Invisalign damage to bone and roots

[VeggieQueen]

Hello All,

I just got out my treatment papers and noticed that one of the risks asserted by Invisalign says, "Health of the bone and gums which support the teeth may be impaired or agravated". and then this, "The length of the roots of the teeth may be shortened during orthodontic treatment and may become a threat to the useful life of teeth". Yikes! These two "disclaimers" do not sound very good! I was hoping to live another 30 years (that would make me 88:)) with most of my teeth in my mouth. I am super vigilant about flossing and brushing every time I eat and my gums look better than they have every looked, but could I be doing unseen damage to the roots and the bone?

I am hoping one of the doctors might weigh in on this one, or anyone else with any knowledge in this area. My dentist is out on maternity leave for six weeks, so I do not have access to her right now.

VeggieQueen

[myhollywoodsmile]

I have heard that this is a possible risk, but my take on it is that it is unlikely and the orthodontist will do whatever possible to minimize the risk.

If you look at the packaging for even many over the counter drugs you find dire warnings. It doesn't mean that you shouldn't use them, only that it is a possibility, however slight, that the company must make you aware of.

I haven't ever seen anyone on these boards complaining of that.

[Sunny]

There are always risks when teeth are being moved, especially of the roots of the teeth become shorter due to resorption. The best way to prevent many of these problems is to not make your teeth move too quickly and this is why it's important to follow the instructions of your ortho ... and another reason why in may countries ony a qualified orthodontist is allowed to do orthodontic work.

It's important to x-rays done before treatment is started, to see the conditions of the roots of the teeth, as some people do have shorter roots to begin with. Plus if you've had ortho treatment before, there's always the risk that you have some root resorption from that.

Root resorption of secondary teeth can occur as a result of pressure on the root surface. This can be from trauma, ectopic teeth erupting in the path of the root, inflammation, excessive occlusal loading, aggressive tumours and growths. The most common cause in Western Society is orthodontic forces. (Weiland 2003)

If teeth have to move a lot ... due to how crooked they are or due to closing gaps etc ... the result can be gum recession. Plus gum recession is often a genetic and age problem ... so it may happen whether you have ortho treatment or not.

Gum recession can also be caused due to over brushing, which some people do when having orthodontic treatment. This is why it's wise to use a soft brush with a small head, and to make sure you brush gently and in a circular motion, so as not to damage your gums or the enamel of your teeth. It is not necessary to floss more than once a day and brushing only needs to be kept to a minimum, as long as you're keeping your teeth and the areas around your brackets clean. Seeing your dentist or hygienist to have your teeth cleaned, is usually recommended six monthly while wearing braces.

Hopefully your treatment will go well VeggieQueen, but it's good that you're being made aware of the possible issues that may occur. :thumb:

[Punkin]

It is not necessary to floss more than once a day and brushing only needs to be kept to a minimum, as long as you're keeping your teeth and the areas around your brackets clean.

When you have invisalign, it is sometimes necessary to floss more than once a day. It is very easy for food to get stuck between your teeth, and you certainly don't want that food in there when you put your aligners back on. And trust me on this, brushing does not always get that food out.

I floss after every meal, simply because it's so very important to get that food out of there.

[MCOMarkhamOrthodontist]

We ask our patients to floss and brush after meals if possible. When there is food lodged between the teeth, it may actually cause pressure enough to move teeth, or prevent the required tooth movement.

As for the damage to roots and bone... this is something not unique to Invisalign. It is a standard risk for any type of tooth movement. There is usually a genetic predisposition or improper forces used. The biggest predictor of root resorption is if the condition existed before orthodontic care.

Invisalign has made claims that there are fewer problems with its product than with braces in terms of bone loss and resorption. More studies are needed before this can be listed as a true advantage of Invisalign.

[Punkin]

We ask our patients to floss and brush after meals if possible. When there is food lodged between the teeth, it may actually cause pressure enough to move teeth, or prevent the required tooth movement.

I hadn't even thought of that possibility. I just know that that food stuck in there with the aligners on is bad news from a decay point of view. I hadn't thought that it might actually inhibit/cause tooth movement

[VeggieQueen]

Thanks to all of you users and Dr. Tam for replying to my post. I do not think that I had any root reabsorption prior to beginning Invisalign, but I will ask my dentist.

VeggieQueen

[Sunny]

Sorry for not being more clear, when I refer to flossing, I'm referring to cleaning the area just below the gum, the area where gum disease can begin if you don't floss properly. I don't use floss after eating, but use toothpicks or other bits and pieces I've gleaned from a variety of places to clean between my teeth. Most of these products can be used multiply times, whereas floss can only be used once.

[Punkin]

I'm no expert, but I would think using a piece of flexible string would be safer than to be poking around at your gums all the time with a piece of wood or plastic.

And, again, with the food that gets stuck between your teeth, and the placement of the aligners, which prohibits the digestion of that food, you need to be sure it's out, and a toothpick just doesn't cut it.

[Sunny]

My toothpicks are excellent and reusable ... not the thick wooden or plastic type, but the type that slide gently between even tightly connected teeth.

Definitely don't go poking around your gums ... that's dangerous and should never be done. Floss was invented to remove the bacteria particles that may accumulate in that area, which is another reason why larger items don't do the job properly.