Metal Mouth Message Board

My case is definitely not one where I simply change trays every two weeks then go to retainers when finished. The past month or so, I've been wearing the same aligners that are cut off to expose my molars and get them to grow together. I was hoping this was the last step and that it wouldn't take too long. At this point, my right molars are growing out but the left ones aren't. My orthodontist has told me at this point I'll probably need elastics to get the left molars to come out. Then I'll need refinements after that to open my front bite more.

Originally, I was told it would take 18 months, which is about now. But this was before my orthodontist found pre-existing conditions that complicated treatment and required a different method. Given how I'm progressing, it will probably be more like 2 years plus.

I started out with 21 trays thinking like many that once I went through this in 42 weeks, I would be close to finished even though I was told up front my case would be difficult to correct. I was hoping that having braces before would have made my case a simpler one.

I do think my orthodontist is doing a good job, both with treatment and with explaining what is going on. If you're considering Invisalign and have any underlying problems or pre-existing conditions, its definitely worth seeking out someone with advanced credentials.

I do wish there was a quicker way!!!

Hi Wireless

Stick with it. Sounds like the progress is moving along. This thread hints upon some things that others seeking Invisalign should consider:

1. Your treatment time and excitement about the number of trays you have in your first set may or may not have any relation to how long your treatment goes due to complications or refinement(s).

2. The average Invisalign treatment is shorter than the average braces case only because most Invisalign doctors do not treat malocclusions that are complicated.

3. Invisalign is a technique that requires modification to the way the aligners alone move the teeth. Just because the computer shows you something, doesn't mean it will actually happen.

4. Bites can be corrected with Invisalign, but it takes someone experienced to do it.

You've had a great attitude towards treatment thus far, so don't be discouraged and you will end up with a wonderful bite and smile!

Dr. Tam,

Your comments are very much on target - particularly for difficult cases.

I didn't do much research on Invisalign prior to starting treatment - I had gum inflamation from a deep bite that didn't allow much time to look around. What I had read indicated that I wasn't a candidate because of case complexity. My initial assessment was 18 months with regular braces.

My initial perception of Invisalign was very simplistic based on posts - very small but predicable movements would be made with each tray. I noticed a number of posts noting patients were willing to have a general dentist do the treatment as Invisalign's computer did all of the work.

From my case, the computer predictions don't apply since much of the movement is vertical and not easy to predict. My orthodontist is also doing things with individual aligners that aren't part of the computer prediction. He is a relatively young doctor who has an advanced degree in Orthodontics and has done a really good job of explaining why my problem is unique and difficult. I think he is also very creative in working with my problem. We've also made good progress in getting vertical movement - about 3 mm so far and without bite plates and other usual treatments for my condition.

With Invisalign its very easy to get hung up on the number of trays and estimated treatment time, as I did. If a complex case is involved, these things really don't apply well and there is going to be some frustration over the lack of predictability.

In retrospect, I think the computer simulations are a good marketing tool and may guide a general dentist through a basic problem. Otherwise, there is no substitute for the training and experience needed to address the unexpected in a complex case. I hope my experience helps someone else make a good decision about treatment.

In my case, there is more at stake than a great smile and bite - I get to keep my teeth!!