Clincheck not like reality

[SimoSorriso]

Hello all,
I have a concern about my Invisalign treatment that is worrying me a lot now.
My teeth are really really crocked but no only they are badly rotated so not aligned but also they crocked vertically. The slightly bend to the right side.
On the clincheck it's hard to tell because the rest of the face is not there so my dentist can rotate the image as he wants but this will never shows the total result with the rest of my face!
I told him that I had concerns about that but he said that I do not have this problem, sure looking at the clincheck I don't see it but if I look my self in the mirror I can see my teeth straightening nice but they are still crocked vertically bending from one side!
Is this something that I could fix with a refinement or it should be planned up front?

Thanks!

[DrJasonKTam]

My advice is to make sure you do as much as you can in your initial sets, ie not wait for refinement. One way to start is to ask your doctor to communicate with the technician to have them understand how to set up your teeth in the ClinCheck with the angulation of your teeth, and how they should look relative to the ground.

If all of your teeth have the same angulation and they have no direction to follow, they will simply make the long axis perpendicular to the floor. Hope this helps.

[SimoSorriso]

Hello Dr Tam
and thank you for your reply. I was thinking about that something could be done with the refinements since I knew that all the aligners are done from the begin of the treatment. Can I change my aligners during the treatment or you meant additional aligners?

Is this one of the reasons why I should have chosen an ortho instead of a dentist??!!

Thanks again!

[DrJasonKTam]

There are some issues that are actually harder to correct in refinement, depending on the position of the teeth at the time. When teeth are crooked using Invisalign, specific movements may be actually easier than if they are aligned.

You may experience this concern whether you are using an orthodontist or a dentist. The key is that you want an experienced Invisalign doctor who understand your concerns before treatment. By conveying your concerns before treatment begins, the doctor can tell you whether your issues can be corrected using Invisalign, how they can be addressed, and talk to you about any alternatives.

[SimoSorriso]

First of all thanks a lot Dr. Tam for your helpful contributions to this forum.

Secondly based on your reply I'd like to ask you a question: if some issues are better to be addressed during the regular treatment how this could be done if the whole set of aligners is already been created?
What I'm saying is that I believe my clincheck does not identify properly my problem since needs to be associated with the rest of my mouth and face, so I think my Invisalign final result will look ok from a teeth prospective but very bad in the full picture of my smile.

Can I align vertically my teeth with mid-treatment refinements and after that continue my normal cycle of aligners?

Thanks again for your help!

[DrJasonKTam]

My pleasure Slim.

There are times I plan to correct certain problems with mid-course correction or refinement. Those cases are not that frequent, however. As you mentioned, whatever you see in the ClinCheck, if planned properly, is what should generally happen. You might find this helpful:

http://www.torontobraces.ca/gettingstarted/#5

Speak to your doctor to see if it is his/her plan to address certain issues first, before others. Also, discuss your "chief complaint", ie your reasons for wanting treatment. This kind of communication is essential since many patients and doctors have a different idea of what the final result should look like. Good luck!