Invisible Braces

Like many of today's parents, I grew up in the 80's. The 80's was a good time for poor taste - shoulder pads, spandex, hair bands, acid washed jeans and...metal braces. Every teenager dreaded them, food got stuck in them at the oddest moments and kissing was acqward to say the least. So, I feel a little irritated when I hear that today's teenagers have another option - Invisalign - a system using clear plastic trays to straighten teeth. I mean, braces are a necessary right of passage, right?

So, today's teenagers have a far more attractive option. Here's what one reviewer from Realself.com has to say about invisalign:

“All the Invisalign Info You'll Ever Need”


Spent: $5,380 in Kenosha, WI
After having slightly crooked teeth for most of my life, I decided I was ready at age 25 to confront my inner demons and fix my self-esteem crushing mouth for good. As a pre-teen, my folks didn't have the money for braces so I did without. My most notable dental flaw is my left upper canine tooth is crooked and sticks out, and over the years I've compensated for this by adjusting my smile accordingly in an attempt to hide it. I've noticed my forced/half smile in pictures, and decided to finally do something about it.

I knew some colleagues at work who were using Invisalign and they seemed relatively happy with their progress, so I took the plunge and made an appointment with a Premier Invisalign Provider in my area. The orthodontist was very thorough and quite personable initially, and I felt comfortable in their office. Then they mentioned the price of my treatment: $5,000. My associates had said that their treatment had only cost $4,000 so I wasn't sure if I was getting a fair quote. I was referred to another provider by a co-worker and their price was roughly the same, but I was creeped out by the orthodontist and just got a bad vibe from the whole experience. A few months later and after much deliberation, I went back to my initial Invisalign orthodontist and gave them the go-ahead to order the molds and start the process.

Part of my treatment plan was to have a tooth extracted to make room for the crooked upper canine to shift into place. Apparently when all four of my wisdom teeth surfaced (non-impacted, luckily), they shifted everything forward which only exacerbated the degree of my smile's crookedness.

Onto the process: The molds weren't that cumbersome to take, especially compared to some horror stories I've heard. It took a few weeks for the aligners to be sent from the Invisalign headquarters in California. Once they arrived, we had an appointment and went over the ClinCheck, a 3D animated program that shows the progression of tooth movement over time, from tray to tray. I started the trays on Tuesday, 10/6/09 after eating a delicious Cuban dinner in honor of my brother’s birthday. Those first few hours were the most orally painful of my life. The first tray is certainly the worst, but gradually you get used to them.

First, there is pain and pressure. You take the trays out and your teeth feel somewhat loose in their sockets; this is perfectly normal since they are in the shifting process. A good tip is to take an Advil PM about an hour before bedtime and then put them in right before you go to sleep. This gives the trays ample time while you are sleeping to do their magic so it’s not as difficult to remove them in the morning when you brush your teeth.

During the Invisalign process, patients are supposed to visit their orthodontist’s office roughly every 4 weeks to check their progress and make any adjustments. After the first tray or so, my orthodontist had me come back to have attachments put on my teeth. They are small, tooth-colored nubs that fit into what can best be described as pockets on the aligners themselves. It makes them fit tighter and harder to remove, and I believe it helps with tooth rotation. The process of putting on the attachments is less than desirable. They first prep your teeth with a bonding agent and then apply the attachments using a UV/heat gun. After they have set, they use a drill to remove any excess material from the teeth. The drill is scary and loud; if it deviates in the slightest, you smell enamel burning (scary!).

After the attachments were applied, I was told to have a soft diet (soups and pastas) for the next day or so. Despite my adherence to this policy, some of the attachments wore off. My orthodontist seemed slightly concerned by this, but went on with treatment, stating that if they were to try to reapply the attachments they would only be more likely to come off because they would be applied on the attachment polymer rather than pure, porous enamel.

The next step in my orthodontist’s bag of tricks was “elastics” – their fancy way of saying rubber bands. These elastics are strung between my upper and lower arches, making the fact that I am wearing braces QUITE noticeable. I didn’t know this would be part of my treatment program, and honestly if I had I doubt I would have proceeded. The elastics hook on to small tabs that the orthodontist cuts into the aligners. The purpose of the elastics is to put more pressure on the teeth to move, and also to ensure that my bite lines up properly now and later on when treatment is completed.

Of course, nothing is ever easy. In addition to the attachments popping off (making my aligners less than snug), I had trouble with the elastics staying on the makeshift hooks. This is a recipe for disaster! I had rubber bands snapping in my mouth constantly, popping off of one hook or another; it’s painful and annoying. I remember one lower tray in particular that was quite loose to begin with, and the torque from the elastic actually made the tray pop off of my teeth entirely whenever I would open my mouth (yawning, speaking, etc.) which was quite embarrassing. I made an emergency orthodontist appointment that day and went in after-hours for them to pinch the aligner with some pliers to make them grip my teeth better. It was a temporary fix until I put in my next, tighter aligner.

As I write this now, I’m on the last week of my 10th aligner out of 16. I’ve seen some encouraging progress in the shifting of my teeth; my mother even noticed and said that they look a lot straighter. I’m about halfway there and am excited for the final result. Once I’ve completed treatment, I am supposed to wear a retainer at night for the first year, and then one night a week for the rest of my life (or as long as I want straight teeth).

My suggestion for people considering Invisalign is to discuss in detail EVERYTHING in your treatment program. My "invisible braces" are anything but invisible with these God-awful rubber bands in sight. I have developed a lisp that hasn't gone away (even after 5 months). I honestly feel like a teenager - and not in a good way - but if you don't have the elastics as part of your program or if it's only for a limited time, this shouldn't be an issue.

Beyond the obvious obstacles I've had with Invisalign thus far, I feel it's a great way to improve your smile in an unobtrusive way. I wear my aligners religiously and if I am ever EXTREMELY self-conscious about the elastics, I just unhook them from the top arch and let the band fall to rest on my lower gums (making them unnoticeable). When I am free from the embarassing situation, I hook them back on and I'm on my way. The movement I've seen of the crooked canine tooth is very impressive - I would gladly pay $5K merely for the results I've had thus far.

Words can't describe how excited I am for the ultimate end result, when I can finally smile with full confidence! I, of course, will update this review once I'm finished with the program. Best wishes and good luck to all! :)