Finished "Invisalign" and I cannot chew

[Crash]

I finished Invisalign two months ago and have been wearing retainers. Invisilign moved my incisors and cuspids into positions where they hit before the molars close. I cannot chew apple skins, prunes, melted cheese, and a long list of other foods that require--chewing.

When I completed traditional orthodontics as a teenager, I was able to chew on the day my braces came off.

Invisalign has an obvious disadvantage that it can only pull teeth around relative to each other. It cannot leverage vertical movement. For that matter, it cannot cause molars to move left or right to put the chewing teeth into positions where the meet.

My dentist's solution would be to grind away the enamel at the back of my front incisors where the lower incisors hit them. I would lose enamel. What if that doesn't work? I have a bad feeling that I am being led down a path to a whole jaw's worth of artificial crowns at great expense.

I would like to use my money to retire on, instead.

My hunch is that I should find a real orthodontist and start another treatment. The periodontist who did surgery on my gum two years ago said to not use Invisilign, use real orthodontics. I was pressured by my dentist to use Invisalign so that he could make money on it. I screwed up. I trusted him.

I have noticed that most orthodontists promote Invisilign on their websites. I don't know how they would respond to me sitting in the chair and flaming the product.

[MCOMarkhamOrthodontist]

It is too bad you have had this type of experience. However, you finished treatment with Invisalign treated by your specific dentist. As noted on this forum, your results will differ depending on the doctor you choose. There is no point in flaming the product, because Invisalign is a technique, not a product. To say that Invisalign doesn't work is like saying braces don't work... they are both simply ways of moving teeth.

Unfortunately, posterior intrusion happens because of biting on the aligners all day and night, unless proper planning is put into the movements to counteract this. If this occurs, there are other ways to make the back teeth occlude, but it takes a wealth of experience using Invisalign to move teeth. Most dentists and orthodontists do not have this extensive experience.

Moving forward, it is likely that an experienced Invisalign doctor can correct your issue without requiring grinding down your teeth or placing a mouthful of crowns to increase your posterior vertical dimension. You may find this thread helpful: Invisalign: technique rather than a product

[Crash]

Thanks for the advice, Dr. Tam. It is quite likely that I bit on the appliances and drove my molars back into their sockets, in a manner of speaking.

If there was a failure, it wasn't due to my thrift. I certainly paid plenty to get this treatment. I didn't shop around for the lowest bid. My dentist charges more than most practitioners in this wealthy valley.

Upon reading your "technique" thread, I was disappointed to learn that: (1) Align Technologies only trains the practitioners for two days and (2) the off-shore staff in Costa Rica who produce the prescriptions are not doctors and they don't review the plans of treatment. Customers are being treated without a great "body of knowledge" and hence problems like mine occur--at great cost and inconvenience. Dentists like mine are going to lose long term customers due to the casual indifference displayed by Align Technologies.

[MCOMarkhamOrthodontist]

It is unfortunate that all types of patients may suffer because of the indifference displayed by some dentists who are using Invisalign.

Align has no responsibility on teaching doctors how to move teeth with aligners, just as braces companies have no responsibility in teaching docs how to move teeth with braces. This is the responsibility of the schools or continuing education. If doctors do not learn specific techniques in school, then it is their responsibility to learn how to use them properly before "testing" it out on patients. Align does have an educational institute online with a lot of information on treatment techniques, but doctors do not need to go over any of this to use Invisalign.

Align does not produce the prescriptions. If they did, this would indeed be a product where you'd get the same treatment regardless of the doctor. It is the responsibility of the doctor to do this and then the techs in Costa Rica turn the prescription into a simulation. It is up to the doctor to figure out what will work and what will not work.

In short, the onus is on individual practitioners to fully understand the Invisalign appliance, and how to use it before selling it to patients.

[Crash]

My treatment was totally screwed, so I went to a real orthodontist for a consultation. He said that my jaw was properly shaped on account of excellent orthodontics in my teenage years and that I could be treated. He said he could take over and start an Invisalign treatment. I asked him to contact my dentist and tell him what needed done.

My dentist played with the Invisalign viewing software and developed a twenty week :( program involving interproximal reduction on the lower incisors and ten sets of appliances. Presumably, the lower incisors will fit back within the circumference of the upper incisors.

I have three more weeks of this treatment that I thoroughly loathe and then be wearing "retainers" pretty much around the clock until spring. That is, if the treatment is done. I don't think it worked.

Unlike before, I can chew melted cheese enough that I can swallow it. That's progress. However, that is only using the left set of molars. The right side does not mate. The lower right cuspid finally fits behind the top teeth, but there is still a collision of front teeth that means I cannot chew. I still cannot chew anything as tough as a cucumber skin because I don't yet have mating chewing surfaces. Pieces of food just recirculate in my mouth forever. I have never been the kind of eater who just sucks food down in one gulp in the manner of a sturgeon on the lake bottom. Sometimes I get a spinach leaf stuck on the back of my throat and it triggers a coughing reflex. I eat alone.

I have my next appointment in three weeks. My dentist had said he will grind down the high spots form proper "wear facets" and that my teeth would eventually wear into a functioning chewing pattern. That sounds like a snow job. He tried grinding the back of my upper incisors half a year ago for the same reason and it caused my capped tooth to break in half in a few days.

I think I am going to go to a real orthodontist to fix this. I should note that the periodontist who grafted my gums twenty months ago told me to use real orthodontics, not Invisalign. When I pressed him for details on my next appointment, the doctor dummied up and said "just do what your dentist advises".

Invisalign company pressures dentists to prescribe a lot of treatments or they will drop them. I was used.

Care for those nasty appliances:
Don't drink anything while wearing them or they will need to be scrubbed fastidiously
Invi$align company wants customers to buy their inactive cleaners but they are as effective as dumping talc in a tumbler. Throw away the free samples, they are useless.
Save your money. Buy effervescent denture cleaners by the 100 pack instead.
Floss your teeth every time you eat.
Brush your teeth every time you eat, needless to say.
I used to eat about five times a day to moderate my blood sugar levels, but cleaning these things takes too long, so I gave up. Take your appliances out and gulp a bottle of orange juice instead of a real snack to get your energy levels up. Then rinse your mouth out with water or mouth wash.

[robin8]

Crash, you should leave your dentist before he does any more damage to your teeth. He should not grind down your front teeth to fix your bite issues; it’ll only create more problems as you noted. Regardless of braces or aligners, you need a doctor who understands orthodontics and has enough skills and experience to treat your particular case. Based on what you posted, your current dentist doesn’t seem to have either and you’re right about going to a certified orthodontist to fix your problems. Getting an orthodontist to tell your dentist what to do wouldn’t help if your dentist doesn’t have much basic orthodontic knowledge.

Align Tech (maker of Invisalign) is a manufacturing lab and is not in any position to pressure dentists to prescribe treatments. Here’s an informative article about Invisalign and doing due diligence in choosing Invisalign provider …
Specialist in Orthodontics Dr. Ted Rothstein Alerts Public to Rising Levels of Substandard Invisalign Treatment by Insufficiently Trained General Dentists

[Crash]

I finished that twenty week set of "adjustments" and then the dentist said he wanted to treat me again to eliminate the gaps in my teeth. It took forever for Invisalign company to return with a treatment plan. At first, Invisalign company said that the dentist should have ground off all of the attachments because it ruined the "impressions" that he took. So I had to sit through more impressions and then wait for forever for Invisalign to produce their fantasy simulation of just how perfectly my teeth were going to move into positions that were just so functional and beautiful. Seven trays. Fourteen weeks, FFS. I feel like I got a sentence, not a prescription.

My dentist promises me that after I obediently follow the directions for the forthcoming plastic retainers, that my teeth will be in position or need only a bit of grinding. Presumably the wear pattern that I ground into my teeth from age 18 until now had created odd "wear facets" that were not suitable for my dazzling 21st century smile.

I put set 5 out of 7 into my mouth yesterday and they are horrible. I can't even concentrate. They don't cause pain, per se. I have a high threshold of pain, so I would say they ache a bit and distract me. I have been putting local anesthetic benzocaine on my teeth to deal with it. I think my dentist prescribed some extremely aggressive moves. Maybe he is trying to play catch up.

I think Robin8 had a great intuition on another thread on this forum that once somebody gets out of these ghastly plastic appliances, the molars slowly rebound out of their sockets to a normal position. I will be able to chew again. Maybe that is what my dentist is trying to do. Depend on a lay person on the internet to give me better information than Dr. Degreed Professional. Yay for Robin8!

[Random]

hi Crash,

Sounds to me like you might have been best to ditch your dentist quite a while back, or at least to have let him continue on as your dentist, but not to have continued with moving your teeth. Like Dr Tam explains above, invisalign is a technique. You have it correct that the technicians at invisalign have a short training but the idea with invisalign, is not that THEY will plan your teeth movements, its your orthodontist or dentist who has that responsibility, and it sounds like yours does not have the training to know what he should be doing.

Here is how it works essentially, your ortho or dentist scans your teeth and sends that to align. Align techs send back a "treatment plan." The ortho who has experience and training in how to actually move teeth and what happens in the real world, will use his trained eye to notice that aligns plan needs adjusting, and he will plan your real treatment plan, making lots of changes to the original plan to make sure you achieve the results you are looking for. This is why in my opinion I would only trust an orthodontist to make my invisalilgn treatment plan and not a dentist. Hit or miss with a dentist, maybe one could luck out and find one who knows a lot about orthodontics, but if they do not, they will likey just be accepting the treatment plan suggested by align, which will fall quite short of invisaligns full potential, and leave the client with less than optimal teeth in the end.

Here is a great example of what I am trying to explain:

Invisalign ClinCheck Explanation - YouTube

[SopranoKris]

Here is a great example of what I am trying to explain:

Invisalign ClinCheck Explanation - YouTube

Thanks for the link! It was very interesting to watch. I'm looking forward to seeing my ClinCheck video on the 31st when I get my attachments. I was supposed to see it on my first visit, but I was pressed for time and had to leave before we could get to it. I've been curious as to what to expect.

[Random]

np Soprano

An example of the difference between what align proposes initially with their technicians who are not orthodontists, and a revised treatment plan from an orthodontist: my initial clincheck from align proposed that I have something like a total of 6 attachments, and 30 or so trays. My ortho made many adjustments, and my treatment plan became 67 trays, and 19 attachments. My ortho explained that if I had accepted the plan from align, my teeth would have been straight, but not functional, I would have been left with an overjet where all of my teeth would have not lined up properly and I would not have been able to chew properly. In the end, I am glad to be with someone who has treated hundreds of people with invisalign and has the experience with moving teeth, even if it means I have a really long treatment plan(mind you I am a complicated case).

I saw my clincheck before signing on, I felt it was a bit essential in my case, given that I was all "omg" ing over the # of trays lol. I have a copy that was emailed to me, and I open it up from time to time so I can try and figure out when things might be happening, but the video doesn't show tray per tray, you can only see that in the orthos office through the special invisalign software. Maybe you could inquire if your ortho can email you a video? I know not all do, but you never know.

[Millenia]

What a sad situation. Sounds like this "dentist" shouldn't be dipping into "orthodontia" without the proper knowledge.