Invisalign Refinements- Is This A New World Record?!

June 8, 2010 by admin 9 Comments

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?

Understanding Invisalign Price & Cost Issues

June 7, 2010 by admin 4 Comments

The doctor with the cheapest Invisalign Price is not always the best one for you

Woohoo! After 15 months I have finally finished paying off my Invisalign. Whilst the Invisalign have been almost completely pain free the bills have not been, so I am more than happy to see the back of them. Having said that I can tell you quite categorically that it has been worth every single cent I’ve paid -and I haven’t even seen the final result yet! However I get a lot of questions about the Invisalign price I paid, so I’ll attempt to answer them here.

The Invisalign Price I Paid

I have mentioned before that my Invisalign cost $6100, plus $200 for the taking of records and impressions. That amounts to approximately $5300 US or 3600 British Pounds at today’s conversion rates. I paid $1500 at the time of the first impressions, $1550 at the first fitting and then made 15 monthly payments of $220. I did however get around $2000 back from MBF, my health fund here in Australia. Still, even with that refund the bills HURT.

I didn’t choose the cheapest Invisalign orthodontist that I saw. That isn’t because I am too rich for the cost to bother me; with two children, two cats and a husband with a penchant for expensive gadgets, FAR from it in fact. It was just that when I was paying so much already I sure as hell didn’t want to have to pay it twice. Also, I am a perfectionist. So although I told my orthodontist that I was happy for my teeth to be better without being absolutely perfect, I really wanted them to be as perfect as they could be.

Why The Cheapest Invisalign Price Isn’t Necessarily The Best

Given that Invisalign are expensive – and I know that I have written about some of this before, long time readers might want to skip the rest of this post!- I just wanted to say a few things about the costs of Invisalign for those that have not yet chosen their orthodontist or dentist. When you are considering spending several thousand dollars you want to get the best deal possible. Nobody wants to spend more than they have to – let’s be honest, most of us will be sacrificing a lot to be able to afford braces. However, as I have repeated several times on this blog, if there is any way you can avoid it please don’t choose your Invisalign provider just based on their Invisalign price.

Some people getting Invisalign will have only very simple cases. For them, it may not matter whether they look for their provider based on price alone. For anybody with a more complex orthodontic problem like myself, choosing the right provider could be vital. It can honestly mean the difference between good teeth and great teeth. Given that whichever orthodontist you choose will be rearranging your teeth, filling your mouth with moulding gunk, and even possibly filing away parts of teeth occasionally, it’s important to choose the right person for the job.

Having said that cost is something that most of us can’t afford to ignore altogether, so I thought I would run through the things that influence how much your Invisalign are likely to cost.

What Influences the Invisalign Price Your Orthodontist Charges?

Your Invisalign price may be different if your dentist uses Invisalign Express or Invisalign Teen

The first thing that determines the Invisalign price is which Invisalign system your orthodontist uses. Invisalign Express is a system of Invisalign used for only the simplest Invisalign cases. Generally Invisalign Express cases take less than 10 aligners and are for minor spacing issues. Full Invisalign is used for cases other than the very simplest cases where more aligners, more complex movements and possible refinements are required. Invisalign Teen is an Invisalign system aimed at teens who may still have erupting teeth or who may have issues with Invisalign compliance.

Where you live will also have an impact on the cost of your Invisalign. In areas where the dentist or orthodontist will have higher staff and rent costs the Invisalign price will obviously be more. Also, in areas where there are not many Invisalign providers there is likely to be less price competition and therefore more expensive Invisalign.

Another factor is whether you choose an Invisalign dentist or Orthodontist. Orthodontists in most countries are more specialised in tooth movement than general dentists, often having completed several more years of training at university than general dentists. This means that orthodontists sometimes (but not always) charge more for Invisalign.

Invisalign dentists and orthodontists sometimes also vary their Invisalign prices according to their Invisalign experience. Some providers offer a lower Invisalign price when they first start out with Invisalign, increasing their prices when they become highly experienced. This isn’t always the case though- please don’t take higher prices as a definite indicator of more experience. If you need to know which are the most experienced Invisalign providers where you live, the Invisalign website for your country has more information.

Check What The Invisalign Price Includes

You should check what your Invisalign costs include. Find out whether the cost that you are quoted includes everything- including any refinements that you might need if you are not happy with your teeth after the first run of aligners. My orthodontist offers three runs of refinements, but some providers offer less than three included in the price. Some providers also offer whitening and other extras whilst others charge for it. Make sure you know exactly what you are paying for and exactly what extra costs could crop up during treatment.

Get Several Quotes

Finally, I would suggest seeing several Invisalign doctors to get quotes and opinions before choosing who to go with. In my experience they can have very different ideas as to what to do with your teeth and how complex and costly the treatment needs to be. You will also get a feel for their personality and whether they are somebody that you would feel comfortable talking to and asking questions of during your treatment. Also, check with any orthodontist or dentist that you choose that they have completed cases like yours before and ask to see before and after pictures too if they have them.

If you are concerned about whether the quotes you have are reasonable for your area of the world have a look at the realself website. It shows the prices paid by people all over the world, often with reviews of their doctors too. I found this site invaluable whilst looking for my Invisalign orthodontist.

In the meantime, I am off to enjoy my final few days of night time only braces wear. My new aligners are due in this week at which point I will be back to 22 hours a day wear. I’ll post an update and some pictures when I get them…but for now I’m off for a leisurely coffee and some very sticky chocolate cake whilst I still can!

More Invisalign Impressions and Refinements…

May 23, 2010 by admin 12 Comments

What a relief!

I had been dreading my latest appointment with my orthodontist. After the terminal crack in my 31st Invisalign aligner his assistant had told me on the phone that he had some “new ideas” for my teeth that he would talk to me about at my next appointment. I’m not sure exactly what I had thought those new ideas might involve, but I was certainly fearful that it might be metal braces, elastics, possibly even headgear and all manner of torturous orthodontics- my imagination is a wonderful thing!

I know, I know, metal braces aren’t torture devices. The trouble is though that I am horribly, horribly vain, (hence the braces in the first place) and I find Invisalign so easy and so invisible that I can’t even bear considering the possibility of a mouth full of metal. I know that I agreed at the start of treatment that I would wear metal braces on three of the teeth on my lower arch for a short period, just to pull one tooth into line but I really don’t want to go beyond that.

Fortunately, my orthodontist didn’t even mention metal braces. Instead, he took new moulds for a second set of Invisalign refinements which should completely finish my upper arch and get us a lot closer to finishing the lower one.

A mould of someone’s teeth- not mine

Before I had my first moulds taken 18 months ago I had read on an Invisalign forum about the horrors of the impressions process: the gagging, the vomiting, the residual taste left in your mouth afterwards- all manner of terrors. I know that getting moulds taken is a part of the process that a lot of patients work themselves into a frenzy about- I know I did the first time- but in my experience it really is nothing to be fearful about. My post about taking moulds for Invisalign has a full length description of the process for anyone that has yet to go through it, but if you have neither the time nor the inclination to read it I am happy to report that it is a remarkably painless experience.

For the sake of a balanced viewpoint I did question my orthodontist this time about whether there really are patients that vomit when they get their moulds taken or whether the people writing on Invisalign forums are just getting a kick out of terrifying the uninitiated. He assured me that he doesn’t get actual vomiters as a rule, but that he does get the odd patient who feels like they might gag. In his opinion it is largely psychological- in other words some people are very fearful about the impressions process and it then becomes self-fulfilling- their panic makes them feel like they can’t breathe, which combined with the moulding material in their mouth makes them feel that they might vomit. He was happy to reassure me though that the vast majority of his patients cope with impressions quite happily. He did offer the tip that it was best to avoid getting moulds taken when you have a cold though as this can make it harder to breathe and increase your gag reflex.

The moulds made, I now just have to wait until the next sets of aligners are ready which should be in about 4 weeks. In the meantime, I have to wear my Invisalign for only 12 hours a day. My orthodontist told me this and then added “if you can manage that”

I was a little surprised by this last comment; I have after all been wearing them 22 (ahem) hours a day quite successfully for the last 16 months; twelve hours a day would be a synch. However it then dawned on me that what he was saying was I could wear them 12 hours a day if I could bear to wear them that little.
Apparently, (and of all the things that he has told me about orthodontics this is the hardest to believe) some people get so used to the feeling of their aligners that they can’t bear to be without them!

What is wrong with these people!! I love my Invisalign as much as the next person, but I love them because they are doing a fine job of coaxing my bedraggled teeth into a cosmetically enhanced order. I don’t literally love wearing them. Apparently though, some people do. Their mouths have become so accustomed to the feeling of wearing the aligners that they can’t bear to wear them only 12 hours a day. Like thumb suckers they have become almost dependent on them. I’m happy to report that although I talked about my need to cultivate a few more vices earlier in this blog, aligner addiction wasn’t what I had in mind. Something tells me that I’ll cope admirably with the need to wear them only 12 hours a day.

How They Remove Invisalign Attachments Or Buttons…

March 22, 2010 by admin 31 Comments

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:

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.

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 Before And After Pictures : Set 29

March 10, 2010 by admin 8 Comments

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:

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

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 – 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!