When do you need refinements?

[germangirlinva]

I'm nearing the end of my UL treatment. I had 13 trays for the UL and 21 trays for the LL. I'm now on tray #11 and I'm really pleased the way my UL teeth are looking. I actually just started on tray #11 and I can tell, it is moving things that I was a bit worried about last month, so all is good. I'm excited to see how things will look in the next six weeks.

Now the LL still has a way to go (10 more trays) and I'm wondering how will my ortho decide whether or not I will need refinements. Is this something that is up to me or will he decide whether or not my teeth are ready for retainers?

If he decides on refinements, will they be done just on the UL or will I need to get impressions done for both UL and LL trays, even though I have not yet finished with the LL trays? I'm confused about this process?

If the top looks okay, would it be possible to get a retainer while the lower teeth are still being moved?

I'm really starting to like my smile and everyone has noticed that I'm smiling a lot lately. I'm indeed very pleased with my results so far, even though I was VERY sceptical at first. I still think that traditional braces would have probably produced a better result, but this is really working out nicely.

I will definitely post before/after pics once I'm all done. It is amazing to see the process.

[Phantom Muse]

Hi German Girl!

My ortho has had me wait until both arches are finished (12U/7L - I just put in the final upper tray last night) until taking impressions for refinements. Not only would refinements on only one arch "use up" one of my three refinement series, but he also prefers to keep the uppers and lowers on the same schedule. I am fine with that, so I have been wearing my lower tray for many weeks, and will have impressions done for refinements for both arches on June 25th.

I doubt I will need more than one series of refinements, but at this point, my ortho has done such a good job, I am comfortable handing over control to him (BIG deal for me!). Every ortho does it differently, but I'd call to find out if this is also the plan of your ortho.

Feels great to really SEE the progress, doesn't it?! Congratulations!

[MCOMarkhamOrthodontist]

Wow. It seems like you just started treatment the other day! Happy to hear that you're smiling more .

Your treatment is up to you. If you are happy with the way your teeth look, then you can let your orthodontist know how you feel. If there are movements still required, refinement is an opportunity to allow you to move your teeth with additional sets of trays.

Generally, we wait for both arches to be completed before going into refinement, reason being, Invisalign counts each submission (whether one arch, or two) as a refinement. This would limit the number of opportunities for you to do further correction. It would be ok to stay in your last aligner as a retainer on the upper arch until you are ready to get started with refinement if necessary.

Good luck!

[germangirlinva]

Thanks Dr. Tam and Phantom Muse,

It does, indeed, seem like I just started yesterday, but it was January!!! I guess, this is probably how it is going to work with the refinements. I fully expect them. Even though, my teeth (at least the upper arch) looks good, I expect that it can probably look a bit better with refinements. I'm actually surprised at how well Invisalign worked because I had quite a bit of crowding and I did not really expect these results. I have to say though that I did not really see 'visible' changes until about tray #9. That is when I started getting comments from others about my teeth.

Here's a funny for everyone: my son (3 yrs. old) was walking around with this tiny plastic tupperware container in his mouth the other day. I scolded him and removed it and he said "Mommy, I'm wearing braces just like you.". The tupper container was clear, just like the invisalign's. :-)))

[Phantom Muse]

Germangirl,

Your son is precious! What a delightful story; thanks for sharing it...

I am in the same position regarding refinements. My teeth are at about 90-95% of where I want them to be in the end, so I will do refinements, as well. Isn't it funny how things change?! I was convinced I wouldn't have the patience to continue past the initial trays, but now over 5 months into treatment, I hardly think about them anymore - except when I am hungry!

One ortho I saw initially for a consult was convinced that Invisalign could not really move teeth well, and so I, too, was a little bit apprehensive, but I couldn't be more thrilled, really.

[loynut]

That's such a cute story, German Girl!

[Rosieee]

Hi German Girl,

I finished my Lower arch about 2 weeks ago and got a permanent retainer put on.

I still have 15 more trays on my upper arch so will get refinements when they are finished. There is a tiny change I want to make with one tooth in my lower arch - the permanent retainer will then be taken off so my lower teeth can be included in the impressions.

So for now I am loving only having to think about my upper teeth invisalign wise!

[dopamine]

great to hear that you can see results already only on tray 11! I get tray 8 tomorrow.. don't see any progress yet.

[myhollywoodsmile]

That's interesting Rosie that you got a wire but can have it removed again for impressions. I am on refinement #2 and I just wore the upper arch aligner at night whilst the bottom teeth completed their first run.

I too was sceptical about Invisalign, but my teeth have already moved massively.

[Rosieee]

Once the attachments were removed the tray kept on slipping out so we decided to go with the permanent retainer...which I was secretly hoping for anyway haha! The thought of having to wear the same aligner for over 6 months was too horrible for me to think about anyway.

[lizzieg]

Hi Rosie
Do you wear your permanent retainers all day - or just at night??
I am dreading the thought of having to wear permanent retainers all day..

[Sunny]

Lizzie permanent retainers are not actually permanent, but they're bonded to some of your front teeth, usually four or six teeth. This means that they stay there and this is why they're so good, is that you don't need to wear your removable retainers so much and you also have the confidence that comes with having a partial retainer in place 24 hours a day.

[Rosieee]

Hi Lizzie....permanent means permanent...in other words bonded forever to my teeth. I have a tiny metal bar behind my bottom teeth (see the attached picture). This bar will be replaced every 5-7 years I think.

Once my treatment is fully done I will have them on both arches for the rest of my life. I chose them over plastic/wire retainers because I don't want to have to remember wearing them every night for the rest of my life or risk losing them.

Apart from flossing I think it is sooo much easier and better at doing it's job because it is always there.

[Sunny]

Rosie permanent does not mean permanent, it means bonded. You need to be careful with a bonded retainer, because if it becomes loose due to any of the bonding coming away, those teeth may (and usually do) move. This is why it's necessary to have removable retainers as well as bonded ones. The removable retainers usually only need to be worn at night and will hold your teeth in their correct place if your bonded retainer becomes loose, until you get an appointment with an ortho to have it rebonded.

Some bonded retainers will last months, maybe years without a problem, but you should be checking it every night when you floss. The bonding used is the same as that for attachments and to bond brackets on teeth. You need to be careful when biting into anything hard and we recommend never biting into hard food with the teeth that are bonded to the retainer.

Rosie it's interesting that your's has to be replaced ... which does comfirm there's no such thing as a permanent retainer.

We recommend bonded retainers to most patients who've had gaps or lots of tooth movement, as long as their oral hygiene has been great.

[lizzieg]

Hi Rosie
Thanks for your reply, and really interesting to see the picture too.
I am relieved to hear that you don't have to wear an invisalign style brace permanently.

[Sunny]

Lizzie even if you have bonded retainers ... which is the same as I'm getting, you still need removable retainers to keep all the rest of your teeth in place. Remember these bonded retainers only hold the front 4 or 6 teeth in place, and they won't last if all the teeth behind them start to push them forward, which is the way most teeth move.

The second reason you need to have removable retainers is for when the bonded retainers come loose ... which at some time they will.

Boneded retainers are amazing, because they make sure those front teeth don't move while you have the removable retainers out, but you still need to be committed to a lifetime of retainer wear.

Good luck!

[kimnim1]

Germangirlinva...
I am similar to phantom muse. 13U/17L so i kept using my last upper while waiting for the bottom to catch up (eventually just wearing it at night, while wearing my bottom full-time). i've been wearing the lower one now for a month and have to wait about 2 more weeks for the new clincheck to come in so i am practically just wearing them at night right now until the new ones come in (which I hope is soon even though I am enjoying the "freedom"!) This was advised by my ortho otherwise i'd still wear them all the time.

I, too, thought i'd want to be done w/out doing refinements, but when you are so close to having it perfect a few more trays is worth it. Like i said...i'm enjoying the snacking again, but won't have a hard time going back to full-time for a couple more months. Glad you are liking the results!

[Rosieee]

Sunny - you don't HAVE to have a removable retainer aswell.

[Sunny]

Rosie you do need removable retainers as well, unless you want your ortho teeth to move. With a bonded retainer, the only teeth being retained are those that are attached to the bonded retainer. Just like with ortho treatment, all our teeth move ... they move individually ... and they will continue to do this for life!

Removable retainers have an important second job, as bonded retainers can come unattached due to biting/chewing and many people don't realise this has happened until their next dental cleaning. This is because the removable retainer will still be retaining the teeth. Also useful if you realise some of the bonded part has come away ... and you have to wait a few weeks/months to get to see your ortho.

[Invizzle Rizzle]

Generally, we wait for both arches to be completed before going into refinement, reason being, Invisalign counts each submission (whether one arch, or two) as a refinement. This would limit the number of opportunities for you to do further correction. It would be ok to stay in your last aligner as a retainer on the upper arch until you are ready to get started with refinement if necessary.

Good luck!

What about a 12 upper and 27 lower situation? Kind of a long wait. Please explain what could happen in my situation.

[Phantom Muse]

Invizzle -

In my case (12U/7L), I continued to wear the same lower tray until the top arch was finished last week. I am now wearing tray number 12 on the upper and tray number 7 on the lower until my retainer comes in next week. Honestly, I thought the lower tray would get gross, but it's fine. If the trays didn't have attachment bubbles, I'd be wearing them as retainers for 6-12 months.

[MCOMarkhamOrthodontist]

What about a 12 upper and 27 lower situation? Kind of a long wait. Please explain what could happen in my situation.

It would still be a good idea to wait if you would like to have all of your refinements available. You may have to ask your orthodontist to order a couple of extra upper trays for stage 12 if you find that it is not keeping fresh. Keep in mind that there may be a fee for this.

Our patients are rarely in this situation as I plan treatment to have the same number of aligners on the top and bottom 99% of the time. We do our best to make Invisalign as simple as possible for our patients!

If there is a large difference between the number of upper and lower, you may consider wearing the upper ones on a longer cycle. If you had not started your upper trays yet, you could also consider starting them at a time to coordinate finishing with the lower ones.