Last summer I went in for a typical dental cleaning and asked the hygienist about an area where my gum is receding. Many moons ago the dentist nicked it while filling a cavity. I was told the gum would repair itself, but low and behold time has only made matters worse not better.
The hygienist told me not to worry about my gum, but she did say, “one day you will need to have it repaired.” To be honest I didn’t want to wait and let the problem get worse, so I scheduled an appointment with a periodontist.
To the Periodontist
About a month later I found myself reclining in the periodontist’s chair. I asked about the gum that needed repairing, but I also asked about the gums just below my bottom, front teeth. I noticed my gums were slowly shrinking away from the sides of my teeth, forming little areas known as black triangles.
Well the periodontist took one look inside my mouth and said, “First, you most definitely need a night guard. Second your gums are receding because you are losing bone in your front teeth. The night guard will prevent you from grinding your teeth at night, but really you need braces or Invisalign to resolve this problem. Six months to a year after Invisalign you can complete your gum graft to fix the damage that has already occurred.”
To say I was shocked is an understatement. My teeth are actually quite straight. I had braces as a kid and religiously wore my retainers for years after they came off.
The periodontist explained that although my teeth looked good my original orthodontist probably straightened my teeth without correcting my bite. He tilted a bunch of teeth in my mouth slightly backwards to correct my underbite, but my upper and lower teeth didn’t line up properly. In other words, they looked good, but they didn’t work so well.
The periodontist handed me a cost estimate for gum repair surgery and a night guard. It would cost nearly $2,847 for both.
I decided to wait to do either. Instead I explored the possibility of getting Invisalign.
First the Dentist
I have to be honest. I’m pretty miffed that my dentist never said anything about my worn down teeth, my gum recession or my bone loss, so I left the periodontist office in search of a new dentist. I found one a few blocks from my house. I explained my situation and was told I would be a great candidate for Invisalign. The dentist showed me the Invisalign molds and explained the process, but she didn’t provide many details. The cost estimate for service: $4,800 if I signed up within forty-eight hours of my visit.
Back to My Original Dentist
I didn’t have a great feeling about the new dentist and even though I wasn’t exactly happy with the first one I thought I should get a second opinion before proceeding with braces or Invisalign. My dentist said, “You should definitely get Invisalign.” I still have no idea why she didn’t tell me this, um, maybe twenty years ago, but here we are and there’s nothing I can do about the past, so it’s time to move on from it.
Although she has many Invisalign patients she politely declined to perform the work herself. She explained that major bite issues should be handled by a trained orthodontist. She said, “If you have a few gaps that need to be closed or a few teeth that need straightening feel free to visit the dentist, but for major bite work choose an orthodontist.”
Orthodontist Here I Come
At this point I’ve seen one periodontist and two dentists and this journey has not yet begun. I drive forty-five minutes away from home to visit a very well respected orthodontist.
She points out some major flaws in my mouth. My lower jaw is too big, my upper jaw is too small, a few teeth are small, and oh yeah, my former orthodontist jammed my teeth into my mouth which corrected the aesthetics but not my bite. Forty years later I’ve worn down the tops of many of my teeth, because my bite was misaligned.
Great! That’s just great! Again, I do not know why my former dentists failed to mention this to me, but didn’t I say I wouldn’t be bitter about that. Yes, yes, I did, so let’s move on.
The initial Invisalign visit and scan were entirely free. The orthodontist took a digital scan of my mouth and provided me with the imaging results and projected Invisalign plan. If I liked what I saw I could pay monthly or receive a 6% discount by paying in full.
The whopping cost: $7,950!
I was hesitant, but given the fact that my gums were receding and my teeth were constantly getting damaged by the forces of my mismatched bite I decided to proceed.
I took the advice of my original dentist and chose an orthodontist to perform the work even though it is more expensive. In this case I am willing to pay more in exchange for more training and experience.
If you are contemplating Invisalign here are a few things to consider:
The First Visit is Free
Ask up front about fees for first time patients. Most providers won’t charge for your first visit. If you are considering treatment there is no harm in visiting a dentist or orthodontist to explore your options and discuss possible treatment plans. I visited three providers and not one charged an upfront fee. Some do charge fees for your initial digital scans, so make certain to ask about that when scheduling your appointment.
Qualifications of Your Invisalign Provider
Did you know Invisalign providers are given designations for the number of Invisalign cases they have completed? A General Provider only needs to perform 10 Invisalign cases per year; while an Elite Provider designation requires over 300 cases including a minimum of 50 every six months. To reach the Top 1% designation, dentists must provide treatment for over 800 cases and perform 200 cases per year. It’s important to know the experience level of the dentist or orthodontist who will perform your work. The more cases your orthodontist completes the more familiar she will be with the tweaks required for each particular case. On the flip side be careful of a practice that feels more like a factory than an office. You don’t want to be the cog in someone’s wheel, but you may not want to be a guinea pig either.
Some Invisalign providers still use those molds, also known as conventional impressions, for capturing a three dimensional model of a patient’s teeth. If you aren’t familiar with this process might I say it sucks. The dentist or orthodontist fills a piece of plastic with goop that you bite into. You hold your mouth very still while trying to prevent this goop from running down the back of your mouth. Hopefully everything goes according to plan, but if it doesn’t you’ll have to perform the process all over again.
I still remember those molds from my youth and if I wasn’t a fan of them back then I’m sure I wouldn’t be a fan today. My orthodontist used a 3D Scanner, which felt like a pen being pressed gently against each tooth in my mouth. No messy goop! Hooray! It also meant the orthodontist could review the scan and make certain there weren’t any gaps or unaccounted spaces in the images. If anything went wrong I would simply lay back and have them scan that tooth again.
I don’t like doctors, dentists or orthodontists. I wish I felt differently but after surviving my own medical crisis I’ve found it difficult to trust the medical community. When I search for new medical professionals I always take into account their bedside manner. If you are anything like me you’ll want to choose a dentist or orthodontist who will take the time to explain the course of your treatment and listen to your concerns. Make certain you will get to see the actual orthodontist every time you visit, not just his or her assistants. If you feel uncomfortable, rushed or ignored in your initial visit its time to move on to someone else.
In my experience Invisalign hurts. Some trays hurt worse than others, but most of them hurt at least a little bit for the first few days you wear them. I wore braces in my early teenage years and I have completely blocked out the pain they caused. I didn’t think Invisalign would hurt much, but I was most definitely wrong. You get used to the pain and it decreases as you wear each tray, but don’t think they won’t hurt at all. They most definitely do!
Taking Them Out
If you require a lot of attachments it can be very difficult to get your Invisalign trays out! I struggled a lot over the first week or two, sometimes standing in front of the mirror crying as I tugged at that thin piece of plastic that seemed permanently stuck in my mouth. There is a learning curve for this and you will get better in time. Now it’s a piece of cake to pull them in and out.
You Can’t Eat Whenever You Want
I’ve been wearing Invisalign for six months and I still hate taking those trays out every time I want to eat. I tend to eat a whole lot in one sitting so I can limit the number of times I take them out. Also, I’m not a coffee drinker, but I hear they are absolutely awful for those who like to sip colored beverages. When you have them in you are only supposed to drink water!
Aesthetics During Treatment
Some treatment plans involve creating space or gaps between your teeth. In some cases your teeth will look worse before they look better.
If you were prone to cavities before Invisalign you may incur quite a few during treatment. Despite brushing and flossing at least three times a day my dentist has already discovered two cavities. The dentist said this happens with Invisalign. With the braces on your saliva cannot break down bacteria.
Brushing Your Teeth
You will get tired of brushing your teeth after every snack and meal. I now keep a toothbrush in every bathroom in the house and one comes along with me whenever I leave the house. If you plan to use Invisalign you will need to work vigilantly to keep your mouth clean.
My Invisalign journey is not over. I have another four months of treatment and may require refinements, but I cannot wait to be finished. Hopefully, these clear aligners will fix my bite and prevent further gum and tooth damage. They might be expensive and a pain to wear, but if they fix my problem it will be well worth the trouble.
Invisalign Black Triangles
Straightening my teeth caused black triangles to form around my lower front teeth. There are solutions for fixing black triangles including interproximal reduction and bonding, but my dentist doesn’t really like either option.
For the time being I have decided not to do anything about them. It is possible that my gums will regrow around my teeth, but the odds are relatively slim that this will happen. Still I want to wait to do anything about this, because the black triangles cannot be seen when I talk or smile.
If they continue to enlarge I will definitely need to seek options.