The Reboot

Three weeks after my visit they finally called to tell me that my new aligners were in. However, the doctor was out of town that week so I couldn't get in until a full month after we had ordered them. It was longer than expected, but still quicker than the old way. But here's the thing with wearing the same trays for 4 weeks: it's gross. They turned yellow. I soaked them in peroxide. I soaked them in Efferdent. I soaked them in peroxide and Efferdent together, which made a nice bubbly mess, but left them still disgusting. I do not ever want to have to wear them for that long that again.

The big question I've been wondering while waiting was how far out this whole episode with the tooth that wasn't tracking would set my treatment plan back. I was on tray 16 of 44, so 28 to go. My new set has 21 total. So even though I lost a month waiting, I'm still going to finish 3 weeks ahead of schedule. Can anyone explain that to me? How exactly did having to adjust for an uncooperative tooth shorten my overall treatment? Makes no sense to me, but I'm not complaining.

At the visit, they had to adjust some attachments for the new aligners. The two on my front upper teeth came off (though they told me that they would be going back on later) using basically a dremel tool. They added two to my lower teeth towards the back one side. I can't quite figure that out, either. You would think since the bottom were doing fine that the same course of treatment would apply.

The assistant that was working on me clearly did not want to do any more messing with the attachments than necessary. I specifically asked her if the attachment on my trouble tooth needed to be changed, and she said no. After she was done, the doctor came around to examine me and pointed out that all the attachments on my bottom front teeth were a different shape and size and needed to be changed. So back in she went, ground them off and re-applied them with the new mold. Another inspection from the doctor, and I was done.

Except I wasn't.

After I got home, the first time I took the tray out and looked in a mirror I realized that the attachment on the tooth that had been giving me problems did not line up with the notch in the tray. At all. It was in a different spot, and was a different shape and size. I was very frustrated. If it was any other tooth, I would not have been so worried. But since it was the tooth that caused us to have to completely redo my whole treatment plan, I thought that we had better get it right.

I called and asked to speak to the orthodontist himself. I explained what I saw and he agreed that it should be redone. He said to come on over and they would get me in right away, which they did. When I walked in, the assistant that worked on me the day before gave me a funny look and said, "What are YOU doing here?" It was kind of awkward, but she fixed me up and now I don't have to worry about it.

Two days later, an attachment fell off a bottom tooth. I'm going to just keep an eye on it and have them fix it at my next regular appointment.

OH! One more thing...   Since they removed the attachments on my front two upper teeth, I got to see if the whitening I've done permeated the attachment. It did! There is not a darker color where the attachment was, they are evenly white. NICE!

The Waiting is the Hardest Part, Part II

It's been two weeks and one day since I was at the Orthodontist and they told me that we would have to get an all new treatment plan to correct for one insubordinate tooth. They said the new trays would be there in about a week and a half. Meanwhile, I am to stay on the set of trays I was already on. In other words, we're making no progress while we wait. When my new trays come in, I find out how many sets I will have. I was on set 16 of 44, I can only imagine that the overall treatment plan will be longer, plus add in the down time while we're waiting. The anticipation is once again killing me.

Can You Bleach Your Teeth With Invisalign?

Time to reveal more of my sordid dental past. When I was a kid, my teeth were horribly stained and yellow. They not only had an overall yellow-ish tint, but had splotches of darker yellow peppered throughout. I'm not sure what caused it. I don't think that I had worse dental health than most children, especially after observing my kid's habits (we found out that when my oldest son was away at camp, he found it best to just wait to brush his teeth until someone would comment on his breath). It got so bad that my parents agreed to let me get bleach trays from the dentist. But like most things, we did it only half-way and just got an upper tray. I'm sure my parents thought that I would be a typical irresponsible middle-schooler and lose the things anyway, so they only paid for one.

What I remember actually making the most difference was the scrubbing the dentist gave me before the treatment. To prepare my teeth, he sort of just got in there and ground on them with some rotary instrument. After that, they looked much better and frankly the treatment could have stopped right there. But I got my tray, and my gel. I was to wear it all day and keep the tray filled, which was tough to do because the gel was flavored and it's hard not to suck it out. But I tried, and my upper teeth did get noticeably whiter than my bottoms. And then I lost it. Of course. I blamed the cat.

Now that I'm wearing similar trays 22 hours a day, I got to thinking that maybe I could try the whitening process again. Nowadays my teeth aren't terribly yellow, but I do find myself jealous of other's white smiles sometimes. I also do still have an interesting stain on one of my front teeth that sometimes seems more pronounced than others. I'm sure no one else notices it, but I do. So I looked up on some info on using whitening gel in Invisalign trays. I didn't find any clear answers as to whether this was a good idea or not. Some said that it's pointless because you'll end up with dark patches where the attachments were. They also point out that the Invisalign aligners fit much tighter than whitening trays, and they insist that the gel will just be forced out when they snap in anyway. Others insist that it's a great time to do it since you're already wearing the trays, and the bleaching actually permeates the enamel and whitens the teeth beneath the attachments. Everyone recommends consulting your orthodontist first. I didn't.

I am NOT recommending this, I'm just sharing my experience. I found some whitening gel on the internet one night and just decided to go for it. I won't tell you where I got it or what brand it is or how much it was, but let's just say that it's readily available and is surprisingly cheap. I keep calling it bleach out of habit, but it's actually carbamide peroxide, whatever that is.

First I remove the trays and dry them. Then I carefully place the gel across the front of the aligners, making sure to coat the entire surface and remove any excess. (the first time I made the mistake of using too much). Then I dry my teeth with a paper towel and insert the trays. I then wipe any excess off my gums with the paper towel. It is supposedly mint flavored, but tastes like medicine. If the gel sits on your gums too long, it burns. While I have them in I try not to suck the gel out, and limit swallowing. Dabbing the paper towel around my mouth every now and then helps. It's an unpleasant process. The instructions say to leave it in for 30-60 minutes and repeat as needed. I did it once a day for roughly a week, and have done it a few times since then to refresh. It has made a noticeable difference.

So can you bleach your teeth while using Invisalign? Even though I am, I'm still not sure.

What Happens When Invisalign Doesn't Work?

As I discussed in my last post, one of my teeth is not cooperating. Here is the culprit:

As you can see, it's just not moving with the rest of them, and now the attachment on that tooth no longer lines up with the notch on the tray at all, so it's pretty much hopeless that it's going to fall back into the program.

So today I went to the orthodontist for my regular appointment, and discussed it with him. He noticed it right off, of course. Basically the only way to correct it is to toss the rest of my trays and start over with a new plan from the computers at Invisalign beginning with this point in time. I was assured that this will not result in any extra costs for me. I can only guess that this will add time to my overall treatment plan, but we won't know until my new trays arrive. Luckily, that shouldn't be too long from now because my orthodontist has a new toy.

Rather than make molds like they did the first time, the office now has a machine that skips that step and creates the computerized 3D images right on the spot. This means no more mailing the physical molds to California and waiting 4-6 weeks for them to send the trays. Instead the file will be sent electronically, and I will have my new trays in a little over a week. The machine even does a preliminary treatment overview and shows you exactly how your teeth will look when done. Really cool. Here's the machine with the rough model of my teeth before it did all its processing:

The process involves a technician simply taking that wand and going over and over your teeth with it until a complete image is generated. She had some trouble with mine, mainly because the machine is new and I was only the third person she'd ever used it on, but also because it was very difficult to get the wide wand all the way to the back of my mouth to get my still-present wisdom teeth. It was very uncomfortable, and someone with a very active gag reflex would have certainly had a hard time tolerating it. But nonetheless even with the complications the whole process took about 20 minutes. If 20 minutes of being uncomfortable can save me 5 weeks of waiting time, I'm all for it.

Other than that, the visit went well. I'm to continue to wear the tray that I'm on until my new ones arrive. He was pleased with the way that the elastics (rubber bands) have been moving my lower jaw back. I was pleased that they had a fix for my wayward tooth, and that it won't cost me any more money.

Week 15 Update

Things are still going along remarkably uneventfully. However, I do have one concern that I will bring up with my orthodontist at my next appointment later this week. One of my more crooked teeth is obviously not behaving the way it's supposed to. You can see it in this picture:

It's the one on top just to the right of the large one in the center. You can see that it doesn't fill out the bottom of the tray, because it's not moving like it's supposed to. The attachment on the tooth no longer comes anywhere near the notch on the tray. This means that the flat part of the tray is actually being pressed out by the attachment, distorting the tray and affecting how it lays on the next tooth. I took this picture more than a week ago, I can tell that it's even worse now with the next tray in. That tooth is not moving.

I'm not sure what they do when things don't go as planned. All the trays are made for the whole process already. If it's bad enough do they start over with new molds? Or do they just ride the process out and then make extra corrections at the end somehow? I guess I'll find out soon.

Movement!

I think I understand the strategy now. It seems like my teeth are spacing out quite a bit. The plan must be that they get spaced out first so there's room, and THEN they start turning/straightening. The gaps between my teeth are huge. I can tell becauseand I'm getting food stuck in places I never have before, and because the floss just glides between them without even touching sometimes. Next time I'm at the orthodontist I will confirm this by watching my progression video again. Maybe they'll let me video it so I can share!

Regular dentist visit today

Today I had my first regular dentist visit since getting my braces.

Now, a little strange background on this. When I was a youngster, I of course went to the dentist regularly, and regularly had cavities that would need filling. I think four or five altogether. But then as a young adult, I stopped going. You see, I missed an appointment (due to being a lazy teenager that refused to get out of bed), and somehow I was under the impression that when I did go in, I would have to pay for both appointments, which seemed unjust to me. Where I got this idea, if it was true, and why I was even concerned when I wasn't paying my own medical bills yet anyway is all a mystery. But rather than suffer this grave injustice, I didn't go back. For 20 years.

Time just got away from me I guess. And I've had zero issues with my teeth. I've been very lucky. But my family recently found a great dentist, and I knew I was way overdue. So finally, a little over a year ago, I went to the dentist. We did x-rays, cleaning, the whole deal. No issues. I was worried sick that they would tell me that I had to have my wisdom teeth removed, but no. Everything was fine. The hygienist said I had some plaque buildup, but no worse than anyone else that gets regular checkups. They were all just completely amazed that I really hadn't hadn't been to the dentist for 20 years, and had no complications.

When I checked out, she asked if I wanted to schedule an appointment for my next cleaning in six months, and I laughed and said, "No, I'll see you in twenty years."

But then the braces thing happened, and I know that I should get regular cleanings at least while I have Invisalign because the trays trap things in them and actually promote plaque forming. So only a little over one year later, I found myself back at the dentist.

They wanted to do x-rays, but I declined and she was very polite about not pressuring me. It's not that I mind doing them, it's just that it seems unnecessary at this point for any reason other than to help pay for their machine. That's not meant as a dig against dentists, or a suggestion for other people to follow. It's just how I feel about my particular situation. I don't get my car aligned unless it's pulling or shows unusual tire wear, either.

Anyway, the visit went very well. The hygienist scraped my teeth with the pokey thing, and ran that icky paste over them, and it was all done. She was shocked at how many "buttons" we're on my teeth, and I told her that it was indeed an office record. Then the dentist came in and was just as flabbergasted. "You've even got metal ones! That's very unusual." Yes, yes, I know office record-holder here.