clincheck seems fishy...

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#1 Post by **clinchick** » Tue Mar 31, 2009 1:14 pm

I just looked at my clincheck on my ortho's website and I don't get it-- while my front teeth are straightening out, all my molars look like they're simply making space by moving out, as if my jaw is widening. That is obviously impossible.

Plus, the clincheck shows 21 sets of trays and my actual aligners show that the set only has 19 trays.

I haven't seen the ortho, who is an Invisalign Premium Elite provider, since I had my consult. Her staff seem nice enough, but I'm not really getting much guidance here about IPR (which she had mentioned during the consult) or anything else. I took it upon myself to order some chewies online because the bottom aligners aren't sitting properly on my teeth. I'm paying too much for this. Can anyone shed some light before I call up the office?

#2 Post by **gdriftr** » Tue Mar 31, 2009 1:56 pm

I think it's quite possible for the molars to move out a bit, or more likely the tops of the teeth if they are angled in at the moment.

Regarding the number of trays, my dentist made adjustments after the first clincheck. Maybe yours did too and you are looking at a different version?

#3 Post by **shagsoprano** » Tue Mar 31, 2009 5:32 pm

Hey, I don't know your ortho, haven't seen your clinchek, or the rest of it. But you need to give things a chance. If you've researched this doc's patient history, and you trust him/her, let things proceed for a little while. Anxiety about looks, money, quackery, etc. is normal, and if all you're doing is venting here, that's fine. But make sure there's a definite problem before confronting him/her about the treatment. Not all of these invisalign clinicians/specialists have superior communication skills or bedside manner and a lot of that is a question of style or personal preference. I would just advise calm unless evidence of something really wrong occurs. Then you have every right to voice any and all concerns from that point forward. Who knows, yours may be a special case requiring much closer scrutiny and you're the best one to let the ortho know that early and often. Anyway good luck, you'll love the results.

#4 Post by **myhollywoodsmile** » Tue Mar 31, 2009 6:29 pm

Hi there,

The widening of the molars is standard, and they certainly can widen your smile. I'm not exactly sure how it works, but that is the way they make more room. There is a great blog called smiling wide open and the lady on there very definitely had her molars moved out. http://smilingwideopen.blogspot.com/
If you look at her early to her late aligners the shape is dramatically different.

If you look at my clincheck on my blog link below you will see that mine appear to do the same. I haven't actually asked my ortho how that is achieved, but they have to do it, as I have a lot of overcrowding.

Anyway, ask your ortho, I'm sure there is a simple explanation.

#5 Post by **jnet** » Wed Apr 01, 2009 6:25 am

I am on aligner no. 28 of 33/36. A couple of weeks ago, I was informed by my ortho that the last 3 sets of aligners (34-36) for my bottoms are considered overcorrection and they told me I may not need them if all is well when I'm finished with set 33. This was exciting news to me - that I may be done 6 weeks earlier than expected!

Anyway, that is another possible reason why your clincheck shows 21, but they've only given you 19. The extras may be for overcorrection that may or may not be necessary.

#6 Post by **clinchick** » Wed Apr 01, 2009 8:13 am

Thanks for the advice, very helpful indeed. The reply about overcorrection makes a lot of sense. So far treatment has been fine, I'll just make sure to ask my ortho during the next appointment about the Clincheck/IPR. Guess I will trust that I am not the expert here and defer to my ortho (who, by the way, has great bedside manner).

Great blog, myhollywoodsmile!! Your teeth look terrific.

#7 Post by **John37** » Thu Apr 02, 2009 12:27 am

My upper molars and premolars moved outward also. It is possible. (See the link to my clincheck videos.) It is called a crossbite I think.

They can only move them as far as the jaw will allow though. If they try to move them too far then there won't be enough jaw bone to support the tooth which will result in the gum receding. The gum can only go a few millimeters past where the bone is.

It's true about the overcorrection trays. Sometimes they do that. My refinements have 14U/14L but 3 of those are overcorrection in which the front teeth all kind of move inward to close any gaps I have.

On each set of aligners there should be instructions for any IPR that you need on the package. It should say something like Lower: 3.3-3.2, 0.1mm. The doctor is supposed to do the IPR before you start those aligners. My dentist seemed to just do all the IPR at the beginning. If you have crowding, then they should be checking to make sure your teeth aren't crowded too much for the aligners to move them. Some of my teeth at one point were too close so they shaved a tiny bit more away.

The aligners should fit pretty good. If they are not fitting, then make sure you tell them. Although they should check that at your regular appointments. I usually see an assistant and she lets the dentist know if there is anything unusual like tightness between teeth or aligners not fitting correctly on some teeth. But I noticed that she will sometimes miss something and I'll have to point it out to her.

I was going every 4 weeks for my first year. With my refinements there is less movement, so they've been giving me 3 sets of aligners at once, so I only go back every 6 weeks.

How often to you have to go back for them to check to make sure everything is moving correctly?

#8 Post by **clinchick** » Thu Apr 02, 2009 7:00 am

I have to go back every 6 weeks, and they give me three sets at a time. The first three sets of trays don't have those markings for IPR on them you mentioned. Just popped a new set in last night and my right molars feel very wonky, as if they need to move out to fit the tray, hmm... Woke up mouth breathing!

Thanks for mentioning that it's called a crossbite-- my ortho didn't really discuss with me in technical terms what's going on in my mouth.

Have any of you used chewies to move your teeth faster or get the trays to clamp over the teeth more tightly?

#9 Post by **John37** » Thu Apr 02, 2009 5:52 pm

My dentist gives me chewies, but I don't use them a lot. I use them just to press the aligners on good when I first put them in. I'm not sure how much it would help to chew on them during the day, but they tell me to do it...or at least used to tell me earlier on in the treatment.

#10 Post by **clinchick** » Wed Apr 08, 2009 9:39 am

Has anyone found that they have increased difficulty getting the trays off and/or increased pain in the second week of a set?

My lower tray of set #2 is suddenly killing me and my teeth are super sensitive (I know it's partially from them moving because it's suddenly hard to get floss in between my molars). The muscles around my jaw feel incredibly tender, almost bruised.

Not sure why this would happen if I'm supposed to be fitting into the trays more easily at the end of the set. Maybe I'm grinding really hard and I don't notice?

#11 Post by **John37** » Wed Apr 08, 2009 6:46 pm

Mine are always less painful and easier to take off and put on the second week. Maybe you are grinding more in your sleep or biting down more during the day.

They should probably check, but mention to your ortho that the floss is not fitting between your teeth well. It could be the first sign that the trays off going off track, or maybe you need a little IPR.

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