Metal Mouth Message Board

I'm gonna vent a little....

I was so excited when my ortho's office called yesterday asking if I could come in at 12 today. I had had my impressions taken a little over 3 1/2 weeks ago so I wasn't sure if it was to see the clinicheck or if my aligners had come in.

Well, it turns out, my aligners had come in. And I went in and about 15 minutes later I left with aligners in my mouth and disappointment. Nothing's wrong with the aligners, they're great, except that for a while I was wondering if the top aligners were the wrong ones because they were way tighter than the bottoms and my two front teeth are extremely sore when I take them out and put them in (especially putting them back on) but I'm sure that's to be expected.

Anyway, my point is that I'm very disappointed that I'm paying a lot of money for this treatment process ($5400) and I feel like the ortho office isn't earning the money I'm dishing out. One of the ortho-assistants came and got me and had me sit in a chair, my aligners were already opened and laying out on a tray. She was like here are your aligners, you'll be changing them out every two weeks. Go ahead and put them on. I was like, wow, I thought we'd be going over the clinicheck and the process, what to expect, how to care for them...you know, things they should tell you without you having to ask. So, remembering what I read about some people experiencing sore throats after putting their first aligners in, I asked, "have they been washed? Do you mind if I rinse them out first before I put them in?" I swear she looked at me like i had 12 heads. Then tried to tell me how they come in there own individually sealed bags. (So! They still should be at least rinsed before someone inserts them into their mouth. )

I went and rinsed them out and then I went to proceed putting them in. I started with the bottom first, I wasn't given a mirror to look in so I couldn't see what I was doing, but after about 10seconds of struggling, it was on, or at least I think it was, I didn't hear a "snap" or anything to let me know they were only all the way. Then I picked up the top and I struggled for a while before the assistant finally handed me a mirror. (It was shockingly a lot tighter than the bottom). At that moment the Orthodontist was walking by to go see a patient and the tech asked him to stop and check my aligners. After literally 5 seconds of looking into my mouth, he said they were fine. (Okay...when do I get to see the clinicheck? What am I supposed to expect from my treatment?)

The tech/assistant whatever, then told me about the two different containers and that my next appointment would be in 4 weeks. She was then getting ready to hand me my little invisilign baggie and send me on my merry way. (Wait-a-darn-minute! Is anyone going to explain my treatment to me?...apparently not, so I had to start asking questions)

"Do I have to any attachments put on?" Oh, yeah, she responds, she then pulls up my clinicheck on the computer, and says 5 on the bottom, 5 on the top (wow, that's a lot. My teeth aren't bad. I have a little gap inbetween my 2 front teeth that no one seems to notice, so they say. To me it stands out like a big neon sign) "Okay." (I notice two of them are on the teeth right next to my upper front teeth. Oh boy, I don't like that. So I ask) "Is it possible to have those two put on the back of my teeth?" No, she says, but I notice on the clinicheck that two of my bottom molars have attachments on the inside. (Okay, if those are on the back of my teeth, why can't those other two be put on the back of my teeth. But i give up.)

She then looks at me expectantly, likes she's ready for me to get up and leave. "Can I see the finished outcome on the clinicheck?" oh, yeah, okay, she says. (ARE YOU SERIOUS!?!? Why am I having to ask to see this? Don't you want your patients to be informed?) So I see it, it looks nice. I can't wait! But, as you guessed I'm the one that has to ask her how many trays I have to wear. 16, she says. (Not bad...I like that).

I then ask her about caring and wearing where, she leaves out quite a bit of vital information, which I wouldn't have known about if it wasn't for this site.

How frustrating. I sure hope that my future appointments aren't as rushed or as less informative as this one. I want to feel like a valued patient. $5400 might seem like pocket change to them, but it's 10 fortunes to me. Not at all what I expected from a "Premier Provider", especially, after my consultation was soooo detailed.

Otherwise I like them..so far, I'm only 12 hours in. Eating dinner was fun, putting them back in after, was not so much. However, I laugh because wearing the aligners makes my gap look like it's closed, which it's not. Pretty cool illusion though!

So sorry you had such a rotten first appointment - I really feel for you! Personally I'd be writing a letter of complaint and to ask for a more detailed consult with your ortho at your next appointment (but I'm a narky patient!).

Good news that its only 16 trays though ....yey!

Hiya

I can't believe they didn't show you your Clinicheck video!
My Ortho showed me the video then I had to sign a form that I was happy to go ahead with it before he ordered the alligners.

You should be having a word with him, the least he could do is show you how to put them on and off again. Has he said anyting about refinements and retainers? Prob questions you should pin him down on now.

I've lots of attatchments which I'm pretty gutted about, in a couple of weeks i'm getting the last one put on my crooked front tooth - like it doesn't stick out enough already!!! I'll be asked about it going on the back of it now.

You can see my clinivideo if you want its,

http://iwantstraightteeth.blogspot.com/

Lol, thanks guys! I am going to demand that the ortho actually deal with me next time. I was really surprised by the lack of care yesterday because my consult and the appointment to have the impressions made were far better. Plus, I've heard lots of good things about the ortho.

Thanks for letting me look at your clinicheck. Your blog is hilarious. You've made me feel better about having the attachments put on.

I'll let you know how it goes.

I have enjoyed posting in these forums to help educate the board on various topics. Posts like these are fantastic to hear the perspective of the patient, to educate myself.

One of our goals is to make sure that patients are educated, excited, and happy about treatment, on their path to a great smile. Much of the education is before treatment begins, but we continue to keep our patients updated along the way.

As for having the orthodontist sit down with you and fit your aligners him or herself, please note that having a DA work with you for Invisalign is no different from an appointment with braces. A lot of time and effort is in the planning of your treatment. An orthodontists job is to use their training and expertise to make sure your treatment stays on track, not necessarily to be the one performing the task.

Keep in mind that you have been reading these forums and know a lot about the types of things involved in Invisalign. There is a wealth of many many patients on this site. Not everyone walking into an office has the knowledge that you have. At the same time, the office is not necessarily bad or rushed if they do not do everything you have heard about here. In fact, you may actually know more about the various issues with Invisalign than the assistant or orthodontist.

It may help for you to constructively speak to your orthodontist, the office manager, or treatment coordinator to let them know how you feel. You definitely have some valid concerns.

Don't let this experience curb your enthusiasm for treatment. Good luck!

mjshorses, I agree with the doctor that you shouldn't let this one appointment curb your enthusiasm. Not all patients want to know all the details. After a few times, your appointments will become routine. Just have your questions or concerns ready and start asking when your appointment starts.

My experience when I first got my aligners wasn't as bad, but I may have been asking a lot of questions and I knew a lot of stuff from reading here. When I got my impressions I knew about the clincheck process and discussed seeing it before it was approved. If I hadn't show interest in seeing it maybe my doctor wouldn't have even shown me, and he's a premier provider too.

About rinsing the new aligners off, I think it helps just to have the water act as a lubricant when pressing them onto your teeth.

And I always seem to have to ask the assistant to hold a mirror when I'm putting my new aligners in. I'm just so concerned about bending/breaking them if I don't see that they are where they're supposed to be.

My ortho puts them on and takes them off for me a few times before he lets me loose on them - either he thinks i'm going to break them (6 attatchments, broken and counting) or I just won't be able to do it.

Both are right.

Good luck.

My ortho puts them on and takes them off for me a few times before he lets me loose on them - either he thinks i'm going to break them (6 attatchments, broken and counting) or I just won't be able to do it.

Both are right.

Good luck.

Had impressions taken on April 20, 2009.
Got a call this morning, I would be there tomorrow at 8:00 to pick up the aligners.

Never had a chance to look at my Clinicheck stuff.... Got curious once and asked the techie and she said I wll be able to see that when I get 1st set of aligners. Hmmm.. If I do not see it tomorrow I will have a word witht the doctor. The doctor seems to be a little bit stingy with spending time with patients.

Thanks for your post, now I know what all I should be asking tomorrow if they turn out to be sluggish.

To the last poster-
you are so lucky! I have been waiting, and waiting and waiting for my aligners .....it has been WEEKS since my impressions, and it's another 3 weeks until my appointment to go back (when the aligners should be here) total of 6 weeks expected ....I am getting so restless!!!!!!

They said theyd call if the aligners arrive before my appnt on june 5th...i am so sick of waiting!!!

Hi there,
The majority of each of my appointments is with the assistant. At each appointment, just like you, he dashes in, checks them, and then dashes out. Except, poor man, I don't let him get away! I come pre-armed with a set of questions about almost every aspect of my treatment and fire them off.

I think my original fitting appointment was fairly similar to yours. They didn't give me a huge amount of info. However, like you I was well informed so I asked lots of questions and got the information I felt I needed.

I'm sure if other people rate your ortho then he is good. I don't think it's a major issue that he doesn't do most of the appointment.

I must say though DrJasonKTam your point that "In fact, you may actually know more about the various issues with Invisalign than the assistant or orthodontist. " did worry me slightly. I really hope that I haven't gained more knowledge about Invisalign by reading forums for a few weeks than the man that is treating me has. I fear in some cases you may be correct though. Perhaps these sites should be part of the required Invisalign training!

Sorry, by the "he" above I meant my ortho!

I feel lucky that I see my ortho at every visit and don't see an assistant unless something unusual is needed. He's been very tolerant of me as a patient - even when I bring in articles from the web that bring up questions about my treatment. He seems to like the fact I am doing side research and does take the time to explain any problems.

In my case, I may be getting special treatment as I am an older patient who has experienced a major relapse of a deep overbite. This is probably a lot more interesting to work on than a 14 year old!!

I must say though DrJasonKTam your point that "In fact, you may actually know more about the various issues with Invisalign than the assistant or orthodontist. " did worry me slightly. I really hope that I haven't gained more knowledge about Invisalign by reading forums for a few weeks than the man that is treating me has. I fear in some cases you may be correct though. Perhaps these sites should be part of the required Invisalign training![/quote]

I'm just telling it as it is. I see a lot of 2nd opinions and get a lot of questions from Invisalign certified doctors who have run into trouble during treatment. Having taught Invisalign to orthodontists, dentists, and dental staff, I believe this is one of the major reasons for "Invisalign not working". The other major component is patient compliance.

Still, most people wrongly think the computer is responsible for your treatment. There is so much involved in proper sequencing, attachments, IPR, etc required.

Truthfully, with the content on this forum, there is a wealth of information. Very few, except some of the most experienced providers (Premier and Elite) will have encountered and successfully dealt with the topics discussed.

Now on top of the technical aspects of Invisalign, there's also patient management and communication... a completely separate issue!

Dr. Tam,

I think you have some really good comments on the importance of communications in ortho treatment and it applies to patients as well as doctors.

When a patient seeks treatment, or referred, it is a major decision that involves as much as a couple of years of inconvenience and discomfort, in addition to substantial cost. This is difficult enough without going in to find your treatment delegated to assistants with minimal doctor attention. While the doc may think this is efficiency, the result is patients start self diagnosing themselves on the web or venting their disgust on message boards rather than the correct forum - the ortho's office. It is important for docs to understand why the patient is there and their specific concerns, and to note how progress is being made at each visit. The key point is for the doctor, not the assistant, to open this conversation and draw out problems.

Its also important for the patients to advise their dentists and orthos of any specific issues, best done in writing. This gives everyone a point of reference, and may help identify problems a doctor may overlook. Patients often expect their doctors to catch everything.

In my case, I've had two previous ortho treatments that failed, and I had decided there was no way I was ever going to do this again - even though I was experience a lot of discomfort from my condition. It took comments from my wife, dentist and ortho to convince me otherwise. My ortho did a great job of explaining why I had a recurrent problem and the difficulties in treating it. His time explaining all of this made me feel better that he would have a better outcome.

The biggest mistake I have made in my dental treatment is not documenting my past history, including the two ortho treatments when I started going to my present dentist around 17 years ago. I thought he would catch any problems before they became serious. My relapse happened over 20 years, so the changes were so slow as to not be noticeable. When I first experienced gum irritation, it was diagnosed as a "coffee burn". At this point I realized my dentist wasn't looking for a new ortho problem in a person my age. I then did the detailed write-up I should have done in the first place and gave to my dentist and ortho. I could have avoided a lot of discomfort and a couple of emergency dentist visits if I had done this in the first place.