Bump in the road

It was going so smoothly - the final 2 sets of aligners, though a bit painful, came and went, and I was officially done with active treatment.

Ortho and I decided upon Essix retainers made in the office rather than either Invisalign Vivera retainers or fixed retainers behind the teeth. While he prefers fixed, I was not happy about the difficulties with flossing that fixed retainers cause.

Molds were taken, top mold was no good but bottom was fine for pick up. It fit OK, and they took new upper molds.

Pickup day came, and I was asked to insert the new upper retainer. I said it felt tight to go in, assistant said it was supposed to be tight, and so I pushed it in. And promptly cracked off 3 of my 4 veneers. I think a couple of the kids in the other chairs learned a new word, and it wasn't "Fudge."

To say I was angry was an understatement. I had decided to keep my old veneers for another year before incurring the significant expense of new veneers, and now the choice had been made for me. Now, they weren't perfect, but they looked OK, and as they lasted through 18 months of Invisalign aligners there was no good reason they should have cracked off, except the possibility that the retainer had been made incorrectly.

Ortho denied any responsibility, but it seems to me that (1) when I removed my aligner in the morning, everything was fine, as it had been for 400 prior mornings with Invisalign, and (2) suddenly they break off when I switch to an office made retainer, that (3) the ortho and the retainer he made are at least partly to blame. I asked him to consider what he would be willing to pay toward new veneers, and he again denied any responsibility (like a dry cleaner who is never responsible when your shirt comes back with a hole...).

Will leave it for now while I go through the process of getting new veneers, but I am reserving my right to my day in court if ortho doesn't come up with something.

So ortho walked me next door to the cosmetic dentist, who took some molds and photos, put in some pretty nice looking temporary bonded front teeth, and sent me on my way until next week. I am looking at $6500 - $7000 + for new veneers. Ouch!

The Home Stretch

Finishing set 13+ shortly; only 1 set to go. The over-correction (noted by the "+" sign) has been a bit uncomfortable. Over a week into this set, and my teeth still hurt. I haven't helped things much - have been leaving them out more than I would like, so I will keep them in a few more days before moving on to my last set.

I am really ready for treatment to be over. Still not sure about fixed versus removable retainers, but I am fairly sure I will keep my existing veneers for a while more. They still look decent, and I am in no rush for such a big expense.

Catching Up

Wow - time has flown since my last post. Things have been going so easy that I didn't really have anything to say.

I am now on set #12 of 14 of my refinements. The set actually says "12+" - ortho says that means it is "extra" refinement. A quick web search said it means certain teeth will be over-corrected so that when treatment ends (and my teeth have some movement) they will move back into the correct position.

Whatever it means, this set is the most painful I have had for quite a long time. I put them in last night before bed. Today I had the old "my teeth are being torn out by the roots" feeling whenever I removed my aligners. I am using Sensodyne toothpaste at every opportunity, and hopefully the pain will turn into a dull ache quickly.

Will have to make some important decisions soon. First, whether to replace the veneers on my upper incisors now, or wait a while. They are in decent shape, but I'm sure new veneers would look much better. Not sure I want that expense wight now.

Second decision will be fixed versus removable retainers. Ortho seems to favor fixed retainers. I'm not sure - I certainly have enjoyed the freedom to remove my aligners throughout treatment - might be nice for that to continue. Will have to think about it for a good while before making any decision.

Experiment

The first 2 sets of refinements have been really easy - little discomfort, even the first day or two, and after a week they feel, maybe not loose, but they certainly go in and out really easily. So I am going to experiment by moving on to the next set at day 11 instead of the full 14 days. Now this is not a real experiment - my orthodontist gave me the option - but I have worn every past aligner for at least 2 weeks, and sometimes longer. If this is successful, the remaining refinements will go that much faster. I'm not counting on it, but it would be nice to be through with treatment already. The weeks I spent wearing aligners only at night (while I waited for the refinements to come in) were quite pleasant. It was good to feel my real teeth all day, and my bite began to settle in.

Refinements are In

Refinements are in. I was surprised to learn that there are 14 upper and lower aligners - was expecting 10 to 12. Two positive developments - (1) No attachments. The aligners go on and off so much more easily, and removal was far less painful this first day; (2)My ortho said that some of his patients change aligners after 1 1/2 weeks instead of two full weeks. He left it up to me whether to attempt to accelerate the process. I am unsure - while I would like to have the process over faster, the materials I have read suggest that 2 weeks is ideal.

Phase 1 Complete; on to refinements

Finished the last of my 23 upper and lower aligners. Orthodontist says there are a couple of teeth he would like to move a bit more. He also said that it looks like some of the upper incisors needing to come down more are not likely to move much - that type of movement is generally tough for Invisalign, and with my veneers it makes it even more difficult. He said he will try, but not to expect much; that new veneers will make everything look great (though I am not looking forward to the expense of all new veneers).

Meanwhile, he ground off my attachments and took new impressions for refinements. He expect 5-10 aligners for round 2, followed by retainers which he will make in-office. They also took new photos. Will post when available.

The last aligners feel strange without attachments - there is no "click" to know they are properly placed, and they are much easier to remove. He told me to wear the aligners only at night until the refinements are in - he is hoping some of the teeth in the back will "settle in" - with Invisalign the aligner prevents full contact of the teeth, so they need time without aligners to get into final positions.

The FDA and Invisalign

The recent activity between the FDA and Align Technology is concerning. Seems the makers of Invisalign have been neglecting to report side effects reported to them by patients and dental professionals. This is an FDA requirement for makers of medical devices.

This was a concern of mine going in...I have sensitivities to many chemicals, and Invisalign aligners are essentially plastic gadgets you leave in your mouth nearly full time for a year or more. I also read that the aligners are sprayed with a disinfectant before leaving the factory; the disinfectant could also cause reactions.

What should we all be doing about it? First, keep an eye out for side effects like swelling, sore throats, itching lips or gums. Keep you orthodontist in the loop, and don't be afraid to report to the company or FDA. I also take the precaution of thoroughly cleaning fresh aligners before inserting them. This means soaking in Dentasoak (which I love [unpaid endorsement]) for 15 minutes, then brushing with a toothbrush and a little low abrasive toothpaste, then a good rinsing in warm water. Seems to take away the "plasticy" taste and odor of new aligners.