My experience with InvisAlign and Dental "Veneers"

[patrickosmith]

Over the years my teeth have shifted a fair amount. The teeth adjacent to my two front teeth were moving forward. Relatively speaking, the two front teeth were moving back. Most concerning: the rate of shift was increasing. So, I decided to straighten my teeth in a way that would allow me to practice and play trombone with the understanding that my performance and progress would take a hit for years but also with the understanding that the experience might make me a better player and teacher in the long run.

So, before I forgot too much, I am here to report on my particular experience with InvisAlign and dental restoration (with veneers and crowns). I would not recommend my approach to anyone who relies on performing a brass instrument for a living. For those I would recommend an approach that attempts to retain and/or straighten teeth as early as possible with a nightly appliance.

1. Expectations / goals at outset:
* achieve a permanent, stable tooth structure without need for retainers
* allow practicing and playing the trombone without too much of a hit
* multi-year process

2. Plan / steps
* Use InvisAlign to straighten teeth and correct cross bite as much as possible; 22 hours a day (~2 years)
* Retain teeth with InvisAlign retainers; nightly; 6 to 8 hours a day (~1 year)
* Temporary restorations: round one and round two (~1 year)
* Final restorations (~1 year)

3. Experience to date is a loss in range and endurance:
* when beginning to play with InvisAlign (3 to 6 months)
* after removing InvisAlign (2 to 3 months)
* when beginning to play with Temporary restorations (3 months and counting ...)

4. Final outcome; was it worth it?
* For playing trombone, I'll know more in a few more years
* For other reasons (cosmetic and otherwise), definitely Yes.

Even though this is expensive (you can seriously buy a nice BMW instead of fixing your teeth), it is a permanent investment/improvement in yourself. If you are going to do it, then plan to do it right with an expert dentist close to your home. Luckily I am fortunate to have one of the best in the world very close to where I live.

[harrisonreed]

It's a gamble for sure. My dentist wanted to give me braces and all kinds of things for my crooked teeth. They actually aren't all that crooked, but to an American dentist a slightly shifted tooth is like a horrible disability. They also said to me as a high schooler that as I grew my teeth would just get worse and worse until my jaw wouldn't work any more.

What they didn't tell me, and what I wouldn't find out until I went to a military dentist, was that my crooked teeth and teeth shifts were being caused by my wisdom teeth. Got those removed, teeth problems solved. My childhood dentist absolutely knew this, and I suspect he only would have suggested the removal of my wisdom teeth AFTER we agreed to do braces, as a part of the process.

In your case, it sounds like you did the right thing, or at least a very expensive version of the right thing. I just tell my story because dentistry is big business, and my dentist as a kid was talking out of his ass to get me to go through braces and retainers and all kinds of crap unrelated to the problem, which was impacted wisdom teeth. Always get a second opinion.

[robcat2075]

I'm surprised there is a detriment when straightening with Invisalign.

I would have expected the changes to be so slow that you would adapt to them before you noticed them.

[Doug Elliott]

What are "Temporary restorations"?

And how's that BMW your dentist drives now?

[patrickosmith]

I'm surprised there is a detriment when straightening with Invisalign.

I would have expected the changes to be so slow that you would adapt to them before you noticed them.

That's true if you play without the InvisAlign attached. But you are required to wear it 22 hours a day (pretty much always on). You can keep them on only if drinking water. And you must brush and floss your teeth after every meal and/or drink (other than water).

That leaves no time for practice/rehearsals/performances.

[patrickosmith]

What are "Temporary restorations"?

And how's that BMW your dentist drives now?

So my 2nd round of "temporaries" look and feel quite good. But they are in groups of 3 (ganged together). I am told that compared to the permanents to come that the material and look isn't quite as good and that the milling isn't as fine.

I'm guessing my dentist has a stable of exotic cars. I'll ask next time I'm there. The machine he used to digitally scan my teeth was $250K. He probably has 2 of them.

[patrickosmith]

I just tell my story because dentistry is big business, and my dentist as a kid was talking out of his ass to get me to go through braces and retainers and all kinds of crap unrelated to the problem, which was impacted wisdom teeth. Always get a second opinion.

Totally agree to get a second opinion *and* to do your own research. FWIW my twin sons just completed their course of orthodontics. The X-rays shown that one of them requires wisdom teeth to be extracted but the other does not.

[harrisonreed]

FWIW my twin sons just completed their course of orthodontics. The X-rays shown that one of them requires wisdom teeth to be extracted but the other does not.

Heh, they must not be twins then! Ask for your money back from the doctor at the maternity ward for false documents and damages! Maybe it will fund their braces.

[Kbiggs]

I had InvisAlign braces and retainers about 10-15 years ago. I wrote about it on the old TF. I’ll try to find the link…

Like you, Patrick, my teeth had shifted in adulthood. I had braces in my teens, and I had my wisdom teeth pulled as a young adult. With my braces as a teen, it was standard practice to remove some teeth in order to “make room” for the remaining teeth to shift into a cosmetically pleasing position. In my case, they removed four teeth: the premolars on both sides and both the upper and lower jaws.

Yes, removing four teeth helped the remaining teeth to move into that cosmetically pleasing position. Unfortunately, over time, that extra room (where the removed teeth were, creating an empty socket that was “filled in” by the shifting of the teeth) has allowed the teeth to re-shift back into their old place post Invisalign. It’s most noticeable on my lower incisors, which have once again become crowded, with one having a slant to the inside of the mouth. Ironically, that tooth was the primary reason chose to get braces as an adult. It also created a lot of space between my back molars. Lots of room for food to hide. Suffice it to say I floss—a lot.

FWIW, I chose Invisalign precisely because I could remove the braces while playing. I discussed it with my dentist, who said it shouldn’t be problem. It simply extended the treatment by a couple of months.

[AndrewMeronek]

There definitely is incentive for dentists to get patients to agree to more work than they actually need in the U.S. - I believe I've seen that in action for me. For example, add a filling for a cavity that is currently posing no problem (but maybe it will in the future so get rid of it) but don't take a proper molding of the tooth beforehand, requiring a few post-filling visits (each charging more $$$) to refine the shape of the filling so it doesn't change my bite or impact other teeth and potentially cause damage, that they should have gotten correct from the start. I'm glad my current dentist office (with a very good oral surgeon on staff) doesn't go for that nonsense, but it took some shopping.

My teeth had also been moving as an adult, so I currently have Invisalign retainers and my teeth where they need to be now. Trombone'wise, I noticed no endurance hit, and some things are noticeably easier now, like shifting in and out of my pedal register. The whole pandemic was frustrating for my tromboning, as I haven't had my normal schedule of gigs to really test-drive my "new" chops.

[Dennis]

I'm surprised there is a detriment when straightening with Invisalign.

I would have expected the changes to be so slow that you would adapt to them before you noticed them.

I got my teeth straightened out with Invisalign a couple of years ago. It was a 15 month process. I wore my aligners except when eating, so about 22 hours a day. I kept the aligners in while playing. (For reference, I had a Type II malocclusion with crowding. I had the braces done because the malocclusion caused me to chip a lower incisor. My dentist told me it was going to continue to happen until/unless I got it fixed. That convinced me to spend the money.)

Invisalign actually works faster than conventional braces. The orthodontist I consulted said brackets and wires would be a 24 to 36 month process. He recommended brackets because Invisalign required a large number of leverage points. I went with Invisalign, and it worked fine. He also warned me that shaving the sides of my incisors might be needed. It was necessary.

I found it easier to play bass than tenor with the aligners in. The worst effects were to articulation: my aligners ended right where the tip of my tongue went to articulate. It caused some wear and tear on my tongue. I used orthodontic wax to create a smooth surface up there when I played. I lost a little in the upper range. I still have to wear a retainer overnight, and will for the rest of my life. But I'm accustomed to it now. Now that it's over, I've regained the upper range on the tenor, slightly increased the upper range on the bass. What has changed is endurance: it's rather better now on tenor. (I've never had an endurance problem on the bass.)

My only regret is that I waited so long to do it.