It's Invisalign's Fault !

My Dentist says: “It’s Invisalign’s Fault!”

My bite just feels a little off from what it was before I got my Invisalign.  My dentist says: “It’s Invisalign’s fault… sometimes that just happens with Invisalign.”  

This front tooth right here just didn’t get straight when I had Invisalign before. My dentist says “It’s Invisalign’s fault…sometimes that is all the straighter Invisalign will get the teeth.”

As an Orthodontist, I have heard comments like these many times in recent years from patients who have come into my office for a consultation regarding the results of their previous Invisalign treatment.  They have come in because they feel Invisalign didn’t work and it’s all Invisalign’s fault.  The only way the typical lay person would know what to blame is if their Invisalign Provider told them it was Invisalign’s fault rather than  offering any further recommendations or treatment alternatives to further correct these legitimate concerns.  Or, if they did offer an alternative, quoting an additional fee to “fix what Invisalign messed up”.

As I have made perfectly clear in these writings, Invisalign is not a cure-all and straight-all in orthodontics.  Yet, neither is any other “tool” in the Orthodontist’s available range of braces and appliances.  In fact, there are certain types of orthodontic mal-alignments and problems that there simply is no complete fix available short of extensive facial-jaw surgery to correct.  Generally speaking, these can and should be identified in advance before Invisalign or any braces are even recommended.   

So…Is it really Invisalign’s Fault?

Well…let me tell you about the “Plumber with One Wrench”.

Let’s imagine your home is equipped with a relatively standardized valve to turn the water on…and your homes valve is stuck closed.  So you call out a plumber to open the valve.  The plumber shows up with just one wrench that he knows how to use to open the valve.  He gives you the fee estimate, explains the process and shows you THE wrench he always uses to open the valve.  You assume he is “the expert” knows that wrench must be the answer to your problem, no other alternative was mentioned.  You approve, pay him the fee and “put him to work”.  He returns saying the job is complete but the value is only open half-way, the water is running but very slowly.  He says as he leaves your home…”It’s THE wrench’s fault...sometimes that is all the further THE wrench I use will open some valves.  Now that I tried it, I know yours happens to be one of them.”   As the door is closing you vaguely hear: “Oh by the way, THE wrench caused your valve to be struck in this position.  If you want that fixed…schedule another service call.”

So…is it really THE wrench’s fault…well…the wrench had a part to play, yes.  Certainly the wrench has some limitations since it apparently doesn’t work quite right sometimes.  Unfortunately, the Plumber seems to only knows that after there is a problem.  With only one wrench to work with, this Plumber fixed it the best he could. 

And so it is in orthodontic care, Invisalign is an absolutely wonderful orthodontic “wrench”; it works beautifully most of the time.  But what if it doesn’t, what does your Invisalign Provider have in their Orthodontic “toolbox” to offer you?  Ask them before you start your Invisalign care…”If by chance Invisalign does not work for me, do you use a different kind of braces or appliances to resolve the problem.  Do you charge me for that additional treatment?”  You decide what the right answer is but at least get an answer other than: “Don’t worry; Invisalign always works”.  My suggestion following an answer like that…leave the office ASAP and get a second opinion because it does NOT always work as we would expect or hope.

Every type of orthodontic appliance works; just not every time…

that includes Invisalign.

Do NOT blame Invisalign for “not working”…it’s not THE wrench but the Plumber who fixes the leak.

 Thinking about getting Invisalign?   Always look for this logo:

                          

Choose a member of the American Association of Orthodontists to provide your Invisalign care.   Membership requires training in all aspects and types of orthodontic braces including Invisalign.  All members of the AAO are referred to as Orthodontists or Orthodontic Specialists…they possess all the orthodontic “tools”. 

Dr. Paul Hamersky DDS, MS is a member of the American Association of Orthodontists and a Preferred Provider of Invisalign and Invisalign Teen.  Here at Douglas County Orthodontics we proudly offer a full range of fixed braces, clear, colored and removable appliances including the extensive use of Invisalign…each chosen specifically as the best available treatment for you and your family.  

Invisalign: A Replacement for Braces? You Now Can Choose

Invisalign; A Replacement for Braces?

Part 3

If given a choice…“I would choose Invisalign” and here’s why:

I would NOT have said that a year or two ago.  Until recently, it was my opinion that Invisalign was highly marketed product that simply did not achieve the consistent superior quality results I expect as a trained Orthodontic Specialist.  That has now changed with the development and release of Invisalign Teen and Invisalign Generation 3 in 2010. 

Much to Invisalign’s credit, Align Technology, the manufacturer of Invisalign has diligently researched and technically improved their product to the point that results are now comparable to those achieved with fixed braces when diagnosed and utilized correctly.

SO…why would I choose Invisalign?

1. The Cost, Treatment Time and Final Results are now relatively equal.

This statement may not be true at all Orthodontic Providers.  It is in fact true at Douglas County Orthodontics; we charge a very similar fee for either Invisalign or fixed braces.  Furthermore, it is now my professional opinion that both methods of treatment if diagnosed correctly and provided by a fully trained Orthodontic Specialist will finish with similar great results in about the same time. 

2. Invisalign is more comfortable to straighten your teeth.

Generally speaking, pain is not a big problem in orthodontics today with all the new techniques.  However, this is not to imply there is no discomfort at all with either fixed braces or Invisalign, which can be extremely variable from person to person.  Overall though, it is my experience that there are less complaints or reports of pain from our patients wearing Invisalign verses patients wearing fixed braces.

3. Invisalign is completely removed to brush and floss your teeth.

This is where Invisalign “shines”!!  Because the Invis-Aligners are removable from the mouth you can clean, floss and brush your teeth as you always have.  This is obviously not possible for fixed braces…nothing more needs to be said.  This alone can be the sole deciding factor for some people especially many teenagers to choose Invisalign.

4. Invisalign is less likely to cause injuries and irritations.

Again, another obvious big advantage Invisalign has over braces.  Invisalign is just smoother than fixed braces.  Consequently, braces are more likely to rub raw spots on your cheeks and gums, as well as be the cause of additional injury if the mouth area is bumped or bruised.

5. Invisalign is generally “thought” to be more Socially Acceptable.

Most of you would agree, Invisalign is more socially acceptable but actually this is really your personal opinion.  How important it is for you to hide or display your orthodontic braces or Invisalign is your choice.  Thankfully, the world is made up of all types, those that proudly display a mouth full of braces full of different colors and others who will not even smile with Invisalign in.

The Bottom Line

First and foremost…find a fully trained Orthodontic Specialist so you have a choice between fixed braces and Invisalign.  Generally speaking, only an Orthodontist is fully trained in all the tools in the World of Orthodontics.  Without that prerequisite, you really don’t have a choice, do you?  Ask your dentist if they offer fixed braces as well as Invisalign…if they don’t; are you receiving the best recommendation or the ONLY recommendation available?

After that…you decide…there is no wrong answer, so relax.

Invisalign: A Replacement for Braces?

Invisalign; A Replacement for Braces?

Part 2

Is it REALLY that Simple?  Here’s the challenges with Invisalign:

1. Achieving perfectly straight teeth at the end of the initial course of Invisalign Aligners

The teeth are always straighter from the “starting point” but as an Orthodontic Specialists (Orthodontist), my expectations are for perfection.  Many times we just cannot get the alignment as perfect as I expect with Invisalign the first time through the prescribed course of Aligners.  This is not to say Invisalign can not make your teeth straight, but if anyone guarantees or implies perfectly straight teeth with Invisalign only…be aware, that may be optimistic.

2.  Limited control of the bite and/or its correction.

Invisalign uses independent Aligner for your upper and lower teeth which have been fabricated using a computer imaging model for your mouth.  During this fabrication process, the positions your jaws are related to each other in a static or fixed biting position to plan and construct your custom Aligners.  The natural movement and jaw function are not considered when planning Invisalign treatment but rather only the fixed biting position with your teeth touching together in a full bite.  It is assumed that once you start to move your jaw, the positions of the teeth do not matter anymore.  It is also assumed that you will always bite back together into that same position every time.  I think common intuition will tell you that both of these assumptions are simply not true most of the time.  So…if this is not mentioned or explained by your Invisalign Provider, it may be a very optimistic to expect that it is not important.

3.  An unexpected and undesirable bite change can occur while straightening your teeth with Invisalign.

This is perhaps in the same general category as the above but warrants separate mention.  What if your bite is just fine and you only want to “get your teeth straight”?  Many times that is only intention and in fact the only thing that needs to be done.  Invisalign is typically the perfect solution.  No change in your bite is needed or wanted.

Here is a general statement of truth in orthodontics…changing the position of any single tooth will in fact change your bite to some extent.  In most cases, the body simply adjusts and adapts to these minor bite changes as virtually unnoticed.  But on occasion, you are very much aware of that change to your bite and find it very undesirable and even painful.  This has actually been one of my personal frustrations during my 30 year career in orthodontics in general…what starts as a seemingly straight forward simple orthodontic treatment turns into a complete overhaul of ones bite just to straighten a single tooth.  This is not unique or solely a problem with Invisalign, it happens all the time with fixed braces.  Ask your Invisalign Provider what alternatives or solutions they may offer if this problem should arise during your treatment.

 

4. Compliance

There really is not much that needs to be said about compliance, it is required across the board in orthodontics.  The reason I have mentioned it in this topic of “challenges I have with Invisalign” is that compliance is absolutely required for successful Invisalign treatment…”If you do not wear your Aligners virtually 24/7, Invisalign will not work, period.” Be realistic and brutally honest with yourself or your teenagers contemplating Invisalign treatment, be prepared to do your part or opt for fixed braces which can work with a less compliance commitment on your part.

Does all this sound like Invisalign doesn’t work…?  I hope not!

Invisalign is actually quite amazingly effective to correct and straighten orthodontic malocclusions.  Align Technology, the manufacturers of Invisalign, have diligently researched and developed their product.  The most recent release of their Invisalign Teen Aligner System, as well as a major upgrade to Generation 3 Invisalign has been breathtaking in scope from an Orthodontist’s viewpoint.

The Bottom Line

My purpose here is to shed light on the advertized apparent simplicity of Invisalign treatment.  It seems to be offered and available in many neighborhood family dental offices.  Yet…is it really that simple.  It is a very effective tool in hands of a trained Orthodontic Specialist.  Everything in the Orthodontist Toolbox works…just not every time.  It is optimistic to expect a system of Aligners which are all made in advance with no particular knowledge of the unique movements of your  bite and muscle function, will “work” every time.  This is not a problem with the tool…there is not something wrong with Invisalign.  There are solutions to every one of these challenges…it first requires a recognition there is a problem, then having the education and experience to provide a modification or alternative.

Obviously…not the end of the “story

Invisalign; A Replacement for Braces?

Invisalign; A Replacement for Braces?

Part 1

“Invisalign.....what a concept?”  Ads everywhere, your family dentist, magazines, Internet touting that perfect smile WITHOUT those ugly braces.  In fact, wearing those stupid looking braces is usually the primary reason that’s stopping many adults and older teens getting orthodontic treatment.

“Hey, Invisalign is even removable, I can wear it only at night and no one will ever know I even have braces.”…Whoa there Kemo Sabe…read further.

Great marketing BUT, is Invisalign really just as good as Braces?

The Myth: Invisalign is a Complete Replacement for Braces to Straighten Your Teeth.

The Truth: Most of the Time but Not Every Time.  In fact, this is a true statement about everything in orthodontics…everything in health care…quite frankly everything in Life.

Let me make something clear…I use Invisalign, in fact I am a committed provider of Invisalign and use it just as regularly as I use fixed braces or any other orthodontic appliances.  Invisalign is a great product…just understand it’s an orthodontic tool.  The many, many tools which have been developed in orthodontics all work…just not on everyone and not every time.

Invisalign marketing has implied they have created an invisible replacement for braces, period.  I believe that is an optimistic statement or implication.  I will make it very clear to my patients who are contemplating Invisalign to expect some potential limitations with Invisalign treatment.  It is the same “Informed Consent” I would use prior to treatment with fixed braces.

“It’s not the paint and brush that creates the masterpiece”

Invisalign “works” differently than braces and has some limitations that fixed braces do not have.  The primary difference is the Invisalign “Aligners” are not actually attached to the teeth as braces are. The Aligners work by basically “squeezing” your teeth into place.  The Aligner is made from a clear thermo-molded plastic which has been formed to the exact shapes of your teeth. Invisalign’s patented process progressively changes the location of where your teeth fit into the Aligner. As you wear each Aligner, it has been shaped with the teeth a little bit straighter each time. The teeth get “squeezed” closer and closer to their projected finished position.

I’m dating myself here…but have you ever seen a “flip book cartoon”?  You flip the individual changing cartoon drawings to create the movement of the creatures.  Each Insalign Aligner is a 3-D model of your mouth very slightly altered and very slightly straighter.  Add them all up, flip through the “cartoon pages”, and lo and belold…your teeth “move” from crooked to straight..

The Bottom Line

If compliance and instruction are followed, getting your teeth fixed without wearing braces can be worth all the extra challenges if you are just know what to expect.

Introduction

Welcome...I'm Dr. Paul Hamersky orthodontist at Douglas County Orthodontics located at 9362 S. Colorado Blvd. Suite D-14 in Highlands Ranch, Colorado 80126.  I am breaking step with many of my professional colleagues by actually writing my own blog. It won't be as fancy or as professional looking as one published by a professional internet marketing service company but it will contain information of value.  Let's see how this goes.