refinements – My Invisalign Blog

I don’t know about you, but I’m one of these people that always comes away from appointments with doctors/dentists/orthodontists with a list of questions that I forgot to ask. My last few appointments with my orthodontist have been like that. I intend to write a list of questions beforehand, I procrastinate, I mean to get around to it, and then, in the end, I leave it too late and forget everything I want to ask.

This time however, wasn’t like that. For the first time I managed to actually remember all the things I wanted to talk about, coming away with a lot of good new information.

The first thing we discussed was refinements. I have 17 Upper and 34 Lower aligners on my first run of Invisalign (yes, there will be more!) and I was expecting that I might have to wait until all my lowers were finished before I could start the refinements on the top arch. I was relieved then, to be told that we actually get three attempts at refinement with my orthodontist, so I can start on the tops whilst the lowers are still going. Of course, it’s impossible to know whether I’ll actually need refinements at this stage, but knowing that it won’t impact on the overall timeframe of the treatment means that I may be more of a perfectionist on my top arch than I might otherwise have been. I’m not sure why but I had somewhere along the line convinced myself that there was only one refinement possible, so this was a great relief for me- with a case as complex as mine I have a feeling that we will need a few tweaks here and there.

My Orthodontist _ Dr Brett Kerr

Secondly, although I have written about my orthodontist a fair amount on this blog, I’ve never before named him as I felt that it wasn’t appropriate without his permission. I do get quite a few emails asking for his details, so I was keen to get them on here if possible. Anyway, another of things that I remembered to ask was his permission to give his name, and it was duly granted. So, if anybody is looking for an orthodontist in Brisbane, Australia, I’m happy to highly recommend Dr. Brett Kerr. His website is here with all his contact details and examples of past cases. (update: I think he’s now retired sadly!)

I did also tell him about my blog, which he said he’s going to read- I guess I’ll know whether he liked it next time I visit. If I suddenly need an unscheduled and highly painful round of extensive IPR (filing between my teeth) We’ll know that he wasn’t happy with what I’ve written!!

The other thing we talked at length about was the Vivera retainers that Invisalign offers. For those of you that haven’t heard of them, Invisalign offer a system whereby you receive a new retainer by mail every three months. Previously, some patients had reported that when they had bought two retainers, worn one for 6 months and then switched to the second, their teeth had moved making inserting the second one difficult. In other words, the retainer itself had altered slightly, allowing their teeth to slightly relapse. To prevent this happening the Vivera system was introduced. My ortho told me that he thinks that the system is a great idea, but unfortunately isn’t available in Australia yet. Hopefully, that’s something that might change in the future. Incidentally to those of you in the US it costs in the region of $300 p.a. depending on the orthodontist.

My ortho’s main reservations about Vivera were that once you ask Invisalign to make your aligners they consider your case finished, even if you haven’t used up all your refinement entitlements. In his experience sometimes people do come back a few months after the end of treatment and ask for something extra. If there are still refinements available that weren’t used in the first instance, he can just get another series of aligners made. However, if retainers had been ordered this wouldn’t be possible. A new Invisalign case would have to be opened.

I am on set 12 at the moment and will post more about the trials of those in the next few days. Thank you for all your comments, as ever, they make writing this thing seem worthwhile.

Once or twice I have watched Extreme makeover, that show where ordinary people undergo transformations through plastic surgery and dental procedures to make themselves look and feel better. Or, at least, that’s the idea. The thing that has always struck me about the whole “reveal” experience on those shows is that very often the thing that makes the most difference is not the breast enlargements, the liposuction or the face lifts, it’s their new teeth. The teeth alone can make someone look ten years younger, wealthier, healthier- like a completely different person.

teeth with whitening tray

I think that may be one of the only problems with Invisalign as far as I am concerned. Whilst I love- really love, the ability to remove them at whim, it does mean that I am watching my teeth improve week by week and the ultimate reveal may be something of an anti-climax. I imagine that with metal braces it is much harder to see the results as they happen, and getting them removed must therefore be much more exciting. Of course, it is motivating to see your teeth improving set by set, but you have to go back to your pre– invisalign braces photos to see how bad they really were at the beginning and why you are going through this process.

The thing is, you see, that I am starting to really, really like my teeth- well the top ones at least. They look straighter, they look whiter (thanks to the bleaching), they look, well, like someone else’s teeth to be honest! It is such a thrill to see them like that. I am now getting ridiculously excited about getting my new crown on my upper right incisor(despite how much I am dreading the actual procedure) as that is the only thing marring their new improved look. Nonetheless, I am delighted with how things are proceeding.

I am on set 10/17 for my uppers, which is why I am now seeing such an improvement. (More than halfway through, yay!) My lowers however, are on 10/34 so they still have a long, long way to go. I can already tell though that it is harder to get my fingers between my upper and lower front teeth, so there must be some movement happening, it is just less obvious to the eye. I should point out that although I have a large overjet it is caused by my bottom teeth being too far back, not my top teeth being too far forward. Apparently, the way that I used to suck my thumb (and frankly, I don’t even want to tell you what age I stopped, it is truly, truly shameful!) pressed my bottom teeth back.

Set 10 haven’t been a problem at all. The bottom set of aligners were spectacularly difficult to insert at the first few attempts, in fact, I went and checked the packet very carefully, just to be sure that I hadn’t skipped a set. I hadn’t, they were the correct ones. I think the reason is that they are having to work very hard now as there is such a long way for my bottom teeth to move. You can see how much work they have to still do on my clincheck here.

I think I am back on track compliance wise, bar the odd slip up, and judging by how tight the last set were I need to be.

I have a small issue that I have been discussing with my orthodontist regarding one of my upper molars. (see tiny pic above) I think it is too long, he thinks the one next to it is too short and is attempting to pull it down. Whilst I disagree with him on this one tooth, I am happy to finish this course of treatment and see how it looks. He has promised that if I don’t like it we can adjust it through refinements. On balance given what Invisalign cost and as he has studied orthodontics for 30 plus years and I have only been wearing braces for 4 months, I am prepared to concede to his better judgement on this one. I’ll let you know if he was right!