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After Invisalign.. Clear retainers -Essix Retainers, Vivera or Fixed?

January 27, 2012 by admin 18 Comments

When I first started Invisalign, the time when I would finally be wearing retainers seemed like such a distant prospect that I barely even allowed myself to give it a second thought. In my imagination, a day when I would have good teeth was a day that I dreamt about, but not one that I ever REALLY thought might come.

My friends, that day is here.

As I mentioned in my last post, my upper teeth have now been happily ensconsed in clear retainers for some time, and I thought those of you still on your journey to get that to that point, might like to see what the different retainers look like.

My orthodontist has chosen Essix retainers for me, and ever one to question his professional judgement, I did a fair amount of research as to what I think the most comfortable and unnoticeable clear retainers are, ready to fight battle if need be.

Essentially there are two main options when it comes to retention following adult braces. The bad news is that either way, you need to wear retainers forever. Not forever, as in, for ten years and then your teeth will grudgingly conform and stay elegantly upright in their new, more attractive positions. Nope, this kind of forever is really the forever kind. The kind of forever where fifty years of wearing retainers, followed by a week long slip up will still mean that your unobliging teeth will start to dance back to the position they were in before you trussed them up in Invisalign.

So, retainers fall into two main camps. Permanent retainers and removable retainers, both of them forever retainers.

When I first did my trawl around the various orthodontists seeking an opinion about my teeth, retention was something that was often mentioned to me. I was shown various pictures of retainers, and the types that different orthodontists preferred, and quickly came to a realisation.

Just as I’m not a fixed braces kind of a gal, I’m really not a fixed retainers kind of a girl either. I suspect that many Invisalign wearers feel the same. So an orthodontist that insisted on fixed retainers was never going to be an orthodontist that I could love, a preference that did influence my choice of ortho from the start.

The fixed retainers that I was shown were mainly along the lines of those shown below and were of a permanent wire connected to the back of the teeth that holds the teeth firmly in place, not allowing them to shift :

Clear Retainers Or Fixed Retainers

Clear Retainers Or Fixed Retainers?

The benefits of these retainers, according to the orthodontists that I saw, are that they are a set and forget kind of a deal. Once they are on, you don’t have to worry about lost or forgotten retainers, and your teeth stay in place as long as the retainer is correctly attached. The downside of such retainers is that they are fiendishly difficult to keep clean, and obviously, they ain’t that pretty when you open your mouth wide.

The good news, for someone as averse to metal in their mouth as I am, is that there is also the option of removable clear retainers, which are worn only at night. These are divided into the type that your orthodontist (or dentist) can make for you, and those that come from Invisalign themselves, known as Vivera. Both look, to all intents and purposes, very similar to an Invisalign aligner.

My orthodontist, when enduring his regular eight weekly grilling of a thousand of my stupid questions, told me that there are two reasons why he doesn’t use Vivera. Firstly, they simply weren’t available here in Australia at the time of asking and very similar ones could be made more cheaply and easily here. (A pretty good reason, I’ll have to concede) Secondly, he says that once you order your Vivera retainers from Invisalign your case is seen as effectively closed. He often has patients who decide not to proceed with a refinement or final tweak and then, several months later, change their minds. Using Vivera would remove from him the option of ordering another refinement free of charge, as they would be treated as a new case, with a correspondingly large new bill.

For those who are certain that their treatment is complete though, Vivera certainly sound like a great option. As long as you keep up your subscription to them you receive a nice shiny new set of clear retainers every three months. These can be made either in the shape of your last set of Invisalign, or, if you weren’t an Invisalign patient or if your teeth have been crowned or filled, can be made from a new molding. This gives you the reassurance that as long as the retainer still fits your retainer isn’t changing shape and that your teeth are actually stable and in the position that they were at the end of your orthodontic treatment. There is an interesting review of an orthodontist wearing Vivera here for those that are interested in this system.

In my case, my orthodontist favours another alternative for clear retainers, an Essix retainer.

Whilst this might look fairly similar to an Invisalign aligner, in truth they feel quite different to wear. Whereas Invisalign seem finely crafted and take in the shape of every tooth and gum line, these seem more like Invisalign would be were they crafted by a five year old. The shape and the general appearance are the same, but the execution looks and feels altogether more clumsy. Peering closely at my clear retainer I can see that it does have the individual shape of my teeth molded into it, but that they are not as distinct as they would be on an Invisalign aligner and cover part of my gum as well as my teeth.

Whereas Invisalign feel that they fit very closely to the teeth, these feel larger and thicker in the mouth. However, that isn’t to say they aren’t comfortable. I would equate the putting in of my retainer each night as similar to putting on a pair of comfy old bed socks. Not the most attractive thing in the world, but comfortable and somehow comforting. Comforting too to know that these retainers can be made cheaply (well, relatively- this is orthodontics after all) and easily by any general dentist in a couple of days so losing them isn’t the issue that losing an Invisalign aligner might be. Also, they are doing a fantastic job of keeping my teeth exactly where they were when I completed my treatment, which has to be a good feature in a retainer.

In reality the right retainers will be down to personal preference, but as someone who loves the fact that Invisalign are removable, and just can’t face the prospect of a metal wire permanently fixed to my teeth, Essix clear retainers are perfect for me.

Which is a good job given the amount of time we’ll be spending together.

Which retainers will you be using or have you worn, and how did you find them?

Filed Under: clear retainers, invisible braces Tagged With: essix retainers, invisalign braces, invisible braces, retainers, vivera

Invisalign refinements….Freedom for teeth!

September 8, 2009 by admin Leave a Comment

After 9 months of confinement inside their clear plastic Invisalign prisons my top arches are finally free; the only thing is, at times I have almost missed my braces!
After 17 aligners and 34 weeks I have finished the first run for my upper arches. I still have 17 aligners left for my bottom arch however, so I wear the lowers full time and the upper ones only at night. That in itself is proving to be something of a challenge. Whilst it was easy to remember to put my braces back in when I was wearing both sets- my teeth felt strangely naked without them- it is much harder to remember to put only one aligner back in. My teeth seem to have quickly adjusted to the naked feeling on the top arches; wearing only lower aligners is nowhere near as intrusive. That means, however, that I never get the sensation that used to remind me to put my braces back in and consequently I have been skipping a few hours here and there.
It was strange at first not to have to wear them after all this time. The only way that I can describe it is as similar to the time when I gave up sucking my thumb as a child, my mouth felt strangely empty and my tongue almost throbbed with some unmet need. However, that quickly passed thankfully and I am now fully happy with my 12 hours a day wear.
My orthodontist has told me that that is the ideal balance between the need for retainment and the need for my top aligners to last intact until my refinements arrive.
Arggh, refinements. Those of you that have read this blog from it’s earliest days will remember my confident proclamations about how I didn’t require perfection, only improvement in my teeth. Funny how these things change. Whilst my teeth are enormously improved there are still a few minor tweaks that I now deem absolutely necessary for my orthodontic happiness. As discussed a couple of posts ago in my “invisalign set 15 -ugly photos”my front tooth is not yet in complete alignment, although it is pretty close.
Similarly the left hand side of my upper arch has not widened as well as the right side and the length of the teeth is mismatched when viewed both from the front and the side. Fortunately, my fabulous orthodontist agreed 100% with my assessment of this as well as picking up a couple of other minor points and thinks that we can fix it in about 6 additional aligners including an over correction. The great thing is that this will be done at the same time as my lower arches are still on their first run so won’t add any additional time to the process at this stage.
My orthodontist was happy with how things are progressing otherwise. We agreed that I wouldn’t get my crown completed until I have finished refinements on the upper arch in case when things moved it needed redoing again. I am keen to avoid paying the $1500 charge for a new crown twice.
Here are some pictures of my upper arch pre refinements. Feel free to let me know whether there are any additional tweaks that you think I need. Bear in mind that we are only talking about the top ones though, the bottoms are only halfway through…

Filed Under: invisible braces Tagged With: aligners, invisalign, invisalign before and after, invisalign braces, invisalign pictures, invisalign refinements, retainers, upper arch

Chatting to My Invisalign Orthodontist: Vivera Retainers and Refinements

June 15, 2009 by admin 9 Comments

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.

Invisalign dentist

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.

Filed Under: refinements, Vivera retainers Tagged With: aligners, australia, brisbane, choosing an orthodontist, Dr Brett Kerr, invisalign, invisalign braces, invisalign refinements, invisalign relapse, invisible braces, ipr, orthodontist, refinements, retainers, Vivera retainers

About Me

Ex model, mother, English & Australian. 2 daughters, 1 dog, 2 cats, 2 rabbits, a horribly expensive beauty habit and an obsession with straight teeth.

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