthodontist – Dr Brett Kerr

Apparently though, that is the case. I don’t mind that at all- as far as I am concerned if my teeth can help other orthodontists to improve their Invisalign technique I will be delighted. It is more the title of the lecture that bothers me. My orthodontist cheerily informed me yesterday that my teeth are the basis for a lecture he is giving next week, entitled…”Silly things to try and do with Invisalign braces” That makes me feel so, so much more confident! My only consolation is that he might need to provide an update to the students in the future, so perhaps this will encourage him to do his best work… How much do I wish I could be a fly on the wall and hear what he has to say!
Other than that, my 6 weekly visit was short and uneventful. I asked my query about flouride and he said that as we have flouridated water here now flouride probably isn’t necessary for most patients. However, in patients with large amounts of fillings (i.e. me) it can do no harm. He actually suggested a weekly flouride rinse. His only stipulation was that it should be a ph neutral one.
I picked up three more sets of Invisalign- sets 6, 7 and 8, and immediately put set 6 in. They are tight. For the first time since set 1 at the beginning of this process I actually felt I really had to take a painkiller. I should probably explain something here. I have Crohn’s disease which is an inflammatory stomach disorder. As a consequence I have a lot of stomach ulcers and try and avoid painkillers as much as possible.
When I do take them I try and stick to paracetamol. So I don’t take them lightly, taking one maybe 2 or 3 times a year (as opposed to 2 or 3 times a week like my husband!). Lots of people, I know, always pop a painkiller when they put in a new Invisalign tray in, but generally I haven’t found it necessary. This time though the pain became so much that I had the sense that it was going to give me a migraine, so I decided to preempt that. It seemed to work because by next morning they felt a lot better.
I have had the usual difficulties of removing them with the attachments, and have noticed that there is a tiny crack in the side of one of my molars on the bottom arch. I am ignoring this unless it gets worse as it doesn’t seem to be compromising the strength of the tray. I know that probably I should call my orthodontist, but I know that he will only have two options- to order a new tray, which I don’t want to wait for, or to push me forward a set, which I don’t want to do. So, I am going to try and wear these as long as I can of the two weeks. If they get weaker or snap I will, of course, call him.
I live in Australia, having emigrated here four years ago. Consequently all my family are still in the UK, and haven’t yet seen my Invisalign. They are all arriving next week, and I am particularly looking forward to the comments from my Mother In Law who utterly despises me and will no doubt have some interesting things to say about my braces-I’ll keep you posted!