Invisalign FAQ - 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 is 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."...Stop right there, that's the thinking that can make Invisalign fail.

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" and the same warning I would give prior to treatment with fixed braces...doesn't mean something doesn't work.

"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.

Is it REALLY that Simple? Here are 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 cannot 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!

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 do not have a choice...do you? If the Invisalign Provider you are thinking about using does not offer fixed braces as well as Invisalign in their practice...are you receiving the best recommendation or the ONLY recommendation available?

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