Can Invisalign Fix Misaligned Teeth?

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I went to see my dentist, who also does braces, about having my teeth straightened with Invisalign. He told me that it really doesn’t work with misaligned teeth and I need to do traditional braces. I am a bit confused because a friend of mine, whose teeth were frankly worse than mine, used Invisalign. I just feel I am too old to have a mouth full of metal, but guess if I have to I will.

Betty

Dear Betty,

Invisalign Versus Braces

I am not sure why your dentist said that Invisalign did not work for misaligned teeth. That is exactly what it was designed for. I can think of some possibilities.
1. Maybe he knows how to do braces but isn’t certified to do Invisalign so he is steering you toward what he knows.
2. Maybe there is something complicated about your case that you didn’t mention, though I doubt it if your friend had worse teeth and did fine.
3. Maybe he is thinking about how when Invisalign first started, they would only work for the ideal cases. Now, however, the procedure is much more advanced and can align just about anything, with the exception of unusually complicated cases.

My suggestion is you look for an Invisalign certified dentist and get a second opinion. I bet there is a good chance that you are a candidate for this treatment.

A Hidden Benefit to Invisalign

On top of not having metal wires and brackets, as well as working faster, Invisalign has an additional benefit of allowing you to whiten your teeth at the same time. Ask whatever dentist you end up with to provide you with some teeth whitening gel. The aligners can double as whitening trays and you can just wear the gel for any length of time you are comfortable while you are straightening your teeth. It is like getting a mini smile makeover.

This blog is brought to you by Marietta Dentist Dr. Cristi Cheek.
Click here to learn about our free virtual smile consultation.

Replacing Congenitally Missing Lateral Incisors

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My daughter has congenitally missing lateral incisors. Now that she is starting high school, she is quite embarrassed by her baby teeth when she smiles. Our dentist suggested that we extract her teeth and get braces to close up the space. I am afraid that will look weird. Can you tell me if there are any other options?

Dolores

Dear Dolores,

a smile with missing lateral incisors

Missing Lateral Incisors

 

I am glad you wrote. Your dentist is giving you very bad advice. I’m glad you picked up on the fact that it would look quite weird if you followed through with his guidance.Ā As you can see from the image above, this girl had done what your dentist is suggesting for your daughter. As you can see, it does not look normal. In fact, it looks downright vampiric.

The baby teeth do need to come out, but I don’t suggest you use traditional braces. Instead, I think your daughter would be more comfortable with Invisalign. These use clear aligners. None of her friends will even know she is having her teeth adjusted. Then, once the space is opened up enough to fit adult-sized teeth, you can get her the replacement teeth she needs.

 

invisible braces

Invisalign Invisible Braces

 

The best tooth replacement is a dental implant. However, you will have to wait until her jaw is fully developed for that. In the meantime, she can use a temporary tooth replacement in order to hold the spot open for when she is ready for something more permanent. A dental flipper is inexpensive and will serve her well until she is old enough for the dental implants.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.

Invisalign for Protruded Teeth

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My mother has had protruding teeth her entire life. I know she’s been ashamed of her smile, but was never able to do anything about it. My parents worked hard but were quite poor due to not having much education. They sacrificed their own future to make sure I’d have one and gave me a great education. I’m in a place now where I can take care of myself and them. I don’t know if cosmetic dentistry can work or if she’ll need something else. Can you point me in the direction of some options to consider?

Patricia

Dear Patricia,

You brought tears to my eyes in your love and compassion for your parents and what you want to do for your mother. Often you will find when patients have a misaligned bite, they also have headaches. Fixing her teeth will not only help her feel more beautiful, but it can also improve her quality of life. I haven’t examined your mother or even seen a photograph of her teeth so I’m going to give you all the options I think may work. She’ll need an examination to see what will work best in her situation.

Traditional Braces

This is a tried solution, though most adults are not too thrilled with a mouth full of metal. It is what I would use if her case were too complicated for any of the other solutions.

Invisalign Braces

invisalign aligners

For older patients, I prefer Invisalign. This uses clear aligners to straighten teeth. They are invisible even at a conversational distance.

Because the aligners can double as teeth whitening trays, they will allow her to straighten and whiten her teeth at the same time, giving her a mini smile makeover.

Porcelain Veneers

porcelain veneers

A final option is porcelain veneers. This is the most expensive. It doesn’t actually straighten her teeth but can make them appear straight. It can also change the shape, size, and color of her teeth at the same time. However, it will only work if her teeth are not too protruded.

I’d take her to see an excellent cosmetic dentist and discuss each of these options. Personally, I favor the second option, but it really is up to you guys to decide what is best for her.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.
Click here to learn about our free virtual smile makeover consult.

Can a Dental Implant Fix Her Triangled Teeth?

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I have a complicated case and I am not sure what to do. I have a baby canine tooth that has finally succumbed to decay. That tooth never fell out because my teeth shifted a bit when I was a child after a dentist pulled a baby molar. Now my canine tooth came in but in front of my first and second bicuspids. They’ve formed a sort of triangle. Not only is it embarrassing, but it is nearly impossible to keep thoroughly clean, though I am as diligent as I can be with it. My dentist feels it is too far away and the root system too tangled to use orthodontics to get it in the right place. I do have to remove the baby canine and I just want to have a normal and hopefully attractive smile.

Kelly

Dear Kelly,

dental implant diagram

I would think most dentists, who love their field, would be thrilled to work on a case as complicated as yours. It is possible your dentist feels in over his head with this one. Every dentist goes into the profession with different goals. He may just love being a good bread and butter family dentist and like keeping people’s teeth healthy but not get into all the complicated cosmetic stuff. That’s okay, we need good family dentists.

The only problem for you right now is you need someone with experience in cosmetics. There are a few ways to handle this, but it would take someone looking at your specific bite and x-rays to give you a definitive answer. Here are some possibilities, though.

Options for Fixing This

First, you could extract the baby and adult canine teeth, then use Invisalign to get the opening the right size, along with giving the other teeth proper alignment, and then have a dental implant placed in the area where your canine goes.

Another possibility, if the canine can’t be moved, is to extract it, then have your first bicuspid shaped to look like a canine in the front. That has been done many times with good results.

The key for you, however, it to make sure the dentist you see has the training, experience, and artistry you need to give you a beautiful finished product. I would make sure you look at their smile gallery, which is a sort of brag book for dentists, to see what type of results they get. Then, if they’re good, trust their instinct on the best way to handle this situation.

When Baby Molars are Extracted

I don’t know if you are currently a parent, but I want to tell you how you can avoid this situation with your children. Whoever your pediatric dentist was made a critical error. Baby molars need to stay in place until a child is at least 12 years old. Otherwise, you risk the teeth shifting, which leads to crowding and a complicated bite such as you are facing now.

There are times, however, that a molar cannot be saved. When that is the case, it is imperative the dentist puts a space maintainer in the area in order to keep the teeth in proper alignment. It sounds like your childhood dentist neglected that. Make sure whatever pediatric dentist you have for your children, doesn’t make the same mistake.

I know finding the right dentist will give you a smile you are proud of.
This blog is brought to you by Marietta Dentist Dr. Cristi Cheek.

Fixing a Tooth Gap

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I have a medium-sized tooth gap. My dentist is suggesting we do Lumineers, but I am on kind of a tight budget at the moment. Would I better off getting braces? I’m not too keen on that idea because I’m in my early 30s, but I am ready to get rid of this gap.

Leslie

Dear Leslie,

I’m glad you wrote. I am not going to recommend you go with Lumineers. It is a rather large overtreatment for your situation. The good news is, you can fix this without ugly metal braces. You have two good choices here.

Option One: Dental Bonding

before and after dental bonding

In most cases, dental bonding is the solution. It uses a composite bonding to close up the space. In the picture above, you see it used to repair a chipped tooth. This is not something any dentist can do. You will need to go to an experienced cosmetic dentist, especially since it has to be done freehand. I am not going to recommend you use your dentist for this. My guess is he suggested Lumineers because he doesn’t know how to do dental bonding. The Lumineers brand is often marketed to dentists who are inexperienced with cosmetic dentistry as being easy to place. That is likely why he suggested it. If he does this, you won’t like the results.

One thing to note. While the color can be made to match your teeth perfectly, the color is permanent. If you decide to whiten your teeth in a year, your natural teeth will whiten but your bonding will not. Because of that, I often suggest if you plan on whitening your teeth to do so before you have the bonding done. This will save you money in the long run.

Option Two: Invisalign

Invisalign Aligners

If the only thing you want to fix about your tooth alignment is the gap, then dental bonding is the way to go. It is faster and cheaper than the option I’m giving you now. However, if there are other things about your bite that need to be realigned, it will be worth it to get Invisalign. These are sometimes called invisible braces. That is because they use clear aligners to straighten your teeth. There are no wires or brackets either. No one will even know you have orthodontics on.

Either one of these will work for you and will be a better and less expensive option than your dentist is suggesting.
This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.

Crooked Discolored Teeth

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I am 37 years old and recently divorced. I have discolored and crooked teeth. This is a point in my life where I really do not need to feel ugly. At this point in my life, braces are the last thing I’ll want. Are there other ways of improving my smile given my issues?

Joan

Dear Joan,

Invisalign Aligners

I am sorry to hear about your recent divorce. That is a difficult and trying time. You certainly deserve to feel attractive at any point in your life, but especially at a time when everything else feels up in arms. Fortunately, there is a way to improve both aspects of your smile at the same time, and you won’t have to wear a mouth full of metal.

You have a couple of options. I’ll start with the least expensive. Your crooked teeth could be repaired with Invisalign. These are sometimes called invisible braces. Instead of the traditional metal wires and brackets, it uses clear aligners to straighten your teeth. Not only does this allow you to straighten your teeth without anyone knowing, but it does so in a fraction of the time that the metal braces would.

They also have the additional benefit of allowing you to whiten your teeth at the same time you are straightening them. The aligners can double as teeth whitening trays. This saves you additional money.

If the only thing you are concerned about is the discoloration and crookedness, this is the way I’d go. If, however, you have other things about your smile you would like to repair such as their length or character, then getting a complete smile makeover with porcelain veneers would be the way to go. These are high end and what celebrities use to give themselves that Hollywood smile. With porcelain veneers you can change the shape, size, and color of your teeth all at the same time.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.

Will Invisalign Work with Missing Teeth?

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I have two congenitally missing lower bicuspids and have grown up with crooked teeth. One of the lower bicuspids had to be pulled because of decay. I’ve spent a lifetime embarrassed about my smile. I don’t think having a mouthful of metal will help with how I feel about my smile. Someone recently told me about Invisalign. I would like to use that but don’t know if it can work around missing teeth. I’ve had an orthodontist say no and a regular dentist say yes. I want to believe the dentist but that may be because I really want a pretty smile. Any advice?

Trina

Dear Trina,

Invisalign Aligners

I’ve often found that orthodontists are more conservative with Invisalign because their training is in orthodontics. Dentists who work with Invisalign have invested more time with it and are more comfortable with it. In fact, Invisalign works well around missing teeth. I’d go with your dentist.

There is a hidden benefit to Invisalign as well that you can’t get with orthodontics. The clear aligners that Invisalign uses can also double as teeth whitening trays. This will give you a mini smile makeover while saving you money on teeth whitening.

Once your teeth are in their correct placement, you will want to replace the missing teeth in order to keep them retained in the right place. There are several options in replacing missing teeth, but in your place, I would want dental implants. They are the most like having healthy natural teeth in your mouth again. Talk to your dentist about all the tooth replacement options available to you and you can decide what is best.

Be aware that not every dentist is trained in dental implants. It is possible you’ll have to go to one dentist for your Invisalign or another for your dental implants. A third option is finding a dentist skilled at both. Whichever way you go, you will be able to have the smile you always wanted.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.

Smile Direct Club Complications

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I am not sure how familiar you are with Smile Direct Club. It is a mail-order invisible braces service that compares itself to Invisalign, but less expensive. Does it work? Sometimes. When it doesn’t, though, it is a disaster.

We came across this video on YouTube from a Smile Direct Club user. For the sake of time, we have a shortened version of it. The full version, which is about 20 minutes, can be seen on YouTube.

Here is some background. This patient is entering her 6th month with Smile Direct Club. She is striving, without success, to place her new aligners in. After about twenty minutes, she gives up. The original video was posted in December of 2018.

In a follow-up video, we learn what happened. SmileDirectClub mistakenly shipped her month 5 aligners in month 4 and then shipped the month 4 aligners in month 5. This meant that in month 6, when she should have been finishing her month 5 treatment, she had actually gone backward to month 4’s position. This made it extraordinarily difficult to place her new aligners in.

While you make think what is the big deal? It is a huge deal. Imagine a doctor getting two different patient’s x-rays mixed up. As a result, they gave the treatment to the wrong patient and the patient who actually needed the treatment is left without the necessary health care. This is malpractice and could lead to serious consequences.

For this patient, starting the month five treatment early put a great deal of stress on her teeth, risking root absorption. Then, going backward this means additional stress was put on her teeth. I would love to see some before and after x-rays of her tooth roots from his mix-up on the part of Smile Direct. I’m fairly confident there will have been some root resorption which will put her at risk of tooth loss.

Another huge problem is that the patient is left to figure this out for herself. Fortunately, she made this video which alerted the company they were getting some bad press. There really isn’t follow-up with this company so most patients are left completely on their own.

If you are going to get invisible braces, like Invisalign, my suggestion is you do it through a dentist where you will get constant follow up care to make sure your treatment is going according to plan. And, who is there to make safe adjustments if it is not.

Invisalign has a hidden benefit as well. The aligners can double as teeth whitening trays. So, if you ask your dentist for some professional strength whitening gel, you can straighten and whiten your teeth at the same time, giving yourself a mini smile makeover.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.

Does Smile Direct Club Work?

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I know it probably seems weird that I am asking you, a dentist, about an online orthodontic service when you sell Invisalign. But, I live clear across the country from where you practice, so you won’t lose any business by telling me the truth. Hahaha. So here is my question. Every time I get on Facebook, I see an ad for Smile Direct Club. They do have quite a few good reviews. But, I thought before I invested in it I would like to get a real dentist’s opinion. Does Smile Direct work?

Rebekah

Dear Rebekah,

SmileDirectClub Advert

I’m glad you wrote. And don’t worry, you aren’t the first person to ask about this particular service. My duty is to ensure those who are seeking dental advice from us get the best and understand their options. So, never hesitate to write with questions. Yes, I am not surprised you see the ads a lot. They are heavily advertised. As for the good reviews, that doesn’t surprise me either, but not for the reasons you think.

Recent investigative journalism has uncovered Smile Direct Clubs’ habit of only offering refunds to unhappy clients if they sign a release saying they won’t post any negative reviews and will remove any negative content they have already placed. In other words, we won’t get a true picture of their reviews because patients with bad experiences don’t talk about it in order to get a refund.

However, let me just go into what we know for a certainty about how this program works.

Problem One: Missing Diagnostics

A good dentist will do a full mouth series of x-rays and a comprehensive dental examination. This would include looking for things such as signs of TMJ Disorder, tooth decay, and gum disease. Skipping this step can cause the patient a lifetime of pain and unnecessary dental work that could have been avoided. To me, it is inexcusable to skip this step.

Problem Two: DIY Impressions

In order to get a truly accurate treatment plan, it is imperative the impression is done carefully. That means there will be no bubbles, tears, or other defects. This step is so important that some dentists won’t even allow their assistants to take it. With Smile Direct, they just send you a kit to do your own impression at home. I find it doubtful this will give you the best orthodontic treatment.

Problem Three: Adding Space

Most cases of patients needing braces have crowded teeth. This means they will either need some shaving of a few teeth or some back teeth extracted. This needs to be done by a dentist invested in you and the case. Unfortunately, Smile Direct has a shortcut to this too and I worry about its impact on patients.

Problem Four: Inadequate Follow-Up

When you do a treatment, such as Invisalign through a dentist, you are getting follow up care every two weeks when you are given your new aligners. This prevents so many problems. While the treatment is pre-planned, sometimes our teeth don’t cooperate. Maybe teeth don’t turn the way they are supposed to or more space is needed than we originally thought. Without that follow up, your teeth could end up in a worse position than they were to begin with.

What does this mean for you? Well, you could try Smile Direct Club. It might turn out well for you and you’ll save some money. However, first I would get a complete examination from your dentist just to make sure you don’t have any underlying conditions that could cause a problem. But, you are taking chances. So go into it with eyes wide open.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.

A SmileDirectClub Concern

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Last month I wrote about some reviews customers of SmileDirectClub posted to illustrate potential concerns with using mail-order orthodontics. Today, I would like to look at an accusation levied against SmileDirectClub in a New York Times article. You can read the article in total here.

Does SmileDirectClub Hush Its Critics?

One of the concerns posited by the article is that for some clients to get a refund from the company when their treatment didn’t work, they had to agree not to post anything negative in addition to removing any negative posts or reviews on social media. According to the article, “When some of the customers requested refunds, SmileDirectClub asked them to sign the confidentiality provision. The agreement prohibited the customers from telling anyone about the refund and required them to delete negative social media comments and reviews, according to a copy viewed by The Times.”

Often potential patients rely on reviews to help them make a decision on whether to make a purchase, therefore the more complete the information the more likely the patient is to make the decision that is best for them. However, when some of that information is being suppressed, it makes it difficult for patients to see the whole picture.

While no dentist is perfect, after all, we’re human, when a dentist gets a bad review, their concern should be making things right with that patient, not hiding the review. One of the ways you can know when a practitioner cares is in how they handle problems. Any company, no matter what the field, if they have an occasional bad review but address the issue in good faith, then you know they care about their customers, or in a dentist’s case, patients. On the flip side, if you see bad reviews that are never even addressed you can know they don’t seem to care about making things right.

Why hide the reviews if they make things right? I can’t answer that on their behalf. One thing that makes me wonder, though, is out of the seven customers interviewed by the Times, more than half of them found the treatment made their bite worse and they had to seek outside treatment to get it fixed.

SmileDirectClub’s Litigiousness

A second concern the article brought up was how litigious the company is. In addition to suing Lifehacker over an article they published about the risks of using SmileDirect, they have also sued several dental boards for what they perceived as steps to make it harder to use their services.

Yet, while they seem very willing to jump into court themselves, they make each potential customer sign a form that they would not sue the company for any reason.

I will always stress the importance of doing any type of dental work whether traditional braces or invisible braces, such as Invisalign, under the care of a dental professional. Orthodontic treatment rarely goes as planned from start to finish and the dentist or orthodontist will make adjustments throughout the treatment for you to get the optimum results.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.