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  1. #1

    invisalign vs traditional braces

    Hello,

    I just got traditional braces and I am having second thoughts. I didn't realize how hard it would be to eat (it is really gross how much food gets caught in my braces) and how time consuming cleaning would be (20 minutes after every meal). I only have the uppers on and scheduled to get the lowers in two weeks. I don't think I can do this for 2 years!

    The reason I didn't get invisalign in the first place is the cost. Now I am thinking I would have been better off getting them. I do have some questions before I make that decision:

    1) besides popping them in and out for eating/cleaning and otherwise wearing them all the time, is there other maintenance associated with it?

    2) I have lots of spacing between most of my teeth. The goal is to close gaps and realign my bite. I should have had braces when I was a teen (I'm 30 now) but never could afford them. It sounds like most people who get invisalign have fewer problems or minor adjustments. Does this make me a bad case for invisalign?

    3) What is the likelihood of my teeth going back apart if I get invisalign vs traditional braces? Is it more likely to happen if I get invisalign? I am pretty diligent and would not forget to wear my retainers. Also, I would have to wear retainers after my traditional braces come off.

  2. #2
    As long as your case is such that Invisalign or fixed braces can achieve the same result, then there should be no difference in the stabilty of the results either way. (Of course, we all need to comit to a lifetime of retainer wear if we want to keep that post-braces bite! Usually, after some period of full time wear, and some period of nightly wear, it will be a night or two a week only, but it is a lifetime commitment. It sounds as if you're preapred for that though :))

    But (as you are obviously aware) depending on the case Invisalign is not always able to achieve the same results; and for some cases of course it is entirely unsuitable. Your orthodontist should be able to advise whether or not it could work for you.

    In terms of your experience wearing them, there are in fact pros and cons to Invisalign. Right now you're having a tough time with fixed braces, but trust me when I say that this does improve - a lot! It certainly should not be taking you 20 minutes of cleanup after every meal!! It's sufficient to brush normally after each meal (and some people do even sometimes skip that, relying instead of swirling plenty of water around their mouth whilst they eat) and to do a really thorough cleaning at bed time. It's also worth including a fluoride rinse at night, to help minimise your chance of any decalcification. But all in all, once you're used to brushing and flossing (and you need floss only once/day) with braces, your total daily cleaning time should be under 30 minutes, and that's if you brush after breakfast, lunch and dinner, plus brushing and flossing at bed time.

    Now, cleaning is easier with Invisalign. But it's more limiting in another way. You need to comit to wearing those aligners 20 - 22 hours per day. You can not eat with them in, nor can you consume any hot drinks with them in at all. You are also strongly advised not to comsume any drink but cool/cold water with them in place, which excludes sodas, juice, sport drinks, iced tea, wine, beer ... no sitting and sipping a large latte in the morning or relaxing with a glass of wine whilst you read a book in the evening, or you're going to wear those trays far less than the necessary hours. Some people find this to be quite the imposition, and some do "cheat", but if you cheat by drinking anything but water with them in place, then you are definitely putting your teeth at extra risk.

    Since you're already in fixed braces, my advice to you would be to stick with it a while, because it really does get better with time.

  3. #3
    Just to follow up, in case someone is interested, I got a second opinion from an ortho and he said invisalign is best for minor work. He said because of the extent of realignment of my teeth, he wouldn't recommend invisalign. Also, he said they don't do complete job, meaning they don't close the gaps all the way, because the mechanics of removable appliances don't work on all 3 dimensions.

  4. #4
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    Hi and welcome to this forum daufoi! :)

    Sounds like you're experiencing similar to many people when they first get braces and as Zoso has written ... it does improve, and hopefully you'll be surprised at how quickly it will improve.

    I can't imagine what a nuisance having to cleanup for so long after a meal would be. I've never had that problem, as I make sure I've also got some liquids to have with my meal, meaning most 'extras' are washed away and only a very small amount (if any) is left behind attached to brackets, wires, elastics etc. Please try the liquid idea, and also you may find that keeping food to the back of your mouth and chewing with your molars only will help, until your tongue becomes more able to help with a certain amount of cleaning also.

    I still dislike the 'feel' of food stuck in my teeth ... even while I'm eating, but I do find that I'm able to put up with this 'feel' for longer now. I always carry a small dental kit with me, in fact it's been a constant companion for over three years. It contains a small mirror, plastic toothpick, a travel sized toothbrush, a travel sized toothpaste, a couple of small interdental brushes, a container of wax, and a empty wax container I keep spare elastics in. These are quite inexpensive to put together and it does make cleaning after a meal loads easier.

    Invisalign is a good option for some people, but it is limited in what it can achieve. It's definitely best for minor cosmetic work.

    Please give yourself a little longer to see how you adjust. Drink plenty of water to keep your body well hydrated, as this will also hydrate your mouth, which should help you feel better. Enjoy eating and remember that you do have braces, so it's expected that some food will get stuck ... but be confident that you'll become more efficient at cleaning it away after each meal.

    Good luck! :)
    After 5 years, 11 months and two days of stainless steel brackets ... my teeth now have upper and lower bonded, gold wire, retainers and removable clear retainers!

  5. #5
    Quote Originally Posted by daufoi View Post
    Just to follow up, in case someone is interested, I got a second opinion from an ortho and he said invisalign is best for minor work. He said because of the extent of realignment of my teeth, he wouldn't recommend invisalign. Also, he said they don't do complete job, meaning they don't close the gaps all the way, because the mechanics of removable appliances don't work on all 3 dimensions.
    Based on personal experience only, I'd disagree with that invisalign statement. I'm having pretty significant realignment done, such that it required the extraction of 4 teeth. I've had the aligners for about 8 months now (not quite halfway done), and the change has been pretty impressive. As far as i can tell, they can move those teeth in just about any direction - I have them pushed back, twisted, turned..

    That being said, you're already in traditional braces, i wouldn't change unless they weren't working.
    Last edited by Punkin; 10-16-2008 at 01:19 PM. Reason: it's been 8 months already :shock:
    -Brenda








  6. I am currently deciding whether to go with traditional braces or Invisalign (leaning towards Invisalign) I was under the impression that invisalign was just about as accuatate as traditional braces as far as closing gaps and straightening crooked teeth. Have most of you had or are having a good experience with Invisalign?

    I am looking to fix crowding in my upper jaw. More specifically my 2 front teeth that are rotated inwards a bit, is this considered complicated?

    I'm not looking just for educated answers but also some opinions from personal experiences. Thanks...

  7. #7
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    Aklassen great that you're considering getting your teeth/bite sorted. :)

    You need to consult with a few orthodontists, to hear which type of treatment they consider is best for your case. Invisalign is best suited for clients with minor alignment issues and nil to minor bite issues. With attachements, the rotating of teeth is possible, although each case needs to be looked at by a skilled provider.

    Where I work, we have one premimum invisalign orthodontist and I've seen some great smiles as a result of his work, but he does explain to his patients, that invisalign does not allow the same accuracy that bracket braces do.

    Good luck with finding out more about types of treatment for you!
    After 5 years, 11 months and two days of stainless steel brackets ... my teeth now have upper and lower bonded, gold wire, retainers and removable clear retainers!

  8. #8
    Quote Originally Posted by Punkin View Post
    Based on personal experience only, I'd disagree with that invisalign statement. I'm having pretty significant realignment done, such that it required the extraction of 4 teeth. I've had the aligners for about 8 months now (not quite halfway done), and the change has been pretty impressive. As far as i can tell, they can move those teeth in just about any direction - I have them pushed back, twisted, turned.
    Even with attachments, extrusion remains difficult to impossible, rotating teeth (especially "round" teeth) is frequently problematic, and closing significant gaps will not infrequently lead to significant tipping and poor root positioning rather than smooth closure of the gap.

    I've seen professionals state that open bites are nearly impossible to correct with Invisalign (and difficult to correct even with fixed appliances). And severely tipped molars also present Invisalign with difficulties. Skeletal malocclusions are also better treated by other modalities.

    Aklassen - I agree with SUnny that you should seek at least a couple of opinions before choosing Invislign, to be sure it really can work for you. I'd advise consulting orthodontists, not dentists, since an ortho could treat you either with Invisalign or fixed braces, so should hopefully not be biased (whereas many dentists offer only Invisalign). Yours might be a great case for this type of approach, but only a doc can tell (and then only with a proper examination) and I've seen some people end up disappointed when Invisalign could not, in the end, achieve the results that were promised.

  9. #9
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    Quote Originally Posted by aklassen47 View Post
    I am currently deciding whether to go with traditional braces or Invisalign (leaning towards Invisalign) I was under the impression that invisalign was just about as accuatate as traditional braces as far as closing gaps and straightening crooked teeth. Have most of you had or are having a good experience with Invisalign?

    I am looking to fix crowding in my upper jaw. More specifically my 2 front teeth that are rotated inwards a bit, is this considered complicated?

    I'm not looking just for educated answers but also some opinions from personal experiences. Thanks...
    So far my experience with Invisalign has been good. But I'm only a month into it, on my third set of trays. The pain is bearable, and the fact no one really notices I am in treatment is great!

    I have the same problem as you, crowding in my upper jaw, and my 2 front teeth also rotate in-wards. I am told it will take 8 months to correct with Invisalign. I have a blog which I keep up to date with a new post every week. I have pictures and lots of information on my personal experiences so far. you can see it here: Adam’s Invisalign Blog

    Just make sure when you speak to the Orthodontist you get all the facts from them, because some forget to tell you about certain aspects of the treatment, for example:

    - Teeth shaving. This is often required to correct over crowding
    - Attachments. These are required to rotate teeth.
    - Eating habits. Just make sure you know the routine for eating and drinking
    - Refinement period. A lot of people talk about needing a refinement period to correct anything which is not perfect.

    If you have questions, let me know or just post on my blog. I don't have any specialist expertise, but do have personal experience with the treatment.

    Good luck in your decision.
    Adam

  10. Quote Originally Posted by Adam View Post
    So far my experience with Invisalign has been good. But I'm only a month into it, on my third set of trays. The pain is bearable, and the fact no one really notices I am in treatment is great!

    I have the same problem as you, crowding in my upper jaw, and my 2 front teeth also rotate in-wards. I am told it will take 8 months to correct with Invisalign. I have a blog which I keep up to date with a new post every week. I have pictures and lots of information on my personal experiences so far. you can see it here: Adamís Invisalign Blog

    Just make sure when you speak to the Orthodontist you get all the facts from them, because some forget to tell you about certain aspects of the treatment, for example:

    - Teeth shaving. This is often required to correct over crowding
    - Attachments. These are required to rotate teeth.
    - Eating habits. Just make sure you know the routine for eating and drinking
    - Refinement period. A lot of people talk about needing a refinement period to correct anything which is not perfect.

    If you have questions, let me know or just post on my blog. I don't have any specialist expertise, but do have personal experience with the treatment.

    Good luck in your decision.
    Adam

    I really appreciate the advice...I'll definately visit your blog when I get a chance. Thanks!

  11. #11
    Sunny123 Guest
    Quote Originally Posted by aklassen47 View Post
    I am currently deciding whether to go with traditional braces or Invisalign (leaning towards Invisalign) I was under the impression that invisalign was just about as accuatate as traditional braces as far as closing gaps and straightening crooked teeth. Have most of you had or are having a good experience with Invisalign?

    I am looking to fix crowding in my upper jaw. More specifically my 2 front teeth that are rotated inwards a bit, is this considered complicated?

    I'm not looking just for educated answers but also some opinions from personal experiences. Thanks...
    Hi!

    Well, I got my Invisalign two days ago so I'm not really the expert yet :-) But regarding the cases that Invisalign is able to correct, I made the experience that it depends A LOT on the Orthodontist. I fact, I have developped an overbite due to my wisdom teeth during the last 5 years, and I was consulting lots of orthos and everybody told me different things.
    The first doc who is also working with Invisalign first said that Overbites cannot be done with Invisalign. When I stated that I don't want braces, she then said she could do it with shaving my teeth. I didn't feel comfortable with that, so I went to another docs who only use traditional braces.
    One wanted to pull some (healthy) teeth. I didn't feel good with that. The next one said that I don't need to have my teeth shaved or pulled but I need traditional braces with elastics. This was the best opinion so far but then I found an ortho who is a platinum invisalign ortho and I said to myself, give it a second try.
    He finally said that with my healthy teeth (no wholes, nothing) he would NEVER shave or even pull them (since pulling changes the lower face it should only be done whewn it fits the face), in fact I have enough space in my mouth since my teeth WERE straight before the wisdom teeth came out (and already have been pulled out), and that I'm not even a difficult case for invisalign! I told him about the first opinion and then he said, well, it depends a lot on the ortho - on his experience, commitment, specializing on Invisalign. He said that the other doc didn't really lie, most probably SHE wasn't able to correct my teeth with Invisalign.
    Now I'm into treatment at this ortho and I feel great.

    But since you already started with braces (which I assume, did cost you an amount of money too), I'd say, give it a try. Maybe you can get used to them, and if not, some time has passed and your teeth have been already moving which could make you an easier case for Invisalign maybe?? ;-)

  12. #12
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    The attitude of the orthodontist towards using invisalign can definitely affect whether they'd recommend it or not, but the final 'say' is the invisalign company. They decide what can and can't be achieved for you and that should then be shared with you via your orthodontist. Orthodontist's do not correct your teeth with invisalign, as the aligners are made by the company, and it's the aligners that do the correcting. With invisalign, the ortho acts in an advisory capacity and should never be help responsible for the correction, or non correction of a person teeth with invisalign.

    Invisalign is only suitable for a small number of people, but many more people choose to go ahead with invisalign, accepting that what can be done is better than their current situation. A few of these people will finish their treatment with bracket braces, most will be happy with the improvements, and some will complain that the person treating them did a poor job.

    It's accepted that visiting different orthodontist will result in a variety of treatment plans, and that's why it's recommended to see more than one ortho before being any treatment plan. The final decision is the person choosing the orthodontist, and it's important that they remember why they chose that person, and what the variety of options where that they were offered.

    With regard to shaving between teeth (IPR), this is an excellent option to obtain a small amount of space. Fortunately most orthodontist's will not extract teeth, unless it's considered totally necessary, so IPR is the next best option. For most people it's pain free and fast.

    It's great that you've found an orthodontist you trust Sunny and who's happy to treat your mild case the way you wish. Here's to your results being great! :)
    After 5 years, 11 months and two days of stainless steel brackets ... my teeth now have upper and lower bonded, gold wire, retainers and removable clear retainers!

  13. #13
    Sunny123 Guest
    Thank you Sunny! :-) Yes, I know that the Ortho doesn't correct your teeth but the company does, I didn't express myself clearly enough :-) The attitude of the Ortho towards Invisalign is really a great factor! And since in Austria this method isn't really wide-spread, many Orthodontics don't really want to use them (austrian mentality is: everything we are not used to is something we don't WANT to get used to :-D )

  14. #14
    Quote Originally Posted by Sunny View Post
    The attitude of the orthodontist towards using invisalign can definitely affect whether they'd recommend it or not, but the final 'say' is the invisalign company. They decide what can and can't be achieved for you and that should then be shared with you via your orthodontist. Orthodontist's do not correct your teeth with invisalign, as the aligners are made by the company, and it's the aligners that do the correcting. With invisalign, the ortho acts in an advisory capacity and should never be help responsible for the correction, or non correction of a person teeth with invisalign.
    I abolutely, unequivocally disagree with this! Decisions about treatment are to be made by the doctor and the doctor is solely responsible for evaluating whether the approaches and techniques are appropriate for the patient. Invisalign is a tool just like any other available in the dental office. It is to be supervised and rendered by the dentist, not some guy with a mouse in Mexico. This is not my opinion; this is the opinion of an experienced Invisalign provider. I, for one, would not want to entrust the ultimate decision about how my teeth would be moved to a computer operator, as opposed to placing that trust in a trained dental professional. At its best, for Invisalign treatment, the treatment plan is dictated by a fully trained orthodontist, or atthe least by a highly experienced dentist. The treatment plan initially offered by the clever computer programmes of Align Tech will serve only as the starting point for that treatment plan, and the final course of treatment that is suggested should owe as much or more to the expertise of the orthodontist.

  15. #15
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    Disagree all you wish Zoso. I've recently completed compulsory training with our invisalign provider and am sharing what we learn.

    Treatment using invisalign is very different to other forms of orthodontic treatment, due to the aligners not being made on site. The orthodontist is not able to make adjustments to aligners, although they can request that this be done.

    The plan for treatment comes from the company and the orthodontist's role is more of an overseer in this process. A very necessary one, as they're the person who can advise you if you have questions and also request changes if it's considered necessary. fortunately most invisalign companies seem to be reliable and changes mid treatment seem to be rare.
    After 5 years, 11 months and two days of stainless steel brackets ... my teeth now have upper and lower bonded, gold wire, retainers and removable clear retainers!

  16. #16
    How very strange that is, Sunny. Even Align Tech's own training materials speak explicitly about the dentist or orthodontist submitting instructions with the records, so that the treatment plan produced by the computer will meet his or her expectations. Indeed, the orthodontist can even choose (right there on the Prescription and Diagnosis form that is submitted with the records) to "perform less predictable movements to achieve a more 'ideal' ClinCheck".

    Some things will be included in the treatment plan only if explicitly required by the orthodontist, such as attachments on the back of the teeth. Or, to give another such example, if it is likely that one arch will require significantly more aligners than the other, the orthodontist might prefer to start the arch that takes the longer first so that the aligners end together (otherwise you can end up with the final aligner for the "quicker" arch breaking before the time has come to order the retainers for both arches) and this is something that will be planned for only if the orthodontist specifically requests it. Or, to give yet another example, the orthodontist might specify that there should be no IPR of the anterior teeth (and some orthodontists do specify just that, having found that patients tend to be more nervous when slenderising is done on the front teeth).

    The ClinCheck is, according to Align Tech, "a virtual representation of a doctor’s intended treatment plan." According to Align Tech, their technicians only interpret the directions on the doctor's treatment plan. And their literature advises the orthodontist that the more specific he makes his comments and modifications, when he submits the P&D form, the closer the resulting ClinCheck will be to his desired setup. Align Tech's literature further advises that the orthodontist
    Be tooth/teeth specific; Specify size (mm) and direction of movement; Avoid non-specific instructions such as “align,” “more,” “a little,” “a lot.” Example: Instead of “improve anterior esthetics,” improve communication by writing: “Add 5 degrees of mesial in rotation to the upper left central and 10 degrees mesial crown tip to the upper left canine.”
    Oh, I suppose a practice could choose just to submit the records, and leave it at that, but the superior approach is most certainly for the highly trained dental professional who is considering the individual case, and who is in communication with the patient (and therefore hopefully weighing into the treatment plan that patient's priorities and goals for treatment) to formulate the treatment plan, rather than leaving it to the computer alone. You're absolutely right that once that series of trays has been fabricated the orthodontist is very limited in the changes he can make to the treatment plan without doing a complete "reboot", and that is precisely why it is best if he takes a very active role in shaping that treatment plan at the very outset.

  17. #17
    Zoso - what's your background? Are you a practicing orthodontist?

  18. #18
    No. Nor have I ever, anywhere pretended or presented myself to be a dental professional - I have, on more than one occasion, explicitlly stated this. I am merely a consumer whose educational background is scientific, and I've spent enough time and effort trying to undertsnad the ins and outs of this type of treatment that my own orthodontist's office manager felt that I was aware of references and resources that would be of value to them in the ongoing education of their clinical staff. When I make statements like the ones in my preceding two posts, you can be confident that I can point to specific resources - they are not something I chuck out there without being able to back them up with proven professional information.

  19. #19
    I'm not a dental prefessional but my orthodontist told me that Invisalign give much more flexibility to very experienced orthodontists, and let them decide what they can achieve.

    I had another orthodontist tell me that he couldn't use invisalign for my teeth as Align simply wouldn't let him, so maybe this is true.

    My current orthodontist is an Invisalign only orthodontist and claims to be able to treat almost any case with Invisalign. My teeth are a fairly complex case, so I suppose I will be a good guinea pig for those claims! However, I do have a great deal of faith in him as he has 30+ years experience in orthodontics, and is a lecturer at a very good university. If you are interested in how bad my teeth are as a comparison, please check out my blog where my clincheck videos are included.

    I have to say although I am not very far into my treatment the aligners are having minimal impact on my life so far, other than restricting my ability to constantly snack-which I don't necessarily consider a bad thing!
    Visit my Invisalign Braces Blog MY Hollywood Smile

  20. #20
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    It's great that you found an orthodontist who's experienced and prepared to use invisalign to treat your teeth. Your teeth look quite good, although your bite may be a little more challenging. I'm fairly confident one of our orthodontists, who's a platinium invisalign provider, would agree to use invisalign to correct your alignment, but I can't comment on your bite. One advantage with using experienced orthodontist's, is that they can change the type of treatment if needed. We have a few patients who finish with braces and we have some who start with braces and finish with invisalign.

    From your clincheck it appears that the teeth in your lower arch will be moved to accommodate the second premolar and therefore your upper arch is not needing to come in far, so this may be why your bite is not an issue for your orthodontist.

    It's great you're finding the aligners are having minimal impact. They do require more discipline and also the ability to live with the eating restriction, but if a patient is desiring this treatment and it's suitable, then the outcomes should be good.

    Good luck with your treatment! :)
    After 5 years, 11 months and two days of stainless steel brackets ... my teeth now have upper and lower bonded, gold wire, retainers and removable clear retainers!

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