Invisalign: A Replacement for Braces? Part 2

February 17, 2011

Is it REALLY that Simple? Here are the challenges with Invisalign:

1. Achieving perfectly straight teeth at the end of the initial course of Invisalign Aligners

The teeth are always straighter from the “starting point” but as an Orthodontic Specialists (Orthodontist), my expectations are for perfection. Many times we just cannot get the alignment as perfect as I expect with Invisalign the first time through the prescribed course of Aligners. This is not to say Invisalign can not make your teeth straight, but if anyone guarantees or implies perfectly straight teeth with Invisalign only…be aware, that may be optimistic.

2. Limited control of the bite and/or its correction.

Invisalign uses independent Aligner for your upper and lower teeth which have been fabricated using a computer imaging model for your mouth. During this fabrication process, the positions your jaws are related to each other in a static or fixed biting position to plan and construct your custom Aligners. The natural movement and jaw function are not considered when planning Invisalign treatment but rather only the fixed biting position with your teeth touching together in a full bite. It is assumed that once you start to move your jaw, the positions of the teeth do not matter anymore. It is also assumed that you will always bite back together into that same position every time. I think common intuition will tell you that both of these assumptions are simply not true most of the time. So…if this is not mentioned or explained by your Invisalign Provider, it may be a very optimistic to expect that it is not important.

3. An unexpected and undesirable bite change can occur while straightening your teeth with Invisalign.

This is perhaps in the same general category as the above but warrants separate mention. What if your bite is just fine and you only want to “get your teeth straight”? Many times that is only intention and in fact the only thing that needs to be done. Invisalign is typically the perfect solution. No change in your bite is needed or wanted.

Here is a general statement of truth in orthodontics…changing the position of any single tooth will in fact change your bite to some extent. In most cases, the body simply adjusts and adapts to these minor bite changes as virtually unnoticed. But on occasion, you are very much aware of that change to your bite and find it very undesirable and even painful. This has actually been one of my personal frustrations during my 30 year career in orthodontics in general…what starts as a seemingly straight forward simple orthodontic treatment turns into a complete overhaul of ones bite just to straighten a single tooth. This is not unique or solely a problem with Invisalign, it happens all the time with fixed braces. Ask your Invisalign Provider what alternatives or solutions they may offer if this problem should arise during your treatment.

4. Compliance

There really is not much that needs to be said about compliance, it is required across the board in orthodontics. The reason I have mentioned it in this topic of “challenges I have with Invisalign” is that compliance is absolutely required for successful Invisalign treatment…”If you do not wear your Aligners virtually 24/7, Invisalign will not work, period.” Be realistic and brutally honest with yourself or your teenagers contemplating Invisalign treatment, be prepared to do your part or opt for fixed braces which can work with a less compliance commitment on your part.

Does all this sound like Invisalign doesn’t work…? I hope not!

Invisalign is actually quite amazingly effective to correct and straighten orthodontic malocclusions. Align Technology, the manufacturers of Invisalign, have diligently researched and developed their product. The most recent release of their Invisalign Teen Aligner System, as well as a major upgrade to Generation 3 Invisalign has been breathtaking in scope from an Orthodontist’s viewpoint.

The Bottom Line

My purpose here is to shed light on the advertized apparent simplicity of Invisalign treatment. It seems to be offered and available in many neighborhood family dental offices. Yet…is it really that simple. It is a very effective tool in hands of a trained Orthodontic Specialist. Everything in the Orthodontist Toolbox works…just not every time. It is optimistic to expect a system of Aligners which are all made in advance with no particular knowledge of the unique movements of your bite and muscle function, will “work” every time. This is not a problem with the tool…there is not something wrong with Invisalign. There are solutions to every one of these challenges…it first requires a recognition there is a problem, then having the education and experience to provide a modification or alternative.

Obviously…not the end of the “story”…

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