Invisalign Question

[Icesk8er]

Howdy Docs! Thanks for taking a moment to read (and hopefully answer) my question.

I'm currently in my 24th month of Invisalign treatment. I went through my first 32 aligners and needed a mid-course revision and am now on my 18th aligners of the "revised" set of trays (with one more to go on the bottom, 22 more to go on the top). I asked the doctor whether it would be faster to just switch me to ceramics at this point because, frankly, I'm sick of Invisalgin and I'm not sure it's doing the best job. He had me take out my aligners to look at my bite and said I'd need full braces, top and bottom (I was thinking just top since that's all I have left to go) to fix my bite at this point and that it wouldn't be any faster.

Which leads me to my question: if my bite is still that messed up after 2 years of treatment and my bottom teeth, which are essentially done, are still messed up from a functional standpoint, doesn't it sound to you like I am going to end up in braces at the end of this anyway? My ortho said no, but I can't see how that can be if I would need at least 12 months of metal from where I am now.

Help!

Mary

[Icesk8er]

Bump!

Anyone, anyone? Buhler? Buhler?

[dr.j]

I put on my letterhad that i do Invisalign and I am thinking about taking it off. I see nothing but a majority of dissatified pts who almost all of them say "had I known it would take this long I would've gotten braces". It costs you the patient and me the doctor $$$ for a switch to fixed appliances (braces). I have no idea what your bite looks like but I can only say full braces is sometimes indicated at the end of Invisalign. Some people have success stories and maybe I am low on a learning curve b/c like it or not - not all Invisalign doctors are created equal - but I personally see that the party is over with Invisalign with me - but I am a traditionalist and admittedly not very acceptant of every orthodontic "magic bullet" that comes out each year.


DR.J

[Invisaguy]

I put on my letterhad that i do Invisalign and I am thinking about taking it off. I see nothing but a majority of dissatified pts who almost all of them say "had I known it would take this long I would've gotten braces". It costs you the patient and me the doctor $$$ for a switch to fixed appliances (braces). I have no idea what your bite looks like but I can only say full braces is sometimes indicated at the end of Invisalign. Some people have success stories and maybe I am low on a learning curve b/c like it or not - not all Invisalign doctors are created equal - but I personally see that the party is over with Invisalign with me - but I am a traditionalist and admittedly not very acceptant of every orthodontic "magic bullet" that comes out each year.


DR.J

I always seem to find myself attempting to defend invisalign on this site. I don't know, maybe it's because I don't want to feel like I got sold on something that might not work. However, as far as all the negative comments in regards to invisalign on this site, I think they may be blown out of proportion. I like to read a lot on the subject of invisalign and braces in general (as we all do). There are other sites and discussion groups out there for invisalign and the general opinion seems to be invisalign is working well or has already finished treatment without issue (with the exception of refinements). I don't get why this site is so down on it but I think maybe it's a small group of people who are pushing the negativity. I think everyone tends to forget that invisalign is "NOT" very good with complicated treatments nor does it advertise so. As you say Dr. J, it is up to the Dr. to determine the correct course of action when treating a patient and to make the right choice on the appliance while doing so. I am currently on aligner 16 U/L and have noticed really dramatic improvements and while I'm not counting my chickens before they hatch I am very confident that invisalign is going to work for me. I guess what I am getting at Dr. J, is that to indirectly refer to invisalign as "magic bullet" i.e just another attempt to avoid traditional methods is a bit unfair. I think that statement severely underates the technology, time, and effort put into Invisalign. I know..I know, I sound like a Invisalign sales rep but I think a statement like that would be a deterent to someone who could benefit greatly from the use of invisalign. I understand it's just your opinion but of course your the doc and people are going to listen to you.

[Icesk8er]

Invisaguy,

I don't think that the issue is with Invisalign per se, but rather with peoples expectations of what it can do. I have been in mine for 2 years now and, don't get me wrong, my teeth look much better than when I started. I can see where you might be very happy with yours.

However, that being said, I was given an initial treatment time of 15 months (and I'm in month 24 with at least 12 more to go). My bite has not improved at all (despite my doctor telling me that my bite was being aligned during the first year of treatment and therefore that is why I wasn't seeing results). And, I'm beginning to get an eerie feeling from my ortho that I'm going to need braces after my three year sentence is completed.

Is it Invisalgin's fault? Maybe. They did a very effective job of marketing on me before I ever set foot in an ortho's office, with commercials that stated problems could be fixed in a year or so and that they could fix crossbite's specifically (which I have and which is a fairly complicated fix from what I understand. If they had never mentioned they could fix a crossbite, I never would have sought treatment in them.)

Is it my ortho's fault? Maybe. He underestimated the treatment time in the first place, setting my expectations for a quick fix before the first mold had been made. He also insisted (and continues to insist) that Invisalign could fix my problem and has maintained that throughout my treatment, refusing to switch me to braces, even though Invisalign has failed with my upper teeth now TWICE.

And finally, is it my fault? Maybe. I told my ortho I would do nothing or Invisalign. Period. Doesn't give a guy a lot of options.

Bottom line, Invisalign is not for everyone. Hell, it's probably not for 30-40% of the people who get it, based on what I've read on this and other message boards. But where the fault lies for all of the people that are unhappy with it, that's for the individual to judge.

All the best,

M

[dr.j]

Invisaguy:

I not down on Invisalign per se. But I am on the other side of the coin than you guys. I have to deliver the results that patients are paying for. Everytime a kid or adult sits in my chair I have the stress of worrying that I am going to make them happy - on my dental license.

Also, let's put this in context. This website -esp.ask the doc - is mostly going to be utilized by folks that are having problems or worries that something is not working with their treatment. So most of our discussions are not going to be: "Rah Rah Braces!" but "What's the deal with this or that?"

Marketing of orthodontic products and systems, just like Rx drugs, have skipped the docs and gone straight to the public. Not all of the info is presented in the light the doctors would suggest. I could go on forever on this but there is a place for Invisalign but not as big as the one it currently occupies in many practices. I appreciate your comments. I love contraversy b/c it sparks improvements in how we treat our patients.
Dr.J

[invisagirl]

Just had to weigh in on the issue. I'm a member of a few Invisalign boards and it seems that those who are told up front that the Invisalign results will not be perfect are better prepared for the bumps in the road. I was told I would have perfect results and after 2.5 years it became obvious it wasn't going to happen. The new ortho told me that because of age, etc the results wouldn't be "perfect" but knowing that upfront has made the process easier (so far).

[Dr. Randall]

Marketing of orthodontic products and systems, just like Rx drugs, have skipped the docs and gone straight to the public. Not all of the info is presented in the light the doctors would suggest. I could go on forever on this but there is a place for Invisalign but not as big as the one it currently occupies in many practices. I appreciate your comments. I love contraversy b/c it sparks improvements in how we treat our patients.
Dr.J

You are a man (orthodontist) after my own heart. It scares me that so many people hear are affected by the marketing (online or Invisialign commercials) when they don't really have the basis for understanding the issues that we face.

Invisalign works, but not as consistantly as us doctors would like to see. The same is true for other orthodontic technologies that people read about. Ask your doctors about things and question when they say that one technique or bracket or whatever is the only way to go.

Randall