Metal Mouth Message Board

Well ..... I thought I would come on and do an update now that my Invisalign journey is nearly finished. I haven't posted much for the last year or so, and thought it might be helpful to sum up some of the things I have experienced and learnt.

Things that were easy:

• - Pushing lower incisors forwards and backwards. The tooth that looked the worst (a lower incisor) was actually one of the fastest and easiest to move.
  - Actually wearing the trays was pretty easy too - my lisping lasted a few days and after that no problems. There was a small amount of pain the first morning of new trays, but no more than I experience from a mild headache. I didn't need the super-strength pain killers I had bought in preparation. [NOTE – Except for removing early trays, you will occasionally reach a certain point in the middle of removing them that really hurts. Don’t panic, just keep going].
  - IPR (shaving the teeth) was not much different to filing my finger nails. Certainly I never experienced any pain. It is very disconcerting to know someone is filing your teeth away though, especially those visible front incisors!
  - Intrusion (pushing teeth into the gumline). I had one slightly longer central incisor I asked the dentist to even up, and Invisalign managed it no problems. Unfortunately, a downside to this is that my molars seems to have experienced the same thing just as a side effect of me biting down on the trays, and despite not working on my bite, it is every-so-slightly open. I am hoping this will settle once I am finished and spend my days without trays in.

Things that were hard:

• - Moving roots of teeth. Luckily my teeth did not have to move far, because their roots pretty much stayed where they were. This means that they can look slightly "tipped" - not a problem with small movements, but I am glad I wasn't trying to move them far along the gumline. Unfortunately for me it meant that I have quite a large dreaded black triangle on the lower set of teeth. See “Disappointments” further down!
  - Rotating an eye tooth. That one tooth has probably been responsible for about a year of the time taken for me to finish up with Invisalign!!!!! I had elastics on it for a short time, which worked for rotation, but started to tip the tooth, so had to stop (I think that was probably a little beyond my dentist's ability). It then took an age to resolve the tipping. It has finally started to come good with the last set of refinement. The style of attachment has changed though, and I had a different one for the last refinements. This one seems to be working a treat - both for rotation and extrusion.

What about things that were a pain in the butt?

• - Cleaning seems so easy at first, but was becoming annoying by the second year … LOL. It is a double edged sword though, because my teeth are so much healthier and whiter!
  - The lack of snacks was also frustrating. It just got to be too much effort to take my braces out and clean them. AS a result I got skinnier. There seems to be a lot of debate about whether braces change your facial appearance. Well my teeth have not moved much, and I haven’t had any extracted, but I still look different – I put that SOLELY down to losing about half a stone because I haven’t been eating snacks! :O On me, that’s not a good thing, so I’m looking forward to biccies and choccies again…
  - As for tea and coffee, nope couldn’t give those up. I religiously took my braces out for a cuppa for the first year or so, but realised that I was spending too long without them in. So I switched to drinking it slightly cooler, but leaving my braces in. The trays I’ve kept in longer than 2 weeks have stained a skanky colour but I reckon it has been the better strategy for me.

What gave me a fright?

• - I had jaw pain for a couple of weeks (I’ve just found an old thread about it!) and was terrified that I was starting to get TMJ after never suffering with it before. Luckily it eased up a little, and then went away with the next tray – so the people who told me not to panic were right.
  - I am also still a little concerned that my bite is not comfortably settled. It started out comfortable, but not perfect, and we didn’t work on it. I am hoping that after I am completely finished, it will settle back down again, with my molars meeting rather than a couple of incisor points. If not, I may need to revisit it….
  - Wobbly teeth! They seemed quite loose at times, but that just means the treatment is working, honest. They are all still in my head
  - Teeth moving the wrong way. EVERY time I had a suspicion this was happening, I was correct. It shows up as a gap between your aligner and the tooth, and happened quite a bit with me. By the end of my first set of treatment, at least half of my front teeth were not quite fitting the aligner, some worse than others. I guess it is not a surprise with 31/17 initial aligners. The first refinement went better, and this second refinement virtually no gaps.

THE IMPORTANT BIT – WHAT HAS BEEN DISAPPOINTING? I think my teeth are as good as they are going to get with Invisalign, I have great respect for my dentist and I am happy with the outcome BUT they are not perfect. WHY?

• - My teeth were not perfect to start with. The two lateral incisors mismatch in shape, and one of the centrals is discoloured and no amount of invisalign can correct that. This is not a surprise to me, but a simple reminder to anyone considering Invisalign that they have to take the raw materials into consideration
  - A surprise for me though are the gaps in my gums (the dreaded black triangle). When teeth are crooked, the gums adjust to the crooked shape – so there are no gaps between gums and teeth. As the teeth are straightened out, there just simply isn’t enough gum to fill the spaces created where the teeth meet the gums. This can be corrected to a certain extent by IPR, but for me there was too much gum loss in a couple of places. My initial Clincheck didn’t show this gum loss, but I noticed other people’s now seem to show it. If it is somewhere noticeable, you may want to discuss it with your dentist. I am not sure there is any solution though?
  - This is not (for many of us) a perfect solution. I started out just wanting improvements, but ended up correcting a lot more (it’s addictive!!!). After a while the desire for a perfect set of teeth took over worrying about how visible my braces were. It seems to me though, that Invisalign struggles with very fine adjustments, simply because there is a limit to the number of refinements. This can easily be done with fixed braces, where the dentist can make tweaks at each visit. So I have teeth that might look better with another mm or so of movement, but to do so would mean putting attachments on virtually every tooth – effectively fixed braces Instead I have accepted that my teeth look a lot better, and more importantly, are straight enough to be much healthier as I grow older.

And I have a great, natural smile

Yay congrats! Post pictures!

Wobblydeb - you had a lot of interesting comments and a good summary of what to expect.

In my case, Invisalign not moving tooth roots was important to my treatment - I had a resorbed tooth root that my orthodontist was very concerned about and preferred Invisalign for this reason.

You mentioned that your teeth was as good as they are going to get with Invisalign. My doc has gone with some alternate treatments to finish what couldn't be done with Invisalign. We couldn't get the vertical correction with Invisalign only, so I now have metal buttons and elastics on my back teeth. I finished my last Invisalign trays in April and now have partial Essix retainers on my front eight upper and lowers to maintain space while the rear teeth grow in.

Even though my case has involved other techniques (now metal, plastic and rubber bands) nobody can see that I have braces. It now looks like everything is going to come out perfect even though its taking longer than originally expected. I think it was mentioned earlier that Invisalign was a technique and in my case it's been one of several used to get the needed results. This is something that patients should discuss with their docs if Invisalign can't do everything needed - there can be a combination of options!!

For me the real things that were a real pain is having to remove aligners everytime I want eat something. This now includes 2 retainers and elastics. The metal buttons for my elastics are very uncomfortable with the rubber bands out, but this seems to be doing what is needed. Hopefully I'll finish in a few months - taking somewhat over 2 years.

I started out with relatively straight looking teeth, but had a bite problem that was causing painful gum damage. My orthodontist noted it wasn't that long ago that dentures would have been my primary option. While going through 2 years of ortho hasn't been that easy, I would much rather spend $5K on braces than on dentures!!

thanks for sharing, Wobblydeb
A lot of what you say I can relate to!

Thanks for the summary - can you post a photo of the 'black triangles'?