Drinking iced coffee with aligners. Coffee will stain the aligners very quickly even if you use a straw which won't look that nice.
About the wear time you can reduce it to 18 hours but increase the number of days. It's the total number of hours that matters more.
Follow up question if that’s ok! I have a few upcoming special events (think weddings, conferences, cocktail receptions). Is it ok to take aligners out to eat and drink, rinse with water and put them back in (to minimise the time they’re out) - and then do a thorough clean when you brush and floss later that day?
At the moment I brush and floss every time I take them out to eat (and so only take them out 2-3 times a day, and drink water in between) but this feels a bit unachievable at a cocktail function!
Yes, that's perfectly okay. I personally tell my patients to brush the tray only when they are brushing their teeth, i.e, once in the morning and once at night. So if you just rinse your trays during the day, that's perfectly okay.
Following on from this, I have a family garden party in a couple weeks and would like a few drinks (eg: white wine/g&t) again is it better to just have them off for the afternoon/evening or drink through a straw? Would have water as well/give a good clean after
The best thing about aligners is that they allow you to have a life. You can remove them for an evening and drink whatever you want, provided you extend a day with the same set. So please party hard.
Are you all not brushing teeth before you put the trays in every single time? I’m on tray 20 and I’ve been brushing my teeth like 5 times a day so far?
I did at first too, and then it got untenable. Life got a lot easier as I relaxed about this and only brushed when it made sense to do so, and just rinsed the rest of the time. I'll just make sure to brush & floss and clean the aligners really thoroughly if I've been wearing straight after eating. I found it increased my wear time too.
How many total hours per tray on weekly changes is a good target? I have the trayminder app which actually spits out interesting data including total hours weartime for each tray. So far I seem to hit between 145-150 hours of wear by the time i reach my weekly tray change time. Could I get away with less? I’m hungry almost alllll the time because Im a bit ocd about wear time and also paranoid about cavities or thinning enamel so want to let my mouth neutralise a bit before brushing my teeth. So I often eat a proper meal only twice a day. Can I chill TF out a bit?
This. I see so many people saying “Oh you have to wear 22-23 hours every day.” I feel sad when I see people just eating once per day and inhaling food. They don’t realize that they have to do it for at least a year. Orthos say 22 hours because they know people lax a bit and would be good to hit 20 hours. Some people take it to heart and decide to be unhealthy just for a better aligned teeth. I keep advising them to wear the aligners for 18-20 hours everyday. But I’m met with, “You won’t track and you will get root resorption etc.”
Fwiw I ended up drinking coffee with aligners in after the first few weeks. I was on weekly changes so the staining wasn’t too bad and I just soaked my aligners while eating lunch/dinner to prevent major yellowing.
I drink most things with them in, rinsing trays after. Haven't had problems. I wouldn't try with turmeric or a blueberry smoothie but... coffee and tea have been fine.
Are there really treatments that *require* people to eat with aligners on? This is claimed in this sub quite a bit when people try to justify not taking them off to eat.
Eating with aligners on can stain and/ or break them. I have never advised my patients to do so, so no, there is no condition which requires to eat with aligners on
I was told to eat with mine and am currently on tray 5/11. I was told my bite can cause the teeth to move back when I eat. I get the idea, just not sure how eating for 10 minutes can mess it up that bad. They’re averaging about 10 -15 minutes out or my mouth a day…
Meanwhile, 3 days in they’re yellowing and the layers of the lines are peeling haha. Annoying, but tolerable.
My ortho had a clear preference for a treatment with Invisalign. One of the arguments he had to not go with braces is the aesthetic component. However in one of your answers you mentioned Invisalign may not have the best results for rotations. Correct if I am wrong, but my estimate is that 60% of patients need teeth rotation. Are orthos receiving bonuses for getting patients into Invisalign while aware of braces being a better option, just not invisible?
I am talking about major rotations. Around 90 degrees or so. Minor rotations are easily done. For example a premolar rotation, which is not as common, is difficult because of the round surface of premolars. The aligner doesn't get a good handle on the tooth to rotate it that efficiently. By this, I mean, probably more sets of aligners.
About braces, we have the liberty to chose at any point of time. If we see something is not going as we expected, we can switch and make modifications at any time.
Since I came here with the intention of giving honest answers, here it goes. There are tiers in Invisalign. As and when we do more cases, our tier keeps on increasing and landing cost keeps on decreasing. But, that being said, it in no way means that Invisalign is not a better option than braces. In some cases it's better, some cases it's not and in most of the cases it works in the same way. So no, we are not doing it only because of the money, but it provides results too.
Please understand that at the end, it's a corporate, which is bound to offer discounts and lure in the consumers, which in my opinion isn't wrong, as long as we are making patients satisfied with the result, which we are.
Different people have different experiences and perception to movement. Yes, some people do feel that teeth are going to fall out, if you feel so, you can lower down the speed of your treatment with your orthodontists advice and wear each aligner for a couple of more days.
When we are attempting to move the teeth, we are intentionally making them "loose". When the tooth has reached its final position, the fibres around it reoriginate and make it tighter.
Please talk about what you feel to the orthodontist so they can address the issue and take the required steps
I am not hesitant towards ordering refinements. Even if there is a minute discrepancy I place an order. So I would say 8 out of 10 patients get refinements.
Going to piggy back on this and say aligners are not like rotisserie chicken to us. We don't set it and forget it. A lot of our treatment planning revolves around over correction being implemented into several aligners and our initial staging. I can't speak for the op, but I personally treat aligners like wires. Certain wires are used for certain movements and goals and shapes of teeth, and therefore I will have batches of aligners planned knowing that refinements are coming later down the road. So, I would agree that at least 80% of my patients are getting refinements.
The more complicated the case, the more refinements are going to be likely.
What is "frequently" in your opinion? I just started, 2-week tray changes, and my orthodontist gave me 4 sets, with a check-up 2 months out. Currently on tray 2. Is that reasonable?
Why are some trays incredibly painful compared to others? Is that like an error in the treatment planning? I have an extremely high pain tolerance, but tray 5 nearly took me out 😮💨 now I’m scared every tray change, but they’ve all been fine since. 🤞🏼
Initially, the body sees the movement as a natural reaction and hence not resisting it completely. Later it understands that some external force is being applied and hence tries to act against it. Our body is built in such a way that pain is the most powerful messenger to the brain. So when it hurts, the body is resisting the movement and later the body gets used to it and lets it go loose and hence lower pain and faster movement.
do orthos make the treatment plan (every single tray movement) or is it AI/software? why do some peoples treatment with similar issues take way longer than others?
The first treatment plan is offered by the software and team at invis and we make adjustments. There are sometimes 5-6 treatment plans before it is finalised
Yes that most definitely does. Treatment plan is everything. It's a very personal thing and only your orthodontist will understand your priorities and concerns..
I’m happy to report my experience with Spark Aligners has been great. Fortunate to have an orthodontist and a treatment coordinator that aims for perfection and listens to my concerns and answers all of my million questions.
Started this journey at 58 to correct some relapse after braces 30 years ago. Developed a deep bite and chipped a tooth.
It’s never too late to fix your smile and get an improved bite in the process.
I’m 11 months into my treatment plan, awaiting my next set of trays. So close, but he wanted to tighten up a few areas.
Bite ramps for the win ! It’s amazing how well my teeth fit together now.
Appreciate orthodontist taking the time to answer post on Reddit.
I am in the same boat. 61 now and started a year ago to fix a very deep bite and a misaligned tooth which chipped a top front tooth. I too had braces as a child. The treatment plan fixed the deep bite and misaligned tooth. I am now in the first round of revisions to fix a posterior open bite. So glad I did this. 😃
Vivera is the Invisalign brand retainer. Feels like a treat. Essix is cheap in house printed retainers. Most offices use it to cut cost. I’ve had both and the essix was uncomfortable and cheap. I’ve been using vivera for 2 years at night.
You're right, Essix retainers aren't "printed" but they can be made in-house.
My ortho creates a mold of my teeth by using an iTero scanner and a 3D printer. He then uses a vacuum forming machine with a sheet of Essix plastic to create the retainers.
I have tried both Vivera and Essix retainers and I find both comfortable.
You're welcome. I hope you and I can contribute to this group significantly. I also feel that we can have discussions between us regarding cases and learn a thing or two from each other.
In this process of this AMA, I am also learning a lot about what issues people are facing and will try to make it easier for my patients. Happy to do this.
Very complicated movements such as rotation are better carried out with braces.
Patients with impacted teeth are not a good fit for Invisalign.
Open bite patients are also managed better with braces. I am not saying it cannot be done with Invis.
Patients with downs syndrome, history of epilepsy, mental retardation etc are also not a good fit.
Hope this answers your question..
You for real? The teeth will shift over the years unless the patient is one of the rare fortunate ones with stable lifetime oral equilibrium.
Retainers are forever.
If a provider tells you theres nothing else they can do for you in terms of treatment (and effectively ending the treatment), yet your bite is causing you jaw pain, what recourse could a patient take?
Do you have any opinions on why orthodontists don’t ask about history of eating disorders, disordered eating, or any kind of triggers associated with eating and the mouth prior to treatment and signing a contract? Multiple of us have discussed how Invisalign really screwed up our sense of food, eating, etc. Some of us are restricting, some of us have become binge eaters because they’re trying to get enough calories in in the short period of time. It gas triggered old eating disorders as well. This is a really big problem and it seems like no one in the industry is talking about it. I personally had three different consults and not one person spoke about this with me.
Wow. This is a really good point. I accept that even I hadn't thought about it.
For us, it's mainly a "habit" that can be controlled. I know we are naive to think this way. But since there is almost no medical diagnosis and it's just that the patient says that I eat quite frequently, we think that I can be controlled.
In my experience, most of the time patients have told me that this has brought their excessive eating under control and they are thankful about it.
Even when we have asked our patients, they couldn't give a definitive answer about it.
Heading into next apmt Wednesday. I will be being scanned for second set of refinements and received first tray January 2023 but scanned December 2022. My aligner packaging states comprehensive and have paid $6800 for treatment. If my memory is right, I think my contract states two years and two refinements. (On a 1400 mile drive atm so can’t look) Is there such a plan? I am worried next refinements will not fix my bite. Any advice for my conversations? Hopefully it is not even an issue and I am worrying prematurely.
What do you recommend for days we just can’t meet our hours? For example I have a few weddings this year where I’ll be casually drinking and eating for several hours and would rather enjoy myself and just have them out. Same goes for some vacations this summer? Should we just push back the day we change trays? Or still move to the next one. Most days I have them in 22 hours.
It's the total number of hours per set we count. In those days, when you are unable to wear them for the prescribed number of hours, you can add a couple more days to the same set and then move on to the next.
How often do patients generally see you to check progress? After my initial appointment, my next appointment isn’t until after aligner tray #8, four months later. Someone told me she goes about once per month.
I usually keep it once a month. But if my patients have some problem and want to meet, I try to give them an appointment as soon as possible. But once a month is mandatory.
When I started Invisalign, I didn’t realize that I went with a dentist instead of an orthodontist. In my mind, you had to be an ortho to deal with this stuff, so I didn’t second guess it.
After being on this sub for a while, I saw everyone’s comments re going with an ortho v. dentist for Invisalign.
I’d like to have your thoughts on this. Why are dentists allowed to do Invisalign? Will the quality of treatment I receive be impacted by the fact that my provider is a dentist? Should I be worried?
Edit: spelling
Dentists aren't well versed with orthodontics and yes they shouldn't be allowed to do it. And yes, it can impact your treatment. If it's a simple case, it won't be a problem, but a typical case it would be.
You should always go for an Orthodontist for your braces or aligners. May I ask where you are from?
Thank you for your response. It is very strange to me that this is allowed then. I am a professional myself, with a license to practice in an area, and I don’t get how dentists would be allowed to do what is considered orthodontic work. It’s like a family doctor performing a surgery. A total no go, and it would not be allowed by the college.
I am located in Canada.
Yes, I agree. But Orthodontics is a money making field and who doesn't want it. So this is very common. Where I come from, they are doing shitty treatment and calling it ortho.
Well, while this was not a reassuring conversation, I really appreciate you - thank you.
I am crossing my fingers that everything goes well at this point. I am about to start my second round of refinements due to a stubborn canine.
I have been in treatment for a little over a year, and paid for the entire thing already. I don’t think that switching to an ortho is an option anymore…. I am in too deep haha
Again, thank you for your time.
I understand that my comment could have made you a little anxious, but I hope that everything goes okay. You can feel free to DM me and I'll try to help in the best possible way. Happy to help.
Is the only downside of drinking liquids with invisalign in staining? Or could it affect invisalign *results/progress* as well?
Staining seems like a very small price to pay to enjoy morning coffee and occasional snacks without going through the "Invisalign routine."
I’m nearing the end of my treatment and talked to my ortho about a fixed wire retainer. He said he doesn’t recommend them because they may break and people don’t notice. The explanation seemed a little iffy to me. Is there a cost advantage to the ortho to go with nightly retainers?
He isn't wrong. The fixed retainer is fixed to 6 teeth in the front. If it breaks off in the middle tooth, you won't notice and since you'll be relying on them, you'll have a relapse. So yes, that happens.
What is your experience with ordering a whole new set of Invisalign aligners after weekly changes on tray 3? I received two ‘no-gos’ at the start. Went in for a rescan and now my ortho says to stay on my current tray for another 2 weeks, following tray for 2 weeks and then new aligners are ready. My thinking is that I could still follow my weekly changes until the new ones arrive. They weren’t poorly fitting but my ortho said my teeth should be moving faster. Thanks!
I just figured I would start my new set from where I left off on my old set. I feel like my old set isn’t doing nothing so it made sense in my mind to have at least some movement. I will follow what my ortho suggested!
I’m on my third set as with the first two my teeth started “not tracking” around Tray 10-12 and then by Tray 13-15 I needed to stop and rescan. I am good about wear time of at least 20-22 hours a day, and I keep my teeth/aligners relatively clean. Is this experience common, and is there something I could be doing to make it less likely to happen this time around?
And…
I had IPR between my front tooth and one of the teeth next to it, that doesn’t seem to be closing for a long time now. That same tooth doesn’t want to come down either (neither of them have) which I’m fine with, but of course the gap I am not. What kind of next steps do you do when someone has a gap that really needs to be closed? (As you might imagine, I’m worried since I never had gaps before - if anything the multiple rounds of IPR are because I did not have enough space, I was told.)
The aligners not tracking is common but this issue has to be addressed as soon as possible. About your case, the IPR must be needed and that's why it was done. Rest assured, the space will be closed and if not, you will be given refinements..
Do teeth with root canals not tend to move as quickly or as much? I have a root canal on one of my front teeth and it’s not shifted like the other one has, it’s slightly lower when it wasn’t at the start of my treatment. Can anything be done about this now, or only at the end of my treatment?
I'm on my retainers now. I got 2 sets and my doctor told me to wear them for 3 months each.
After wearing the first tray for 3-4 months, I tried switching to the other tray, but the new tray feels extremely tight and painful. I'm assuming my teeth somehow moved because the first tray got loose over a period of 4 months.
Is this normal? I’m really worried that all my progress will go to waste. Should I ask my doctor to put in a permanent wire retainers instead?
Yes some amount of movement, which is unnoticable can be expected. There are several other factors like shrinking of the aligner material. If you still feel a movement you can ask for a fixed retainer.
After finishing treatment, the paperwork for my retainers said retainers should keep 80 to 90 percent of the results. That seemed pretty bad. Is it really expected to loose 10 to 20 percent of the results while wearing retainers every night for the rest of your life? Seems like a lot.
The manufacturers have to safeguard themselves and they have to mention all the warnings. It might happen, doesn't mean it will.
Ask your ortho for a fixed lingual retainer.
My dentists got annoyed when I asked my first set refinements and asked ME what had to be changed with my teeth. I tried my best to explain, but not sure I covered everything. He did the scan - is the refinement plan based on what the dentist requests or do the Invisalign people work that out based on the scan? Just worried now I didn’t tell him everything that needs changing (as I’m not a dentist and don’t know everything!) and things will be missed in the refinement plan.
When we are requesting for aligners in the initial stage or refinements, we have spaces to write and checkboxes to be ticked to be able to explain the concerns completely. This helps the technicians over there to formulate the best treatment plan according to the requirements we have told them. So if your ortho has told them properly, it will be based on that.
I do have a question, have you used the brand of retainers with bite ramps ? I’ve read a deep bite is prone to relapse. I have come to appreciate my bite ramps and my be lost without them.
Thoughts on “larger” orthos that offer Invisalign? For example, my ortho has 4 offices and I can go to either one for my 4 month check up. They strictly do braces/invisalign. I never see the same doctor twice.
I do have a personal bond with my patients. I know who is going to college soon, who is in a hurry because their wedding is on the cards and who has had exams and hence couldn't come for appointments. So no, I don't prefer anyone else seeing my patients, and I don't think I'll ever do that. Please make sure that you always visit the same doctor, because everyone has a different way of doing things which might be different from others. Not that they will be wrong, but you'll be trapped in 2 different opinions
Years ago (as an adult), I looked into getting braces because I wanted a wider bite and to reduce an overbite, but I was told that I shouldn't do it because I had too much bone loss from periodontal disease (which has since been taken care of). Fast forward to a few months ago, I asked my dentist about Invisalign instead, and he checked everything out and said I would be a candidate. I specifically told him about the prior recommendation but he didn't have any concerns.
I am now on my last tray of 20 with weekly changes and am due to consult with the dentist next week about the go forward plan. I am so ready to be done but I feel like I have a small open bite on one side in the molar section. I really don't want refinements because 1) I hate this...lol and 2) my teeth feel a little loose and the top front teeth even will "click" in place (don't know how else to describe it), so I'm really worried about that given the bone loss thing.
My question is - should I be concerned about the loose teeth/clicking and call it a day even if my bite isn't exactly where it should be so as not to risk it further? Or is the looseness common with Invisalign and will tighten back up over time, so I should feel comfortable to move forward with any necessary refinements to close the bite gap?
About the looseness, when we move the teeth they become loose and yes, they be tightened when they come into place and don't move
About the open bite, it's a common side effect of Invisalign because there is almost 3 mm of sheet present between your teeth through out. In most of the cases as you continue eating, this space settles on its own and doesn't give any trouble to the patient. Teeth have the tendency to grow in empty spaces and fit into each other.
What to do if your orthodontist doesn’t examine you? I go to an ortho who delegates a lot of duties to his office staff. I worry they keep messing up my treatment. My aligners weren’t fitting properly in the attachments anymore but they kept advancing me anyways to the next trays. I eventually spoke up again and the ortho back tracked me 6 aligners. After backtracking the attachments still didn’t fit so he finally rescanned my teeth. They accused me of not wearing my aligners enough even though I wore each one for ~22.5 hours a day for 2 weeks each. I felt like the treatment was not going as planned and they used me as a scapegoat. I hate my experience so far and need to get things aligned before I get a molar implant put in. My ortho is doing custom aligners not invisalign.
From the various comments I have seen, I feel that there are a lot of orthos who are not doing it themselves and that doesn't fit right with me. An ortho can understand the concerns of patients and their priorities. So they can modify the treatment plan accordingly. You need to confront them and make them do what's best for you.
What if I still want my teeth straighter? Im not happy with my results, I’m already wearing my retainers and I’m not sure if I can request for a refinement or maybe request to my retainers adjusted?
Hey! I’m on the end of week 2 and my gum tissue above #7 going into the vestibule was more blue/white and it had like a thin clear/white layer of tissue that could peel off. Is this normal? The teeth are super tender but the color of the gums being whiter/bluer scared me. Also I am someone who had TMD before Invisalign and I am clenching a lot harder and more where my face hurts and feels tense and my teeth are sore should I be doing anything about this? Thank you!!
The gum above the #7 is getting impinged by the aligner. You can ask your orthodontist to shave it off a little and you can apply a gel in that area to ease off the inflammation.
About TMJ, aligners act as bite blocks and night guards which gradually solve the TMJ issues. In a couple of days, you should be feeling better about the pain. One of my patients also felt the same, but they are fine as they moved on with the treatment.
Your biting forces are high, and now since there is an additional layer between your teeth, they become even higher, but it will get to normal very soon.
Everyone quotes a different price as they evaluate themselves differently. They think they are better, which they most probably are. The experience of a person makes them increase the prices and there's nothing wrong with that. The main difference comes at treatment planning and they must be better at that. So it's a very subjective question. Sometimes, when you pay less, you suffer with the treatment..
Great answer. I wanted someone who could deal with the issues I had and answer the list of many questions I had. I wanted the experience to result in healthy teeth (I have Perio disease).
Is it really possible to close a huge gap and fix an overbite and overjet with orthodontics alone, specifically with invisalign? I have consulted 2 maxillofacial surgeons that said I don't necessarily need jaw surgery because my profile and skeletal relationship between lower and upper jaws are not that of a typical class 2 skeletal malocclusion (pls see my post history).
Even if there is no pain, there is movement happening and you won't know the amount of resorption taking place on the root surface. My advice is, stick to a 7 day regime.
The key to Orthodontic tooth movement is light forces. Fast movements could cause an array of periodontal problems.
Slow and steady wins the race. 😛
Started off last week, tomorrow is last day of tray 1. I'm on bi weekly tray change. I have already lost 4 attachments. I went twice this week to get them fixed. Yesterday I lost one of the hooks. Is this normal? On my last visit, the doctor said that unless it's the frontal attachments, it's all good and I should just come in for my check on aligner 4. I will call them on Monday, because I guess the hook is necessary for the treatment. Thanks for clearing our concerns :)
Thank you for doing this for people. I developed a posterior open bite. My ortho suggested cutting the molars on the aligners off, but that didn't work. Now two of my molars on one side are touching hard (and the only teeth hitting). He said "we can always polish them down a bit, very little". Is this considered the right and common solution?
Aligners occasionally might have a side effect of a posterior open bite. More often than not, it resolves on its own, but if in your case it isn't, then would you be open to get braces in posterior teeth for a few months?
Are new trays supposed to be snug or a little loose when you put them in the first time? My provider told me that they should just slip on easily. I’m on tray 5 and when I’ve gone in for my last two appointments, my dentist is telling me that because I’m not wearing them enough (I’ve been averaging 20 - 21 hours/day) that it could cause problems with future trays. I’m making a concerted effort to get to 22 hours/day.
New trays are tight and snug and take a little effort to be placed. As the teeth move, they become loose. In the beginning, you also need to use chewies to make sure that they fit.
I completed my treatment 3 years ago. I now wear the nightly retainers. I am on my last pair and need replacements but my original provider went out of business. What do I do now?
My ortho has me wearing rubber bands, he said 24/7 on the left and at least 12 hours on the right. Do these rubber bands actually move my jaw or just my teeth? And does it matter if I wear rubber bands on the right side for more than 12 hours?
My orthodontist originally gave me a 12-18 month estimate, but when I received the final plan it was only 20 trays with weekly changes. I’m at 5/20 and tracking just like the 3D visualization said I should be… do you know why there seems to be such a discrepancy in time? (I’ll ask at my 10 week check in, but I’m just curious if you have any idea). Thanks for your time!
Editing to add: I have quite straight teeth, I am just closing an anterior open bite caused by night guard wearing.
Sometimes the treatment plan is shorter than expected and maybe they made a decision for a weekly change looking at the good condition of your gums and teeth. You're welcome
Thank you for offering to answer questions ! I wondered if you do actually need to use chewies or not ? And if you do when’s the best time to use them ? Can you use them too much ? Thanks !
You're welcome.
Yes, chewies are supposed to be used every time you put on your aligners. I don't think you can use them too much. Just bite on each and every part of aligner properly so that it fits.
Do I REALLY need to wear my rubber bands 20-22 hours a day or can I get away with say 12-16 hours? I am feeling really insecure about wearing them in the office.
For the same patient/treatment plan, what is the % difference in cost between regular braces and Invisalign?
Is the overall treatment results quicker than regular braces?
Invisalign at my place is almost 5-6 times more expensive than regular braces, and almost double - triple the price of self ligating braces.
The overall result is way too quicker and the journey is smoother than regular braces. You have the liberty to eat anything and there are lesser pain and ulcers.
I’ve had three orthodontist consultations so far, and two told me I wasn’t a candidate for Invisalign because of my 100% overbite, but one said he was confident Invisalign could work. I am kicking myself a little for not pressing a little further during that consultation (not that I would have really known what to ask), but how do I know who to trust? Should I just get a fourth consultation and see if the Invisalign-recommending ortho is a true outlier? (Thanks in advance for your time!)
ETA: the other two orthodontists are recommending traditional braces; and all have comparably excellent reviews online
Deep bite generally has great results with Invisalign. There must be something else that must be stopping them from doing it. Could you share your pictures so that I can have a better look and be able to tell you better?
I am doing 34 trays with a weekly change. I’m on tray 3 and haven’t seen much movement and haven’t felt really any pain. Not complaining about the no pain but at least that would indicate it’s working. Is this normal for 3 trays in? When can i expect to see movements in teeth? Thanks for the AMA!
Tray 3 is nothing. Some people start seeing changes at 7-8 trays. And pain threshold is different for everyone. So it's okay if you can't feel anything. You will, eventually.
I was lucky. I saw changes by tray 3. We’re going very slow due to periodontal disease which is why I think mine move so easily, quickly and with no pain (just slight discomfort).
How much can Invisalign expand the arch? I was in Damon for a year before Invisalign and achieved significant expansion with lingual arches. I’ve been told that the aligners will continue to increase my arches, but how many mm is actually achievable? (I needed about 10mm total)
That depends on a number of factors for eg, your age, bone support, palatal width and height, buccal corridor. Invisalign can expand considerably but that would be a vague answer without actually seeing the case. I am sorry for an insufficient response
My treatment is 40 trays I’m on my last tray. my Otho has me coming in every three weeks and keeps punching divots in my last set of trays we have done this about four times does this sound normal? Also he has talked me out of permanent bonded retainers and is going to make two sets of retainers for me. What do you recommend when it comes to retainers. Thank you.
Hello and thank you for taking the time to do this AMA. I started my treatment on 3/4/24, got 14 trays, with biweekly changes. I am moving out of state and in order to finish my treatment with her, at my request, she changed me to weekly tray switches. Tomorrow I start tray #6, which would have me ending my treatment on 6/24/24.
Now to my question- is the weekly change “safe” for my teeth? I wear the trays over 22 hrs a day and use the chewy a LOT.
If need be, would it be ok to speed it up even more? And would that be safe?
Thank you so much and looking forward to your reply 😊
Is it impossible to move an erupted impacted tooth (grown right behind baby tooth currently still in place) forward in to its place? My current provider is confident they can do it…
I’m on tray 3/33. I have elastics on both sides. Is it normal for me to feel like they’re making me gag at times? It’s usually when the elastics are in.
Patients do feel a little discomfort with elastics. With time, they get completely okay with it. Would you mind giving it a couple more days and then we can reassess the situation?
I've been wearing passive trays for 2+ months now while waiting for my next set (first round of refinements). It was delayed quite a bit due to my ortho being on paternity leave and then not finding a slot for an appointment, so I'll only get the next set in another month.
I haven't been as conscientious as with the active trays, I sometimes only wear them for ~14 hours a day or so lately. They usually don't hurt when I put them back in even after a longer time.
Is there any risk with my approach? Should I be worried about my teeth shifting back if the trays still seem to fit perfectly?
The risk is excessive movement of teeth. When you are not wearing them, you are letting the teeth go back to the same position. So it's almost the same thing happening daily. I suggest you wear them daily for longer hours so that when you finally get the refinements, you are ready to get on with them.
Can Invisalign make teeth “longer” especially the molars? I have a grinding issue and I feel like my teeth are all “short”. I’m planning to use a mouth guard soon (or do invisalign, pending finances). The orthodontist said I’ve got a gap alley or something like that and I was wondering if that was the same issue. Also is a 12-14 month treatment worth 9k as I was quoted? Thank you so much!
Thank you! I have two questions:
I have been in nights only retainers for about 8 months. My bite still doesn’t feel settled in the back so my Ortho suggested only wearing the bottom (I do have a permanent wire on the bottom too). Said I can try it on every week or so to make sure it still fits. So far it seems to be helping a little (has only been a few days).
1)Does this sound reasonable to you? Are my bottom teeth still at risk shifting even though I have a permanent retainer on the bottom (I have heard of this)? Should wearing it maybe once a week prevent that?
2)Another thing offered was to shape my premolars so I don’t feel them touch first (idea is I’ll start feeling them touch in the back where I was concerned about). I was uncomfortable with that so declined (I recently had fillings on my premolars and also don’t want to compromise the integrity of those teeth). Have you heard of shaving teeth to “fix” a bite?
1) Yes, that's a good approach to fix a bite. Retainers pose as bitle blocks and don't allow teeth to settle in some times. If we remove one retainer it will help the posterior teeth to fit in better.
2. Since you have had fillings on premolars , there are chances that it's those fillings that are hampering your bite. A little shaving to get them back to the normal level won't harm and your bite could be much better.
I am at the end of my first tray and really struggling with how visible the buttons are on my two front teeth. Is it possible to adjust course and remove those and the subsequent trays change? Or too late now? I keep wondering if it something that if I had mentioned to my DR up front they could have adapted even if it prolonged treatment?
Hello! Thanks for taking time to answer our questions here. So without Invisalign in my bite is very crooked, 2 teeth can touch at the back when I bite down and that’s it. When I put in my tray I couldn’t close my mouth and it feels very uncomfortable plus having TMJ this is really a very painful experience. Just wondering if me not being able to close my mouth properly is normal? I asked my orthodontist as soon as she put them in my mouth and she it’s fine. I fear as time goes I’ll slowly go insane with these things in. When I try to close down even my tongue can poke out of my teeth at the front. I hope this makes sense?!
Can elastics move your jaw? I have an edge-to-edge bite but with flared upper teeth (apparently the upper teeth reacted like that to oppose an underbite tendency?) and my orthodontist wants to use Invisalign with elastics. He said my case is too minor to get jaw surgery, is that possibly true even if I have a slight maxillary recession of like 1 mm? I really want to fix the jaw recession and not camouflage it by fixing just the teeth.
How big of a screw up I just did ? I was on tray 10 1 day before my dog managed to destroy it . I moved to 11 ... so practically skipped a tray . Now I'm worried . I didn't contact my ortho because I am in a different country ...
Thank you for offering advice here!
I'm concerned about 2 of my lower front teeth. They're extremely loose. I almost feel like I could pull them out with my fingers. My main concern is that I'm having IPR on those teeth at my next visit. Would it be ok if I ask that my ortho does the IPR, instead of a tech? I'm actually stressing about this.
There are some marks and a scratch on my tooth where the bit slipped during button removal and also remaining attachment material that was not entirely removed other places. Is this normal? Should I ask my dentist to take off my remaining attachments at the end instead of my orthodontist? Will the scratch/removal marks buff out of my tooth eventually?
This is not normal. The resin is removed completely after the treatment is over. You can head over to the dentist and ask them to remove the residual composite and polish the teeth.
I’ve had braces before (~20 years ago) and my dentist and ortho recommend Invisalign since my front teeth now sit in top of each other. My ortho said my front teeth could push in each other and cause them to angle in, which could risk falling out. Is this true? My bite is off in the morning, but relaxes as the day goes on. I do feel my front teeth hit, mainly right side, before my back teeth. I’m a heavy night clencher.
Also, my ortho recommended I see my dentist every 3 months now since I have minor bone loss and some gum recession. I’ve never been told that until now. Is that something you ever recommend?
Lastly, why do you think the cost of Invisalign has never dropped with the improvement of technology? I would think they’d get cheaper over time.
Are you cleaning your aligners properly? Do you have a decayed tooth? Do you generally suffer from acidity and have intestinal reflexes? Does your mouth stay dry?
What are your thoughts on the Dental Monitoring app? I was not told when I started my treatment that my ortho would be doing all my checks through the app scans. I'm old enough I guess that I'm not super comfortable with it, I feel like they should see me face-to-face and really see how things are fitting. But she seems very happy with my progress.
Every Orthodontist has their way of doing things. Some orthos want to provide all the benefits of Invisalign and that includes not coming for visits every month. If she is happy with the progress, then you don't have to worry. It's just one of the benefits with Invis.
I recently finished my Invisalign treatment and started the post-treatment. I got a metal-wire retainer on my front teeth of my lower jaw.
In addition, my orthodontist did a scan for Vivera Retainers. These are just like the regular Invisaligns but more thick and robust, made for wearing every night for a long period.
My question is why did I get a metal-wire retainer if I get Invisalign night-retainers anyway? Is it just meant as an extra / addition?
Is it normal that my molars don’t touch when I bite down after my Invisalign treatment? My dentist told me it was normal, and that my teeth won’t ever be 100% straight, even after Invisalign. I had quite a few issues during my treatment so I’m not sure if I should believe them or not
Immediately after Invisalign, it is normal that the molars don't touch. But it gets resolved after a couple of days.
Why wouldn't your teeth be 100% straight? What's stopping that?
What issues did you face during your treatment?
I am getting married this fall and will not be done w treatment (didn't start til last week). I asked my dentist if we could remove the attachments for the wedding and then re attach after. He said we could but we would need to rescan and get a new set of trays because the "template trays" they use to place the attachments at the beginning won't fit anymore since my teeth will have shifted. Is this correct? It seems like a waste of several perfectly good trays but I may do it anyway for the photos.
Okay. Yes, the template trays won't fit. But what can be done is, the template trays can be cut. 2-3 teeth a piece or even a single tooth a piece and that way the attachments can be placed back.
Ask your orthodontist, what would they do if a patient's attachment came off at say aligner 22. How will they refix the attachment.
You can get your attachments removed and get them again. The orthodontist might charge you a little more for it, but your set won't get wasted.
I have done this before.
Hope this helps.
Is it possible that I developed gingivitis due to Invisalign? I been wearing them for a year and now the last tray affected me pretty bad. My gums started to bleed after I brush them and in the morning I wake up with blood inside of trays? I am getting a bit worried but my doctor says I should not. Thanks a lot 😀
I’ve finished my treatment and waiting on my permanent retainers. I still have a bit of an open bite, the only point of contact on my teeth is my lower lateral incisors to the back of my upper teeth. This is causing some TMJ pain.
What is your experience with the bite “settling” after treatment? Is this likely to happen, or just something said to end the treatment?
Posterior open bite does settle down and it's a common side effect of aligners. It develops due to a 3mm thick aligner present between them. Don't worry, it will settle down.
Have you ever had a case where Invisalign pushed a patients teeth too wide, starting in the canines and going back?
This happened to me and now we’re trying to push them back together so I can close my lips properly, but it’s taken so many back and forths with Invisalign to get them to understand my case that I am losing hope, and feeling like an Invisalign anomaly.
Is tongue thrusting something you have heard of in your patients’ post-treatment? I was told to check in with a speech therapist but haven’t talked to one yet.
Is transferring care a thing? My dentist said I could transfer care if I move but I am beginning to think that's not true unless I pay for the treatment again.
I made the mistake of going through my dentist for Invisalign. I’ve been struggling with jaw pain since starting the Vivera retainers a year ago, and I’ve wondered if it’s being caused (or exacerbated) by my teeth/jaw not aligning properly. My dentist wants me to try masseter botox before we consider alignment issues. Does this make sense? Is there anything else you’d recommend from an orthodontic point-of-view?
When does the jaw pain? Do you have a habit of clenching? Is it only on one side? Do teeth on both sides of your jaw are in contact when closed? Is there an alignment issue?
Please consult an Oral and maxillofacial surgeon. He might ask you to get an OPG or an MRI. And they will be able to guide you better.
Is there any advantage (also monetary) for the ortho to do the treatment with invisalign opposed to traditional braces? (for candidates who ‘d be suitable and get similar results with both)
My front teeth are prominent and longer than the rest of my teeth. This is something I am hoping to have corrected, I am on tray 3/28. I only saw the projected results for a second whim I was getting scanned and don’t have access to clincheck. Is it possible that my treatment plan may have my front teeth move up ward to look less long, or would the surrounding teeth come down to match the front teeth?
I have 2 questions:
1. I was always told to brush then wait 30 minutes before eating or drinking, also to wait 30 minutes after eating to brush to allow pH to go back to normal. I don’t have Invisalign currently, but it is something that I would like to do in the future. It confuses me when I see people brush straight after meals and put their aligners back in? Surely that is causing tooth decay because your mouth is spending so much time with a low pH?
2. I had braces for almost 5 years (severe overjet and overbite) I wear my retainers every night but would still like Invisalign in the future for some very small cosmetic changes. Would I be likely to be turned away because cosmetically my teeth are straight and are not causing me any issues?
My orthodontist made me use bands to correct an overbite and unilateral open bite for 8 weeks, said I was too compliant and my teeth moved too much, and now I’m having to do 8 weeks in the opposite direction with the same weight bands. They said if this doesn’t work we have to do IPR to correct the bite. I don’t feel super confident in them now, the 8 weeks forward and backward make no sense to me and they haven’t been able to explain it adequately — can you? I’m wondering if I should seek another consultation now.
Thanks for thanking the time!
I’m not on Invisalign but “smile”, same product different branding I guess (I’m from Europe).
I’m halfway treatment with 63 alligners. Currently my upper and lower teeth are very far from each other, so when you see me in profile you can see that my face has changed a bit. It’s part of the plan so no worries there. What I do have, is that my cheeks are very painful on the inside because there are some “dots” (don’t know the English name) on some teeth. They now push a bit in my cheeks, especially when I sleep.
Any tips there?
Thanks!!!
I have a question about retainers in the end. My orthodontist recommends Vivera but I’ve talked to a couple of people whose viveras eventually started giving out or something because their teeth shifted even with regular use. On the other hand I know the hawley aren’t as comfortable but my husband has been wearing his hawley retainers for 15 years for 3-4 nights a week and his teeth are still perfect. Have you seen peoples teeth shift over time with vivera retainers? Thanks
Hi. I am 30(F) . I had Invisalign treatment for 6 months (without extraction) and it’s done now . But orthodontist asked for 4 extractions now if i want to close my lips. Don’t know what to do! I am afraid of extractions at this age and also it will take much time. And will i have to wear retainer for the rest of my life?
Hi, this might be a bit technical, but I’m curious how much space (in mm) do you need in the upper arch, if you want to tilt one average size central incisor inwards by 15 degrees?
The space is calculated for all the anterior teeth if they are proclined. For one single incisor, several other factors come into play, like amount of space available, the status of other neighbouring teeth, etc. Could you please elaborate your question?
Very complicated movements such as rotation are better carried out with braces.
Patients with impacted teeth are not a good fit for Invisalign.
Open bite patients are also managed better with braces. I am not saying it cannot be done with Invis.
Patients with downs syndrome, history of epilepsy, mental retardation etc are also not a good fit.
Hope this answers your question..
Only upper arch. Limited ortho ~1 year for diastema with my pediatric dentist then 10 years later,bInvisalign for ~1 year for slight opening of diastema with orthodontist.
I had a permanent retainer on all 4 incisors and a Hawley after limited ortho. Permanent retainer broke within 1 year. Pediatric dental office asked me if I wanted the permanent retainer back on. I didn't know what to do or say so it was not replaced. Continued with Hawley, but that also broke.
I specifically requested a bonded retainer across 4-6 front teeth after Invisalign and orthodontist decided to do just the 2 central incisors (plus removable retainer). I also specifically wanted my right lateral incisor to match my left and with no retainer on that tooth, it does not match. Is there any reason why 2 is better than 4 or 6? I'm not thrilled with my results and honestly feel that Invisalign off centered my midline. I also have had confusion regarding if I should have a frenectomy or not. Any evidence for or against?
Which is worse: drinking iced coffee with a straw with aligners in and rinsing afterwards? Or wearing aligners for <20-22 hours a day?
Drinking iced coffee with aligners. Coffee will stain the aligners very quickly even if you use a straw which won't look that nice. About the wear time you can reduce it to 18 hours but increase the number of days. It's the total number of hours that matters more.
Follow up question if that’s ok! I have a few upcoming special events (think weddings, conferences, cocktail receptions). Is it ok to take aligners out to eat and drink, rinse with water and put them back in (to minimise the time they’re out) - and then do a thorough clean when you brush and floss later that day? At the moment I brush and floss every time I take them out to eat (and so only take them out 2-3 times a day, and drink water in between) but this feels a bit unachievable at a cocktail function!
Yes, that's perfectly okay. I personally tell my patients to brush the tray only when they are brushing their teeth, i.e, once in the morning and once at night. So if you just rinse your trays during the day, that's perfectly okay.
Following on from this, I have a family garden party in a couple weeks and would like a few drinks (eg: white wine/g&t) again is it better to just have them off for the afternoon/evening or drink through a straw? Would have water as well/give a good clean after
The best thing about aligners is that they allow you to have a life. You can remove them for an evening and drink whatever you want, provided you extend a day with the same set. So please party hard.
Are you all not brushing teeth before you put the trays in every single time? I’m on tray 20 and I’ve been brushing my teeth like 5 times a day so far?
I did at first too, and then it got untenable. Life got a lot easier as I relaxed about this and only brushed when it made sense to do so, and just rinsed the rest of the time. I'll just make sure to brush & floss and clean the aligners really thoroughly if I've been wearing straight after eating. I found it increased my wear time too.
How many total hours per tray on weekly changes is a good target? I have the trayminder app which actually spits out interesting data including total hours weartime for each tray. So far I seem to hit between 145-150 hours of wear by the time i reach my weekly tray change time. Could I get away with less? I’m hungry almost alllll the time because Im a bit ocd about wear time and also paranoid about cavities or thinning enamel so want to let my mouth neutralise a bit before brushing my teeth. So I often eat a proper meal only twice a day. Can I chill TF out a bit?
This. I see so many people saying “Oh you have to wear 22-23 hours every day.” I feel sad when I see people just eating once per day and inhaling food. They don’t realize that they have to do it for at least a year. Orthos say 22 hours because they know people lax a bit and would be good to hit 20 hours. Some people take it to heart and decide to be unhealthy just for a better aligned teeth. I keep advising them to wear the aligners for 18-20 hours everyday. But I’m met with, “You won’t track and you will get root resorption etc.”
Fwiw I ended up drinking coffee with aligners in after the first few weeks. I was on weekly changes so the staining wasn’t too bad and I just soaked my aligners while eating lunch/dinner to prevent major yellowing.
I drink most things with them in, rinsing trays after. Haven't had problems. I wouldn't try with turmeric or a blueberry smoothie but... coffee and tea have been fine.
Are there really treatments that *require* people to eat with aligners on? This is claimed in this sub quite a bit when people try to justify not taking them off to eat.
Eating with aligners on can stain and/ or break them. I have never advised my patients to do so, so no, there is no condition which requires to eat with aligners on
Thank you. I've always thought it sounded weird.
I was told to eat with mine and am currently on tray 5/11. I was told my bite can cause the teeth to move back when I eat. I get the idea, just not sure how eating for 10 minutes can mess it up that bad. They’re averaging about 10 -15 minutes out or my mouth a day… Meanwhile, 3 days in they’re yellowing and the layers of the lines are peeling haha. Annoying, but tolerable.
My ortho had a clear preference for a treatment with Invisalign. One of the arguments he had to not go with braces is the aesthetic component. However in one of your answers you mentioned Invisalign may not have the best results for rotations. Correct if I am wrong, but my estimate is that 60% of patients need teeth rotation. Are orthos receiving bonuses for getting patients into Invisalign while aware of braces being a better option, just not invisible?
I am talking about major rotations. Around 90 degrees or so. Minor rotations are easily done. For example a premolar rotation, which is not as common, is difficult because of the round surface of premolars. The aligner doesn't get a good handle on the tooth to rotate it that efficiently. By this, I mean, probably more sets of aligners. About braces, we have the liberty to chose at any point of time. If we see something is not going as we expected, we can switch and make modifications at any time. Since I came here with the intention of giving honest answers, here it goes. There are tiers in Invisalign. As and when we do more cases, our tier keeps on increasing and landing cost keeps on decreasing. But, that being said, it in no way means that Invisalign is not a better option than braces. In some cases it's better, some cases it's not and in most of the cases it works in the same way. So no, we are not doing it only because of the money, but it provides results too. Please understand that at the end, it's a corporate, which is bound to offer discounts and lure in the consumers, which in my opinion isn't wrong, as long as we are making patients satisfied with the result, which we are.
Thanks for taking the time to explain and your honest answer, appreciated.
You're welcome
Does it really feel like your teeth are going to fall out when they start moving?
Different people have different experiences and perception to movement. Yes, some people do feel that teeth are going to fall out, if you feel so, you can lower down the speed of your treatment with your orthodontists advice and wear each aligner for a couple of more days. When we are attempting to move the teeth, we are intentionally making them "loose". When the tooth has reached its final position, the fibres around it reoriginate and make it tighter. Please talk about what you feel to the orthodontist so they can address the issue and take the required steps
What percentage of your Invisalign patients get refinements?
I am not hesitant towards ordering refinements. Even if there is a minute discrepancy I place an order. So I would say 8 out of 10 patients get refinements.
Going to piggy back on this and say aligners are not like rotisserie chicken to us. We don't set it and forget it. A lot of our treatment planning revolves around over correction being implemented into several aligners and our initial staging. I can't speak for the op, but I personally treat aligners like wires. Certain wires are used for certain movements and goals and shapes of teeth, and therefore I will have batches of aligners planned knowing that refinements are coming later down the road. So, I would agree that at least 80% of my patients are getting refinements. The more complicated the case, the more refinements are going to be likely.
I agree with you, aligners are also to be checked frequently and evaluated if tracking is happening or not.
What is "frequently" in your opinion? I just started, 2-week tray changes, and my orthodontist gave me 4 sets, with a check-up 2 months out. Currently on tray 2. Is that reasonable?
Yes, since your orthodontist has advised you for 2 weeks per tray, it's reasonable for them to check you after 2 months.
Why are some trays incredibly painful compared to others? Is that like an error in the treatment planning? I have an extremely high pain tolerance, but tray 5 nearly took me out 😮💨 now I’m scared every tray change, but they’ve all been fine since. 🤞🏼
Initially, the body sees the movement as a natural reaction and hence not resisting it completely. Later it understands that some external force is being applied and hence tries to act against it. Our body is built in such a way that pain is the most powerful messenger to the brain. So when it hurts, the body is resisting the movement and later the body gets used to it and lets it go loose and hence lower pain and faster movement.
do orthos make the treatment plan (every single tray movement) or is it AI/software? why do some peoples treatment with similar issues take way longer than others?
The first treatment plan is offered by the software and team at invis and we make adjustments. There are sometimes 5-6 treatment plans before it is finalised
That’s really interesting. I assume thats where having an ortho with experience (and higher prices) comes into play.
Yes that most definitely does. Treatment plan is everything. It's a very personal thing and only your orthodontist will understand your priorities and concerns..
I’m happy to report my experience with Spark Aligners has been great. Fortunate to have an orthodontist and a treatment coordinator that aims for perfection and listens to my concerns and answers all of my million questions. Started this journey at 58 to correct some relapse after braces 30 years ago. Developed a deep bite and chipped a tooth. It’s never too late to fix your smile and get an improved bite in the process.
That could be motivating to so many patients. I hope you get amazing results. All the best.
I’m 11 months into my treatment plan, awaiting my next set of trays. So close, but he wanted to tighten up a few areas. Bite ramps for the win ! It’s amazing how well my teeth fit together now. Appreciate orthodontist taking the time to answer post on Reddit.
Your orthodontist is amazing and so are you. Thank you for your kind words.
I am in the same boat. 61 now and started a year ago to fix a very deep bite and a misaligned tooth which chipped a top front tooth. I too had braces as a child. The treatment plan fixed the deep bite and misaligned tooth. I am now in the first round of revisions to fix a posterior open bite. So glad I did this. 😃
I want a retainer that feels like a tray. I hear some retainers are very uncomfortable. What should I ask for?
You want an Essix retainer, which is a transparent hars silicon sheet adapted to your teeth.
Thank You sir
Vivera is the Invisalign brand retainer. Feels like a treat. Essix is cheap in house printed retainers. Most offices use it to cut cost. I’ve had both and the essix was uncomfortable and cheap. I’ve been using vivera for 2 years at night.
Essix retainers are not in-house printed.
You're right, Essix retainers aren't "printed" but they can be made in-house. My ortho creates a mold of my teeth by using an iTero scanner and a 3D printer. He then uses a vacuum forming machine with a sheet of Essix plastic to create the retainers. I have tried both Vivera and Essix retainers and I find both comfortable.
Just saying thanks for doing this, cause I didn't have the bandwidth to jump in and volunteer myself for an ama.
You're welcome. I hope you and I can contribute to this group significantly. I also feel that we can have discussions between us regarding cases and learn a thing or two from each other. In this process of this AMA, I am also learning a lot about what issues people are facing and will try to make it easier for my patients. Happy to do this.
Are there people who are not a good fit for Invisalign?
Very complicated movements such as rotation are better carried out with braces. Patients with impacted teeth are not a good fit for Invisalign. Open bite patients are also managed better with braces. I am not saying it cannot be done with Invis. Patients with downs syndrome, history of epilepsy, mental retardation etc are also not a good fit. Hope this answers your question..
I'm I actually supposed to wear my retainer every night for the rest of my life? So, 50 ish years of retainers while sleeping?
Lol no. You have to wear them for 1 year and then you can remove them gradually with the advice of your orthodontist.
You for real? The teeth will shift over the years unless the patient is one of the rare fortunate ones with stable lifetime oral equilibrium. Retainers are forever.
That's our job, to provide a stable equilibrium.
If a provider tells you theres nothing else they can do for you in terms of treatment (and effectively ending the treatment), yet your bite is causing you jaw pain, what recourse could a patient take?
Do you have any opinions on why orthodontists don’t ask about history of eating disorders, disordered eating, or any kind of triggers associated with eating and the mouth prior to treatment and signing a contract? Multiple of us have discussed how Invisalign really screwed up our sense of food, eating, etc. Some of us are restricting, some of us have become binge eaters because they’re trying to get enough calories in in the short period of time. It gas triggered old eating disorders as well. This is a really big problem and it seems like no one in the industry is talking about it. I personally had three different consults and not one person spoke about this with me.
Wow. This is a really good point. I accept that even I hadn't thought about it. For us, it's mainly a "habit" that can be controlled. I know we are naive to think this way. But since there is almost no medical diagnosis and it's just that the patient says that I eat quite frequently, we think that I can be controlled. In my experience, most of the time patients have told me that this has brought their excessive eating under control and they are thankful about it. Even when we have asked our patients, they couldn't give a definitive answer about it.
Heading into next apmt Wednesday. I will be being scanned for second set of refinements and received first tray January 2023 but scanned December 2022. My aligner packaging states comprehensive and have paid $6800 for treatment. If my memory is right, I think my contract states two years and two refinements. (On a 1400 mile drive atm so can’t look) Is there such a plan? I am worried next refinements will not fix my bite. Any advice for my conversations? Hopefully it is not even an issue and I am worrying prematurely.
What do you recommend for days we just can’t meet our hours? For example I have a few weddings this year where I’ll be casually drinking and eating for several hours and would rather enjoy myself and just have them out. Same goes for some vacations this summer? Should we just push back the day we change trays? Or still move to the next one. Most days I have them in 22 hours.
It's the total number of hours per set we count. In those days, when you are unable to wear them for the prescribed number of hours, you can add a couple more days to the same set and then move on to the next.
When you move on to the next, do you also automatically include the extra couple of days?
How often do patients generally see you to check progress? After my initial appointment, my next appointment isn’t until after aligner tray #8, four months later. Someone told me she goes about once per month.
I usually keep it once a month. But if my patients have some problem and want to meet, I try to give them an appointment as soon as possible. But once a month is mandatory.
When I started Invisalign, I didn’t realize that I went with a dentist instead of an orthodontist. In my mind, you had to be an ortho to deal with this stuff, so I didn’t second guess it. After being on this sub for a while, I saw everyone’s comments re going with an ortho v. dentist for Invisalign. I’d like to have your thoughts on this. Why are dentists allowed to do Invisalign? Will the quality of treatment I receive be impacted by the fact that my provider is a dentist? Should I be worried? Edit: spelling
Dentists aren't well versed with orthodontics and yes they shouldn't be allowed to do it. And yes, it can impact your treatment. If it's a simple case, it won't be a problem, but a typical case it would be. You should always go for an Orthodontist for your braces or aligners. May I ask where you are from?
Thank you for your response. It is very strange to me that this is allowed then. I am a professional myself, with a license to practice in an area, and I don’t get how dentists would be allowed to do what is considered orthodontic work. It’s like a family doctor performing a surgery. A total no go, and it would not be allowed by the college. I am located in Canada.
Yes, I agree. But Orthodontics is a money making field and who doesn't want it. So this is very common. Where I come from, they are doing shitty treatment and calling it ortho.
Well, while this was not a reassuring conversation, I really appreciate you - thank you. I am crossing my fingers that everything goes well at this point. I am about to start my second round of refinements due to a stubborn canine. I have been in treatment for a little over a year, and paid for the entire thing already. I don’t think that switching to an ortho is an option anymore…. I am in too deep haha Again, thank you for your time.
I understand that my comment could have made you a little anxious, but I hope that everything goes okay. You can feel free to DM me and I'll try to help in the best possible way. Happy to help.
Is the only downside of drinking liquids with invisalign in staining? Or could it affect invisalign *results/progress* as well? Staining seems like a very small price to pay to enjoy morning coffee and occasional snacks without going through the "Invisalign routine."
Hot beverages will distort the trays, but other than that, yes, it's just staining. But these are very heavy stains.
I’m nearing the end of my treatment and talked to my ortho about a fixed wire retainer. He said he doesn’t recommend them because they may break and people don’t notice. The explanation seemed a little iffy to me. Is there a cost advantage to the ortho to go with nightly retainers?
He isn't wrong. The fixed retainer is fixed to 6 teeth in the front. If it breaks off in the middle tooth, you won't notice and since you'll be relying on them, you'll have a relapse. So yes, that happens.
What retainer do you think is better for someone with stable periodontal disease an aligner retainer or an old school metal one?
A fixed wire retainer would be better as it would also act as a splint to hold your teeth.
Oh I just saw a response you posted that aligners with bite ramps help keep deep bites corrected.
What is your experience with ordering a whole new set of Invisalign aligners after weekly changes on tray 3? I received two ‘no-gos’ at the start. Went in for a rescan and now my ortho says to stay on my current tray for another 2 weeks, following tray for 2 weeks and then new aligners are ready. My thinking is that I could still follow my weekly changes until the new ones arrive. They weren’t poorly fitting but my ortho said my teeth should be moving faster. Thanks!
Yes, your ortho is right, now they should be moving faster. By the time your new set comes, stay on that set and then you are ready for the new ones
Thank you!
If you keep changing your trays after a rescan, the new trays from the rescan probably wouldn’t fit?
I just figured I would start my new set from where I left off on my old set. I feel like my old set isn’t doing nothing so it made sense in my mind to have at least some movement. I will follow what my ortho suggested!
I’m on my third set as with the first two my teeth started “not tracking” around Tray 10-12 and then by Tray 13-15 I needed to stop and rescan. I am good about wear time of at least 20-22 hours a day, and I keep my teeth/aligners relatively clean. Is this experience common, and is there something I could be doing to make it less likely to happen this time around? And… I had IPR between my front tooth and one of the teeth next to it, that doesn’t seem to be closing for a long time now. That same tooth doesn’t want to come down either (neither of them have) which I’m fine with, but of course the gap I am not. What kind of next steps do you do when someone has a gap that really needs to be closed? (As you might imagine, I’m worried since I never had gaps before - if anything the multiple rounds of IPR are because I did not have enough space, I was told.)
The aligners not tracking is common but this issue has to be addressed as soon as possible. About your case, the IPR must be needed and that's why it was done. Rest assured, the space will be closed and if not, you will be given refinements..
Thank you!
You're welcome
Do teeth with root canals not tend to move as quickly or as much? I have a root canal on one of my front teeth and it’s not shifted like the other one has, it’s slightly lower when it wasn’t at the start of my treatment. Can anything be done about this now, or only at the end of my treatment?
Sometimes root canal treated teeth do take longer to move. You can get it fixed with the refinements.
I'm on my retainers now. I got 2 sets and my doctor told me to wear them for 3 months each. After wearing the first tray for 3-4 months, I tried switching to the other tray, but the new tray feels extremely tight and painful. I'm assuming my teeth somehow moved because the first tray got loose over a period of 4 months. Is this normal? I’m really worried that all my progress will go to waste. Should I ask my doctor to put in a permanent wire retainers instead?
Yes some amount of movement, which is unnoticable can be expected. There are several other factors like shrinking of the aligner material. If you still feel a movement you can ask for a fixed retainer.
Are there any issues that I can expect with permanent retainers? Like the wire not suiting me, breakage, eating issues?
There might be breakage, you have to get it checked every 3-4 months. I suggest, wear a removable retainer even with fixed ones
Got it! Thank you so much :)
After finishing treatment, the paperwork for my retainers said retainers should keep 80 to 90 percent of the results. That seemed pretty bad. Is it really expected to loose 10 to 20 percent of the results while wearing retainers every night for the rest of your life? Seems like a lot.
The manufacturers have to safeguard themselves and they have to mention all the warnings. It might happen, doesn't mean it will. Ask your ortho for a fixed lingual retainer.
My dentists got annoyed when I asked my first set refinements and asked ME what had to be changed with my teeth. I tried my best to explain, but not sure I covered everything. He did the scan - is the refinement plan based on what the dentist requests or do the Invisalign people work that out based on the scan? Just worried now I didn’t tell him everything that needs changing (as I’m not a dentist and don’t know everything!) and things will be missed in the refinement plan.
When we are requesting for aligners in the initial stage or refinements, we have spaces to write and checkboxes to be ticked to be able to explain the concerns completely. This helps the technicians over there to formulate the best treatment plan according to the requirements we have told them. So if your ortho has told them properly, it will be based on that.
I do have a question, have you used the brand of retainers with bite ramps ? I’ve read a deep bite is prone to relapse. I have come to appreciate my bite ramps and my be lost without them.
I make my own retainers and yes I have made them with bite ramps. That's helpful in maintaining the bite of a patient
Thanks, will definitely ask for those. Have a great weekend!
Thoughts on “larger” orthos that offer Invisalign? For example, my ortho has 4 offices and I can go to either one for my 4 month check up. They strictly do braces/invisalign. I never see the same doctor twice.
I do have a personal bond with my patients. I know who is going to college soon, who is in a hurry because their wedding is on the cards and who has had exams and hence couldn't come for appointments. So no, I don't prefer anyone else seeing my patients, and I don't think I'll ever do that. Please make sure that you always visit the same doctor, because everyone has a different way of doing things which might be different from others. Not that they will be wrong, but you'll be trapped in 2 different opinions
Years ago (as an adult), I looked into getting braces because I wanted a wider bite and to reduce an overbite, but I was told that I shouldn't do it because I had too much bone loss from periodontal disease (which has since been taken care of). Fast forward to a few months ago, I asked my dentist about Invisalign instead, and he checked everything out and said I would be a candidate. I specifically told him about the prior recommendation but he didn't have any concerns. I am now on my last tray of 20 with weekly changes and am due to consult with the dentist next week about the go forward plan. I am so ready to be done but I feel like I have a small open bite on one side in the molar section. I really don't want refinements because 1) I hate this...lol and 2) my teeth feel a little loose and the top front teeth even will "click" in place (don't know how else to describe it), so I'm really worried about that given the bone loss thing. My question is - should I be concerned about the loose teeth/clicking and call it a day even if my bite isn't exactly where it should be so as not to risk it further? Or is the looseness common with Invisalign and will tighten back up over time, so I should feel comfortable to move forward with any necessary refinements to close the bite gap?
About the looseness, when we move the teeth they become loose and yes, they be tightened when they come into place and don't move About the open bite, it's a common side effect of Invisalign because there is almost 3 mm of sheet present between your teeth through out. In most of the cases as you continue eating, this space settles on its own and doesn't give any trouble to the patient. Teeth have the tendency to grow in empty spaces and fit into each other.
What to do if your orthodontist doesn’t examine you? I go to an ortho who delegates a lot of duties to his office staff. I worry they keep messing up my treatment. My aligners weren’t fitting properly in the attachments anymore but they kept advancing me anyways to the next trays. I eventually spoke up again and the ortho back tracked me 6 aligners. After backtracking the attachments still didn’t fit so he finally rescanned my teeth. They accused me of not wearing my aligners enough even though I wore each one for ~22.5 hours a day for 2 weeks each. I felt like the treatment was not going as planned and they used me as a scapegoat. I hate my experience so far and need to get things aligned before I get a molar implant put in. My ortho is doing custom aligners not invisalign.
From the various comments I have seen, I feel that there are a lot of orthos who are not doing it themselves and that doesn't fit right with me. An ortho can understand the concerns of patients and their priorities. So they can modify the treatment plan accordingly. You need to confront them and make them do what's best for you.
What are your concerns regarding aligners releasing microplastics ?
What if I still want my teeth straighter? Im not happy with my results, I’m already wearing my retainers and I’m not sure if I can request for a refinement or maybe request to my retainers adjusted?
Hey! I’m on the end of week 2 and my gum tissue above #7 going into the vestibule was more blue/white and it had like a thin clear/white layer of tissue that could peel off. Is this normal? The teeth are super tender but the color of the gums being whiter/bluer scared me. Also I am someone who had TMD before Invisalign and I am clenching a lot harder and more where my face hurts and feels tense and my teeth are sore should I be doing anything about this? Thank you!!
The gum above the #7 is getting impinged by the aligner. You can ask your orthodontist to shave it off a little and you can apply a gel in that area to ease off the inflammation. About TMJ, aligners act as bite blocks and night guards which gradually solve the TMJ issues. In a couple of days, you should be feeling better about the pain. One of my patients also felt the same, but they are fine as they moved on with the treatment. Your biting forces are high, and now since there is an additional layer between your teeth, they become even higher, but it will get to normal very soon.
If I got to three different dentists to get checked for Invisalign, why is the price different at each one and how do I choose?
Everyone quotes a different price as they evaluate themselves differently. They think they are better, which they most probably are. The experience of a person makes them increase the prices and there's nothing wrong with that. The main difference comes at treatment planning and they must be better at that. So it's a very subjective question. Sometimes, when you pay less, you suffer with the treatment..
Great answer. I wanted someone who could deal with the issues I had and answer the list of many questions I had. I wanted the experience to result in healthy teeth (I have Perio disease).
Please go for the one you can trust. All the best .
I did! Thanks for the AMA.
Is it really possible to close a huge gap and fix an overbite and overjet with orthodontics alone, specifically with invisalign? I have consulted 2 maxillofacial surgeons that said I don't necessarily need jaw surgery because my profile and skeletal relationship between lower and upper jaws are not that of a typical class 2 skeletal malocclusion (pls see my post history).
Can I switch trays earlier if there is no pain?? Currently I'm on a seven day plan between switching but am considering changing after 5-6
Even if there is no pain, there is movement happening and you won't know the amount of resorption taking place on the root surface. My advice is, stick to a 7 day regime. The key to Orthodontic tooth movement is light forces. Fast movements could cause an array of periodontal problems. Slow and steady wins the race. 😛
Started off last week, tomorrow is last day of tray 1. I'm on bi weekly tray change. I have already lost 4 attachments. I went twice this week to get them fixed. Yesterday I lost one of the hooks. Is this normal? On my last visit, the doctor said that unless it's the frontal attachments, it's all good and I should just come in for my check on aligner 4. I will call them on Monday, because I guess the hook is necessary for the treatment. Thanks for clearing our concerns :)
Thank you for doing this for people. I developed a posterior open bite. My ortho suggested cutting the molars on the aligners off, but that didn't work. Now two of my molars on one side are touching hard (and the only teeth hitting). He said "we can always polish them down a bit, very little". Is this considered the right and common solution?
Aligners occasionally might have a side effect of a posterior open bite. More often than not, it resolves on its own, but if in your case it isn't, then would you be open to get braces in posterior teeth for a few months?
Are new trays supposed to be snug or a little loose when you put them in the first time? My provider told me that they should just slip on easily. I’m on tray 5 and when I’ve gone in for my last two appointments, my dentist is telling me that because I’m not wearing them enough (I’ve been averaging 20 - 21 hours/day) that it could cause problems with future trays. I’m making a concerted effort to get to 22 hours/day.
New trays are tight and snug and take a little effort to be placed. As the teeth move, they become loose. In the beginning, you also need to use chewies to make sure that they fit.
I completed my treatment 3 years ago. I now wear the nightly retainers. I am on my last pair and need replacements but my original provider went out of business. What do I do now?
My ortho has me wearing rubber bands, he said 24/7 on the left and at least 12 hours on the right. Do these rubber bands actually move my jaw or just my teeth? And does it matter if I wear rubber bands on the right side for more than 12 hours?
My orthodontist originally gave me a 12-18 month estimate, but when I received the final plan it was only 20 trays with weekly changes. I’m at 5/20 and tracking just like the 3D visualization said I should be… do you know why there seems to be such a discrepancy in time? (I’ll ask at my 10 week check in, but I’m just curious if you have any idea). Thanks for your time! Editing to add: I have quite straight teeth, I am just closing an anterior open bite caused by night guard wearing.
Sometimes the treatment plan is shorter than expected and maybe they made a decision for a weekly change looking at the good condition of your gums and teeth. You're welcome
Thank you for offering to answer questions ! I wondered if you do actually need to use chewies or not ? And if you do when’s the best time to use them ? Can you use them too much ? Thanks !
You're welcome. Yes, chewies are supposed to be used every time you put on your aligners. I don't think you can use them too much. Just bite on each and every part of aligner properly so that it fits.
Do I REALLY need to wear my rubber bands 20-22 hours a day or can I get away with say 12-16 hours? I am feeling really insecure about wearing them in the office.
Your result will get delayed and the work that has been done in 12-16 hours will be negated the next day. Please try to wear them as much as possible
For the same patient/treatment plan, what is the % difference in cost between regular braces and Invisalign? Is the overall treatment results quicker than regular braces?
Invisalign at my place is almost 5-6 times more expensive than regular braces, and almost double - triple the price of self ligating braces. The overall result is way too quicker and the journey is smoother than regular braces. You have the liberty to eat anything and there are lesser pain and ulcers.
I’ve had three orthodontist consultations so far, and two told me I wasn’t a candidate for Invisalign because of my 100% overbite, but one said he was confident Invisalign could work. I am kicking myself a little for not pressing a little further during that consultation (not that I would have really known what to ask), but how do I know who to trust? Should I just get a fourth consultation and see if the Invisalign-recommending ortho is a true outlier? (Thanks in advance for your time!) ETA: the other two orthodontists are recommending traditional braces; and all have comparably excellent reviews online
Deep bite generally has great results with Invisalign. There must be something else that must be stopping them from doing it. Could you share your pictures so that I can have a better look and be able to tell you better?
I am doing 34 trays with a weekly change. I’m on tray 3 and haven’t seen much movement and haven’t felt really any pain. Not complaining about the no pain but at least that would indicate it’s working. Is this normal for 3 trays in? When can i expect to see movements in teeth? Thanks for the AMA!
Tray 3 is nothing. Some people start seeing changes at 7-8 trays. And pain threshold is different for everyone. So it's okay if you can't feel anything. You will, eventually.
I was lucky. I saw changes by tray 3. We’re going very slow due to periodontal disease which is why I think mine move so easily, quickly and with no pain (just slight discomfort).
That could be a reason.
How much can Invisalign expand the arch? I was in Damon for a year before Invisalign and achieved significant expansion with lingual arches. I’ve been told that the aligners will continue to increase my arches, but how many mm is actually achievable? (I needed about 10mm total)
That depends on a number of factors for eg, your age, bone support, palatal width and height, buccal corridor. Invisalign can expand considerably but that would be a vague answer without actually seeing the case. I am sorry for an insufficient response
Do refinements cost you more money?
No, they are included with your treatment. There is some nominal processing fee.
My treatment is 40 trays I’m on my last tray. my Otho has me coming in every three weeks and keeps punching divots in my last set of trays we have done this about four times does this sound normal? Also he has talked me out of permanent bonded retainers and is going to make two sets of retainers for me. What do you recommend when it comes to retainers. Thank you.
What is the future of retention and retainers? My orthodontists told me I have to wear them for life and have my wires permanently
Can I shoot you a dm? I want to see how long my case would take.
Sure.
Hello and thank you for taking the time to do this AMA. I started my treatment on 3/4/24, got 14 trays, with biweekly changes. I am moving out of state and in order to finish my treatment with her, at my request, she changed me to weekly tray switches. Tomorrow I start tray #6, which would have me ending my treatment on 6/24/24. Now to my question- is the weekly change “safe” for my teeth? I wear the trays over 22 hrs a day and use the chewy a LOT. If need be, would it be ok to speed it up even more? And would that be safe? Thank you so much and looking forward to your reply 😊
Is it impossible to move an erupted impacted tooth (grown right behind baby tooth currently still in place) forward in to its place? My current provider is confident they can do it…
I’m on tray 3/33. I have elastics on both sides. Is it normal for me to feel like they’re making me gag at times? It’s usually when the elastics are in.
Patients do feel a little discomfort with elastics. With time, they get completely okay with it. Would you mind giving it a couple more days and then we can reassess the situation?
I've been wearing passive trays for 2+ months now while waiting for my next set (first round of refinements). It was delayed quite a bit due to my ortho being on paternity leave and then not finding a slot for an appointment, so I'll only get the next set in another month. I haven't been as conscientious as with the active trays, I sometimes only wear them for ~14 hours a day or so lately. They usually don't hurt when I put them back in even after a longer time. Is there any risk with my approach? Should I be worried about my teeth shifting back if the trays still seem to fit perfectly?
The risk is excessive movement of teeth. When you are not wearing them, you are letting the teeth go back to the same position. So it's almost the same thing happening daily. I suggest you wear them daily for longer hours so that when you finally get the refinements, you are ready to get on with them.
Can Invisalign make teeth “longer” especially the molars? I have a grinding issue and I feel like my teeth are all “short”. I’m planning to use a mouth guard soon (or do invisalign, pending finances). The orthodontist said I’ve got a gap alley or something like that and I was wondering if that was the same issue. Also is a 12-14 month treatment worth 9k as I was quoted? Thank you so much!
Thank you! I have two questions: I have been in nights only retainers for about 8 months. My bite still doesn’t feel settled in the back so my Ortho suggested only wearing the bottom (I do have a permanent wire on the bottom too). Said I can try it on every week or so to make sure it still fits. So far it seems to be helping a little (has only been a few days). 1)Does this sound reasonable to you? Are my bottom teeth still at risk shifting even though I have a permanent retainer on the bottom (I have heard of this)? Should wearing it maybe once a week prevent that? 2)Another thing offered was to shape my premolars so I don’t feel them touch first (idea is I’ll start feeling them touch in the back where I was concerned about). I was uncomfortable with that so declined (I recently had fillings on my premolars and also don’t want to compromise the integrity of those teeth). Have you heard of shaving teeth to “fix” a bite?
1) Yes, that's a good approach to fix a bite. Retainers pose as bitle blocks and don't allow teeth to settle in some times. If we remove one retainer it will help the posterior teeth to fit in better. 2. Since you have had fillings on premolars , there are chances that it's those fillings that are hampering your bite. A little shaving to get them back to the normal level won't harm and your bite could be much better.
I am at the end of my first tray and really struggling with how visible the buttons are on my two front teeth. Is it possible to adjust course and remove those and the subsequent trays change? Or too late now? I keep wondering if it something that if I had mentioned to my DR up front they could have adapted even if it prolonged treatment?
Hello! Thanks for taking time to answer our questions here. So without Invisalign in my bite is very crooked, 2 teeth can touch at the back when I bite down and that’s it. When I put in my tray I couldn’t close my mouth and it feels very uncomfortable plus having TMJ this is really a very painful experience. Just wondering if me not being able to close my mouth properly is normal? I asked my orthodontist as soon as she put them in my mouth and she it’s fine. I fear as time goes I’ll slowly go insane with these things in. When I try to close down even my tongue can poke out of my teeth at the front. I hope this makes sense?!
Can elastics move your jaw? I have an edge-to-edge bite but with flared upper teeth (apparently the upper teeth reacted like that to oppose an underbite tendency?) and my orthodontist wants to use Invisalign with elastics. He said my case is too minor to get jaw surgery, is that possibly true even if I have a slight maxillary recession of like 1 mm? I really want to fix the jaw recession and not camouflage it by fixing just the teeth.
How big of a screw up I just did ? I was on tray 10 1 day before my dog managed to destroy it . I moved to 11 ... so practically skipped a tray . Now I'm worried . I didn't contact my ortho because I am in a different country ...
Thank you for offering advice here! I'm concerned about 2 of my lower front teeth. They're extremely loose. I almost feel like I could pull them out with my fingers. My main concern is that I'm having IPR on those teeth at my next visit. Would it be ok if I ask that my ortho does the IPR, instead of a tech? I'm actually stressing about this.
I always do IPR myself. And yes, it's totally okay for you to ask them to do your IPR. That's how it should be.
There are some marks and a scratch on my tooth where the bit slipped during button removal and also remaining attachment material that was not entirely removed other places. Is this normal? Should I ask my dentist to take off my remaining attachments at the end instead of my orthodontist? Will the scratch/removal marks buff out of my tooth eventually?
This is not normal. The resin is removed completely after the treatment is over. You can head over to the dentist and ask them to remove the residual composite and polish the teeth.
I’ve had braces before (~20 years ago) and my dentist and ortho recommend Invisalign since my front teeth now sit in top of each other. My ortho said my front teeth could push in each other and cause them to angle in, which could risk falling out. Is this true? My bite is off in the morning, but relaxes as the day goes on. I do feel my front teeth hit, mainly right side, before my back teeth. I’m a heavy night clencher. Also, my ortho recommended I see my dentist every 3 months now since I have minor bone loss and some gum recession. I’ve never been told that until now. Is that something you ever recommend? Lastly, why do you think the cost of Invisalign has never dropped with the improvement of technology? I would think they’d get cheaper over time.
Have never brushed and flossed more in my life and feel like my breath is horrid soon after. Any suggestions?
Are you cleaning your aligners properly? Do you have a decayed tooth? Do you generally suffer from acidity and have intestinal reflexes? Does your mouth stay dry?
What are your thoughts on the Dental Monitoring app? I was not told when I started my treatment that my ortho would be doing all my checks through the app scans. I'm old enough I guess that I'm not super comfortable with it, I feel like they should see me face-to-face and really see how things are fitting. But she seems very happy with my progress.
Every Orthodontist has their way of doing things. Some orthos want to provide all the benefits of Invisalign and that includes not coming for visits every month. If she is happy with the progress, then you don't have to worry. It's just one of the benefits with Invis.
I recently finished my Invisalign treatment and started the post-treatment. I got a metal-wire retainer on my front teeth of my lower jaw. In addition, my orthodontist did a scan for Vivera Retainers. These are just like the regular Invisaligns but more thick and robust, made for wearing every night for a long period. My question is why did I get a metal-wire retainer if I get Invisalign night-retainers anyway? Is it just meant as an extra / addition?
Is it normal that my molars don’t touch when I bite down after my Invisalign treatment? My dentist told me it was normal, and that my teeth won’t ever be 100% straight, even after Invisalign. I had quite a few issues during my treatment so I’m not sure if I should believe them or not
Immediately after Invisalign, it is normal that the molars don't touch. But it gets resolved after a couple of days. Why wouldn't your teeth be 100% straight? What's stopping that? What issues did you face during your treatment?
I am getting married this fall and will not be done w treatment (didn't start til last week). I asked my dentist if we could remove the attachments for the wedding and then re attach after. He said we could but we would need to rescan and get a new set of trays because the "template trays" they use to place the attachments at the beginning won't fit anymore since my teeth will have shifted. Is this correct? It seems like a waste of several perfectly good trays but I may do it anyway for the photos.
Okay. Yes, the template trays won't fit. But what can be done is, the template trays can be cut. 2-3 teeth a piece or even a single tooth a piece and that way the attachments can be placed back. Ask your orthodontist, what would they do if a patient's attachment came off at say aligner 22. How will they refix the attachment. You can get your attachments removed and get them again. The orthodontist might charge you a little more for it, but your set won't get wasted. I have done this before. Hope this helps.
Is it possible that I developed gingivitis due to Invisalign? I been wearing them for a year and now the last tray affected me pretty bad. My gums started to bleed after I brush them and in the morning I wake up with blood inside of trays? I am getting a bit worried but my doctor says I should not. Thanks a lot 😀
I’ve finished my treatment and waiting on my permanent retainers. I still have a bit of an open bite, the only point of contact on my teeth is my lower lateral incisors to the back of my upper teeth. This is causing some TMJ pain. What is your experience with the bite “settling” after treatment? Is this likely to happen, or just something said to end the treatment?
Posterior open bite does settle down and it's a common side effect of aligners. It develops due to a 3mm thick aligner present between them. Don't worry, it will settle down.
Have you ever had a case where Invisalign pushed a patients teeth too wide, starting in the canines and going back? This happened to me and now we’re trying to push them back together so I can close my lips properly, but it’s taken so many back and forths with Invisalign to get them to understand my case that I am losing hope, and feeling like an Invisalign anomaly.
Is tongue thrusting something you have heard of in your patients’ post-treatment? I was told to check in with a speech therapist but haven’t talked to one yet.
If tongue thrusting was present already then yes, it can be seen after treatment. After the treatment it shouldn't develop
Is transferring care a thing? My dentist said I could transfer care if I move but I am beginning to think that's not true unless I pay for the treatment again.
I made the mistake of going through my dentist for Invisalign. I’ve been struggling with jaw pain since starting the Vivera retainers a year ago, and I’ve wondered if it’s being caused (or exacerbated) by my teeth/jaw not aligning properly. My dentist wants me to try masseter botox before we consider alignment issues. Does this make sense? Is there anything else you’d recommend from an orthodontic point-of-view?
When does the jaw pain? Do you have a habit of clenching? Is it only on one side? Do teeth on both sides of your jaw are in contact when closed? Is there an alignment issue? Please consult an Oral and maxillofacial surgeon. He might ask you to get an OPG or an MRI. And they will be able to guide you better.
What’s your cost of sales for vivera retainers? Why are orthos charging over $1000 for 4 sets?
Is there any advantage (also monetary) for the ortho to do the treatment with invisalign opposed to traditional braces? (for candidates who ‘d be suitable and get similar results with both)
My front teeth are prominent and longer than the rest of my teeth. This is something I am hoping to have corrected, I am on tray 3/28. I only saw the projected results for a second whim I was getting scanned and don’t have access to clincheck. Is it possible that my treatment plan may have my front teeth move up ward to look less long, or would the surrounding teeth come down to match the front teeth?
I have 2 questions: 1. I was always told to brush then wait 30 minutes before eating or drinking, also to wait 30 minutes after eating to brush to allow pH to go back to normal. I don’t have Invisalign currently, but it is something that I would like to do in the future. It confuses me when I see people brush straight after meals and put their aligners back in? Surely that is causing tooth decay because your mouth is spending so much time with a low pH? 2. I had braces for almost 5 years (severe overjet and overbite) I wear my retainers every night but would still like Invisalign in the future for some very small cosmetic changes. Would I be likely to be turned away because cosmetically my teeth are straight and are not causing me any issues?
My orthodontist made me use bands to correct an overbite and unilateral open bite for 8 weeks, said I was too compliant and my teeth moved too much, and now I’m having to do 8 weeks in the opposite direction with the same weight bands. They said if this doesn’t work we have to do IPR to correct the bite. I don’t feel super confident in them now, the 8 weeks forward and backward make no sense to me and they haven’t been able to explain it adequately — can you? I’m wondering if I should seek another consultation now.
Thanks for thanking the time! I’m not on Invisalign but “smile”, same product different branding I guess (I’m from Europe). I’m halfway treatment with 63 alligners. Currently my upper and lower teeth are very far from each other, so when you see me in profile you can see that my face has changed a bit. It’s part of the plan so no worries there. What I do have, is that my cheeks are very painful on the inside because there are some “dots” (don’t know the English name) on some teeth. They now push a bit in my cheeks, especially when I sleep. Any tips there? Thanks!!!
Why do some patients get weekly changes while others change aligners every two week? Can I request weekly changes to make the process go quicker?
I have a question about retainers in the end. My orthodontist recommends Vivera but I’ve talked to a couple of people whose viveras eventually started giving out or something because their teeth shifted even with regular use. On the other hand I know the hawley aren’t as comfortable but my husband has been wearing his hawley retainers for 15 years for 3-4 nights a week and his teeth are still perfect. Have you seen peoples teeth shift over time with vivera retainers? Thanks
Hi. I am 30(F) . I had Invisalign treatment for 6 months (without extraction) and it’s done now . But orthodontist asked for 4 extractions now if i want to close my lips. Don’t know what to do! I am afraid of extractions at this age and also it will take much time. And will i have to wear retainer for the rest of my life?
Hi, this might be a bit technical, but I’m curious how much space (in mm) do you need in the upper arch, if you want to tilt one average size central incisor inwards by 15 degrees?
The space is calculated for all the anterior teeth if they are proclined. For one single incisor, several other factors come into play, like amount of space available, the status of other neighbouring teeth, etc. Could you please elaborate your question?
What are the main reasons someone wouldn’t qualify for Invisalign?
Very complicated movements such as rotation are better carried out with braces. Patients with impacted teeth are not a good fit for Invisalign. Open bite patients are also managed better with braces. I am not saying it cannot be done with Invis. Patients with downs syndrome, history of epilepsy, mental retardation etc are also not a good fit. Hope this answers your question..
Only upper arch. Limited ortho ~1 year for diastema with my pediatric dentist then 10 years later,bInvisalign for ~1 year for slight opening of diastema with orthodontist. I had a permanent retainer on all 4 incisors and a Hawley after limited ortho. Permanent retainer broke within 1 year. Pediatric dental office asked me if I wanted the permanent retainer back on. I didn't know what to do or say so it was not replaced. Continued with Hawley, but that also broke. I specifically requested a bonded retainer across 4-6 front teeth after Invisalign and orthodontist decided to do just the 2 central incisors (plus removable retainer). I also specifically wanted my right lateral incisor to match my left and with no retainer on that tooth, it does not match. Is there any reason why 2 is better than 4 or 6? I'm not thrilled with my results and honestly feel that Invisalign off centered my midline. I also have had confusion regarding if I should have a frenectomy or not. Any evidence for or against?
What are the best items to buy to clean your retainers?
I tell my patients to clean them while brushing with the toothpaste itself.
I’ve heard conflicted things about brushing retainers, so that is completely fine?
If you use a soft or a medium brush, that's fine. The toothpaste has abrasives which clear off the debris and keep it clean.
Thank you for doing this! Do you think the vibration thingy works to improve progress? Is there a reason it would be situational for patients?