Invisalign Clear Braces
What is Invisalign?
Invisalign is an almost invisible method to straighten teeth to achieve the perfect smile, without metal brackets, bands or wires. Rather than using metal braces, Invisalign uses a series of clear aligners (trays) that gradually move the teeth over the course of treatment. The aligners are worn for 22 hours a day and changed at regular intervals.
Malocclusion: teeth that do not fit together as they should
Smiles come in many shapes and sizes. Some are perfectly aligned “Hollywood” smiles, others have spaces, crooked teeth or overbites. Teeth are shaped to fit together like puzzle pieces and when they are out of alignment, problems arise. Malocclusion refers to teeth that do not fit together as they should.
How does malocclusion happen?
It is thought that the mouths and jaws of our ancient ancestors looked much different from ours. Ancestral man and woman had different diets of raw, uncut food that required them to exert more energy to chew and break down their food. The jaws, teeth and muscles were bigger as was the shape of the teeth to grind and digest the food.
As humans’ skills evolved, so did their diet. Cooking food made it softer and the discovery of cutting utensils allowed smaller pieces of food. Because less energy was required to eat, it is thought that the teeth, muscles and jaw sizes became smaller.
Genetics and growth spurts contribute to tooth position and jaw size as well. Skeletal discrepancies can run in families and abnormal jaws can lead to malocclusion. Additionally, growth spurts occur throughout childhood and adolescence. The loss of baby teeth and eruption of permanent teeth in relation to these spurts can lead to bite problems.
Some habits contribute to poor tooth positioning. Prolonged use of a pacifier can lead to an open bite. Thumb sucking can lead to an open bite or protruding teeth. A tongue thrust and speech impediment or large tongue puts pressure on the teeth leading to malocclusion.
Types of Malocclusion
There are various kinds of malocclusion:
- Overbite – This term is used to define how much the upper teeth overlap the lower teeth. A certain amount of overlap is desired so as to allow a person to bite and tear their food properly and speak properly. When the teeth do not overlap at all, a person is said to have an open bite. People who have upper teeth that completely overlap or cover the lower teeth are said to have a deep bite.
- Overjet – Overjet defines how much the upper teeth protrude in relation to the lower teeth
- Underbite – When the lower teeth protrude further than the upper teeth. They sit outside or in front of the uppers. This is sometimes called a “crossbite”. It’s the opposite of overjet.
- Crowding – When adjacent teeth overlap each other it’s referred to as crowding. Most people refer to this as “crooked” teeth. Crowding can range from mild with just a little bit of overlap to severe where teeth sit on top of each other.
- Spacing – When adjacent teeth do not touch each other they have too much space between them.
|Open bite||Deep bite||Overjet||Underbite|
Why Straighten the Teeth?
Straightening the teeth is not simply for esthetics. Many problems can arise from teeth that do not fit together properly:
- Chipping teeth - If teeth are not hitting correctly during speaking and eating they can crack or chip. Broken teeth are definitely an esthetic concern. If a tooth cracks badly, it may require a root canal, crown or extraction.
- Wear - As teeth grind on each other when speaking and eating, they can flatten quickly in the presence of misalignment.
- Bacteria - Overlapping teeth in particular can harbor more bacteria, mainly because they are more difficult to clean. Some strains of bacteria can lead to cavities and others can lead to gum disease. Straight teeth that are properly cleaned harbor less bacteria.
- Self Confidence - When asked about their smiles, most people with teeth that are not straight say they feel embarrassed. Having a straight smile boosts self-confidence as well as others’ perceptions.
- Food impactions - Crooked teeth or teeth with spacing can have problems with food getting stuck between them. Food that is lodged between teeth can contribute to bacterial overgrowth. This leads to gum disease, cavities and bad breath.
- Chewing - Being able to shred and break down food is important for nutrition and digestion. Teeth that do not fit together are not as efficient for eating. For example: someone with an open bite cannot easily shred and tear their food as they cannot bite into it with their front teeth.
- Speech - Certain speech sounds are created by the tongue’s position and air flow through the mouth. The “S” and “Th” sounds are the most commonly noticed speech impediments that can occur with malocclusion.
- Loose teeth - If teeth collide abnormally they can move from the pressure. This is called “fremitus” where the teeth “wiggle” when opening and closing.
Dental braces are one way that teeth can be aligned. These braces usually consist of metal brackets that are cemented to the teeth. A wire connects the brackets. Pressure from the wire and brackets allows the teeth to move in the desired direction.
Many people like braces because they work without any effort from the patient. The teeth will move no matter what the patient is doing.
However, esthetics is the biggest reason people choose not to have braces. Metal on the teeth can make people feel self-conscious.
Even clear braces can be seen to some degree and can stain with foods or drinks. The wire and brackets of braces can poke or cut the cheeks and lips making them painful at times.
Oral hygiene is difficult and takes more time with braces. Because regular dental floss doesn’t slide easily between the teeth, aids are needed to clean. Special flossers or threaders need to be used to make sure the teeth stay clean.
Food frequently gets caught around the brackets which can also lead to cavities if not cleaned regularly.
Invisalign is a technology that is well accepted by patients and professionals. Because the aligners are clear, many people can wear them without detection. There are no metal brackets or wire to cut the cheeks and lips and it is easier to maintain oral hygiene. The aligners are easily removed to make brushing and flossing simple.
Invisalign uses computer technology to map out tooth movement toward the final result. Computers generate clear aligners to reach the final result.
There are different types of Invisalign treatment:
- Express – for very mild movement of the teeth. This is usually accomplished in 2–4 months
- Full – when greater movement is necessary. Most cases fall under this category and can take 5 months or more. The average treatment time is one year but treatment can continue for longer on more complex cases
- Teen – This is used on adolescents whose teeth are still growing. It can help guide them into the correct position. The teen also has compliance indicators which can show parents and the doctor that the aligners are being worn properly for the correct amount of time.
Some cases of invisalign use aids to assist in tooth movement:
- Attachments are very small bondings placed on the teeth to allow more controlled movement by the aligners. They are discreet in that they are the same shade as the teeth and are removed easily at the end of treatment. This is the most common aid used in treatment.
- Clear elastics may be necessary in some patients for greater force of movement
- Interproximal reduction is used to lessen the tightness in overlapping teeth. This allows the teeth to move without colliding and getting stuck
What to expect when starting Invisalign?
Necessary X-rays and records are submitted to Align Technologies. The records consist of photos of the face and teeth as well as impressions of the mouth.
The impressions may be traditional putty or scanned using a camera device. The dentist and professionals at Align will work together to determine how the teeth should move to create the best outcome. The aligners are created by the company and shipped to the dental office.
The majority of patients are surprised by the comfort of their first aligners. There is some tightness, as the teeth are supposed to be moving gently. Salivary flow may increase at first or patients may notice some dryness. These are reactions to a new appliance in the mouth and the body should adjust over time. Speech can be a bit more “full” at first but should adjust as the patient gets used to wearing the aligners.
Treatment usually goes smoothly if the aligners are worn correctly. If the aligners are not worn 22 hours a day or taken out frequently, they may not move into the desired position.
It’s important to keep the aligners and mouth clean as well. No food or drink (other than water) should be consumed with the aligners in. To eat and drink, the aligners should be removed and the teeth should be brushed and flossed before putting them back in.
The aligners should be cleaned daily to prevent staining and plaque and tarter accumulation. An invisalign approved cleaner should only be used. The aligners should never be soaked in mouthwash or bleach, as it may damage them.
Inspect the aligners regularly for signs of wear or cracking. Patients who clench or grind their teeth may crack their aligners more easily. The aligners should also be stored in their case when not worn so as to prevent damage.
If an aligner is lost the dentist should be told immediately so that a new one may be ordered. The dentist may advise putting the previous aligner back in or progressing to the next depending on their preference. This will prevent the treatment from getting too off track.
At the end of treatment it’s important to wear retainers so as to prevent relapsing. Teeth may drift toward their original position if they are not kept in place by retainers.
The retainers can be clear like the aligners or a bonded wire that goes behind the teeth. Some dentists may do a combination of a wire and a clear retainer. The retainers may have to be worn day and night at first or just at night depending on the dentist’s preference.
Does my insurance cover Invisalign?
In the past, Invisalign was seen as a “cosmetic” procedure and patients assumed it was not covered under their insurance. For patients with dental insurance, Invisalign treatment should be covered if they have orthodontic benefits.
Some insurance plans have age limits on their coverage, others cover treatments for adults.
Most insurances have a “maximum” that they will pay toward treatment. Fortunately, most offices offer payment plans or discounts toward any out of pocket cost accrued during treatment.
A consult with will determine if you are a candidate for Invisalign. Patients with unfilled cavities or gum disease should have their teeth and gums restored to health before considering Invisalign.
Implants cannot be moved and should be placed after treatment. For most patients, Invisalign is a great alternative to braces for not only aesthetics, but for comfort and cleanliness. The gentle movement can create the same results as braces in most cases.
More information about Invisalign?
If you want more information about Invisalign, feel free to call us at (203) 377–9300 to schedule an appointment.