My Invisalign Blog

My Invisalign Braces Experience

Fillings With Invisalign – My Broken Tooth

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There’s a little rigmarole I have gone through with every dentist I have ever visited. After they have completed my numerous fillings (there always seems to be something that needs fixing up in my mouth…) they ask me the dreaded question about “how often I floss.”

In most of my life I pride myself on being a truthful and honest person. I would rather eat my own arm than steal, I never ever lie to my husband (except maybe a teeny, tiny one about the price of my shoes, but that doesn’t count, right?!) and I am generally truthful and honest in everything I do. But somehow, before Invisalign, I was terrified to admit the truth to my dentist, that I rarely, if ever, flossed.

Fillings with Invisalign - a dentist's syringe

Are fillings with Invisalign possible?

So I would cast my eyes down, feigning a quick mental calculation, and come up with a hesitant “once a week, maybe?” whilst he would consider my face with a dubious expression and tell me how I needed to floss every day without fail. I would look concerned and nod my agreement and then go home to continue on my merry path of rarely flossing.

That is, until Invisalign. The moment I started wearing Invisalign, my ticket to a new, improved me, I diligently followed my orthodontist’s instructions to floss, if not every time I ate, then at least two or three times a day. So much so, that my ten year old daughter, in all her tween wit, has dubbed me a “flossing freakazoid”

All of this flossing has had its benefits. Since getting Invisalign I have had the least fillings of any two year period of my life. Namely none. My teeth look whiter and healthier and when my (very happy) dentist puts his camera in my mouth and shows me my teeth up on the screen I can literally see the difference. In fact, last time I saw him he asked me to thank my orthodontist for getting me to do what he had never been able to.

So my failure to floss has been cured, and everyone is happy.

That is until the other night.

There I was, virtuously flossing, smug and safe in the knowledge of my superior oral hygiene, when I felt a small crack and a tug, and felt something on my tongue. Fishing the ‘something’ from my mouth with the tip of my finger I could see not only that it wasn’t a piece of food, but that it was actually, gulp, a piece of my tooth. Not a large piece, more of a small sliver of one of my back molars. Fatter than a fish bone and worryingly black on one side.

One of the best things about Invisalign is that it is uniquely moulded to the shape of your teeth. However, at times, like when you are foolish enough to break a tooth with over-vigorous flossing, that can be a disadvantage too. I was filled with terror that fixing my tooth would mean that my upper aligner would no longer fit. I didn’t know how long it would take to mould and fit a new one and had visions that before it could be done my teeth would happily rearrange themselves.

Could fillings with Invisalign make my teeth go from this:

Mar ’11

to this:

2008 – Before Invisalign

It was Friday night when this happened, and with my husband out of town and my children safe in bed I thought that there was nothing I could do until Monday. Except that by the next morning it hurt.

So it was with a little fear that I walked gingerly into an emergency dental clinic first thing Saturday morning, two children in tow, each of them a little more thrilled than the other at the idea of watching the dentist giving me a “huge” injection in my mouth. I was also, truth be told, more than a little afraid of the cost; crowns aren’t cheap, and I was dreading being given bad news.

So imagine my joy when the dentist told me that although the ‘something’ (which I handed him, carefully wrapped in tissue paper, and secreted inside an Invisalign case) was a piece of my tooth as I feared, he thought he could fix it with a filling and that he hoped he could do it in such a way that my Invisalign would still fit.

Twenty minutes later, face numb and with my mouth vaguely dribbling, it was time to try and refit my upper Invisalign. The dentist offered to do it for me and after 30 seconds of his rubber gloved fingers vainly scurrying around my mouth, pushing and pulling at my aligner he handed it to me in defeat. Vaguely panicked and without a mirror or any sensation in my numbed cheek I immediately and joyfully popped it into my mouth, slotting it into place at the first attempt. Bingo.

So, all is not lost if you need a filling with Invisalign, and to the joy of my dentist, the flossing can continue. Just a little more gently this time….

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 Before And After Pictures : Set 29

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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:
15.8.08 from camera teeth 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:

Invisalign before and after pictures - teeth set 29 tilt

Invisalign before and after pictures – teeth set 29 tilt

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:

Invisalign before and after pictures - teeth set 29 tilt smile teeth set 29

Invisalign before and after pictures – set 29

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.

Invisalign before and after pictures - teeth nov 09 set 23

Invisalign before and after pictures – teeth set 29

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

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.

Set 26 Invisalign Braces – Happy New Year!

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I intended to follow the old English saying “start as you mean to go on” this year with my Invisalign Braces. So far, not so good.

In fact, not only did I pass midnight on New Year’s Eve without my braces in my mouth, I woke up with them on my bedside table on January the first. Not a great start.

This is actually a first for me. Although I am generally pretty poor in complying with the 22 hours a day Invisalign requirement (I average more like 20ish I think) I have never, ever left my aligners out overnight before! In fact, I’ve never even come close. Whilst I confess that I had consumed rather more alcohol than I might normally and that might have had something to do with it I am still amazed that I managed to go to bed and sleep the whole night (well, OK 1am to 9am!) without realising that something was missing. It took me less than 30 seconds to work out that my aligners weren’t in when I woke up, and a quick glance at my bedside table confirmed what I had suspected. Nonetheless despite my pounding head and the waves of nausea that let me know that I had drunk more than I have in many, many years I was still surprised that I had been drunk enough to forget my braces. I had thought that I was on autopilot these days when it comes to putting them in before bed. Obviously not!

I visited my orthodontist this week for my regular six weekly appointment and in a fit of raging guilt told him that I had a confession to make. He stood there, eyebrows raised expectantly with an expression I haven’t seen anybody wear since I left school, whilst I nervously weighed up whether or not to admit the whole sorry truth. However, I needn’t have worried. After admitting that I had left my braces out for a whole night he did nothing but snort, give a dismissive guffaw and tell me “That’s not a confession!” Apparently the girl in before me had left hers out for several days over Christmas and had to go back two aligners just to get them back in her mouth. So I picked the right time to confess I guess!

Despite me being so remiss all seems to be going reasonably well. I had 9 upper refinements (on top of my original 17 aligners) which consisted of 6 refinements and 3 over-corrections. I have now completed my first 6 refinements and I think there is still a little way to go before my teeth are absolutely finished on the top. My orthodontist told me that this is fairly standard; in fact most people who need refinements need to use the over-corrections. Over-corrections are given by Invisalign because those particular teeth proved stubborn to move the first time around and apparently they then usually remain resistant throughout treatment. For this reason he has told me to wear my next two upper over-corrections and he will then review my teeth again to see whether we are satisfied with the final positioning.

My bottom arch is now on aligner 26/34 and whilst I can see great progress my orthodontist is not convinced that there will be sufficient room after another 8 aligners to get my bottom wonky tooth (which you can see here on my clincheck) in to place. I am cautiously hopeful that he is wrong, but we shall see. If there isn’t enough room by number 34 we will have to do refinements (additional aligners) for the bottom row too. Funnily enough on my clincheck it always looked like there would be plenty of room long before the end and as my teeth seem to be tracking perfectly I am surprised that there isn’t. As my orthodontist has told me repeatedly the clincheck is only a guide, not gospel. Having read numerous other patients Invisalign stories I know that that is the truth. It seems that it doesn’t pay to get too wedded to the final result that the clincheck shows, it’s a useful estimate but nothing more.

There is no massive progress since the last Invisalign pictures that I posted ( you can see the highlights in the sidebar on the right) so I won’t post more now, but I’ll take more after these two over-correction uppers so you can give me your verdict on my upper arch. I think that I could do with a little more widening of my molars, but maybe the over-corrections will take care of that, we shall see. In the meantime I intend to try and make up for the misdemeanours of New Year’s Eve by being especially compliant in January. We shall see how long that lasts! At the very least I am happy that one year into treatment I am still loving my Invisalign.. Watch this space!