Choices in Movement - Invisalign or Braces?
Did you ever have a friend or sort-of-a-friend, that no matter how much you put into the relationship, you always felt you were being taken advantage of? Continuing on with this relationship for several years and always trying to get good results, you always felt the end-product fell short of success. So, out of frustration, you finally end it.
Well, ten years ago, that pretty closely explained my relationship with Invisalign.
Then, last Spring, on the eve of their 20-year anniversary, Invisalign debuted a brand new company! New tray material, new products, and a whole new relationship with orthodontists. I had tried a few knock-off companies over the years, but they could not produce a consistent, functionally stabile smile. Knowing there was a segment of society that wanted a better bite and cosmetic enhancement without the hardware, I felt obligated to give Invisalign another chance. And this last year has been a very rewarding and enlightening experience both for myself and my patients.
Invisalign has provided a regional representative to stop into the office, answer questions, and help with products. We also have a close relationship with laboratory diagnosticians to help with tray design and problem-solving. But the most important change is in the clear polymer that the trays are made of. It’s at least 120 percent stronger with much better direct energy to tooth. This enables the trays to produce better reproducible tooth movements than ever before. They really work! But with some limitations...
Am I still going to use conventional braces?
Of course. There are some cases that can be treated better with conventional braces and some that can be treated better with Invisalign.
Let’s look at some of today’s urban myths about Invisalign:
Myth #1 - I only need to wear my aligner trays at night when I sleep.
False. Only retainers can get away with being only worn at night because, as their name implies, they are only retaining teeth… not moving them. Invisalign trays must be worn 22 plus hours a day. You can drink with them and even eat with them in, but most patients take them out for meals.
Myth #2 - If I clench or grind my teeth, I’ll put holes in the trays before my teeth are able to move.
Nope. The new material is so strong that I have yet to see even wear-marks on the trays after four-five weeks of use.
Myth #3 - The trays will stain or change colors in a couple of days, making them socially unacceptable to wear before I need my next tray.
Yes, this is true with the old material, but not with the new polymers. It is recommended that you rinse them off after drinking strong coffee, wine, or smoking.
Myth #4 - Everyone is a candidate for Invisalign.
Not necessarily. Biologically, skeletally mal-formed, excessive or deficient lower jaws are difficult to treat with Invisalign. I’m not saying they can’t be treated, but conventional braces and possibly jaw surgery may be a faster, more efficient, less expensive way to treat.
And finally Myth #5… the biggest myth of all - Invisalign must be much easier to wear than braces.
Again, not necessarily. Yes, they feel better to the lips and cheeks, but the psychological aspect of wearing and cooperating with Invisalign therapy must be addressed for each and every patient prior to starting treatment. Failure with Invisalign therapy has been reduced, in my opinion, to being able to tolerate a tray covering the surfaces of your teeth, in both jaws, for 23 hours a day. A good candidate for treatment must be able to remove, clean, and rinse his or her trays several times a day. You or your child must be attentive, cooperative, and just darn flexible to be successful with aligner therapy. What I tell every patient contemplating Invisalign therapy for themselves or their child… with braces, the parent and myself are in charge; but with Invisalign, the patient is boss. If your child won’t wear their glasses, corrective shoes, or orthopedic splints, they most surely won’t wear their trays long enough to get a successful outcome. Conventional braces, at this point, would be a better option.
Over the years, my relationship with Invisalign has blossomed, with many positive benefits for our patients. We have moved up to the level of electronic scanning of our patient’s mouths for tray construction, rather than gagging impressions! I’m a gagger and I truly can’t believe how easy and quickly our patients can be prepared for Invisalign treatment. This development, combined with our 3-D Cone Beam x-ray system, gives us an airway, skeletal, and dental assessment - along with a pubertal age analysis - of each of our patients prior to starting treatment.
Never before have we had the ability to thoroughly diagnose a patient as we do today, thanks to the incredibly high levels of orthodontic technology available today.
Those who know me, know I should have been a jeweler. I just love to bend wire (as in the case of braces) and watch it work. But to open up the possibility for those who would like a nice confident smile without the hardware, Invisalign, for many, is a dream come true.
- Dr. P