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.

Dentist Said Overbite Means I Can’t Have Porcelain Veneers

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I wanted to get a smile makeover, but my dentist said I cannot have porcelain veneers because my top teeth cover my bottom teeth in what he calls an overbite. Instead, he wants to do six dental crowns. Will that work? Should I get my bottom teeth whitened so they’ll match the crowns on my top teeth?

Farah

Dear Farah,

dental crown versus a porcelain veneer

We see this a lot with family dentists. They don’t have cosmetic dentistry training and do not know how to do porcelain veneers, so they tell their patient that they need porcelain crowns. There are a few things to be aware of with this.

First, smile makeovers are not taught in dental school. Putting one crown on a decayed tooth is a LOT different than doing a smile makeover with crowns. If he can’t make porcelain veneers look beautiful, he can’t make dental crowns look beautiful. You will not want him to do your smile makeover.

Second, as pictured above, dental crowns require your natural teeth to be ground down to numbs. If they are healthy, why would you want to do that? Porcelain veneers on the other hand only require minimal tooth preparation.

Third, if you have an overbite, it makes more sense to get veneers instead of crowns. Porcelain veneers only go on the front of your teeth and hug the sides a bit. Porcelain crowns on the other hand have to go around the entire tooth. They will bump up against your bottom teeth.

My advice, find a dentist who is experienced in placing porcelain veneers to do your smile makeover. Make certain they place your veneers with a temporary try-in paste so you get a look at them before they are permanently bonded on. If you are not thrilled with the results, they should go back to the lab.

As for the teeth whitening, you will want to whiten both the top and bottom arches before having the veneers done. Most smiles are eight to ten teeth wide. If you only get six veneers, you will want the adjacent teeth to match.

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

Should I Switch Dentists in the Middle of My Implant Procedure?

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I’ve paid my dentist almost $10,000 dollars already and I am worried he is not up for the remainder of the procedure. The price was to cover extractions of teeth #5 and #7, bone grafting, Maryland Bridges as temporary replacements, dental implants, and crowns for each tooth. Thus far, we’ve done the extractions and bone grafting. He’s provided me with the Maryland Bridges but they keep falling off. This worries me not only because it is super inconvenient to have to constantly have to return to the dentist to have my work or repairs done, but also because I’m concerned he just isn’t up for the remainder of this procedure. What do you think? Am I overreacting and fretting over nothing or is there cause for concern?

DeeDee

Dear DeeDee,

Illustration of a dental implant

There is nothing wrong with you switching dentists in the middle of your dental implant procedure. In fact, your dentist is ethically obligated to provide all the labs and diagnostics to the new dentist. Given what you have said, I am actually going to recommend that you do switch for a couple of reasons.

First, he is using a Maryland bridge as a “temporary” tooth replacement. This is not a temporary replacement because in order for it to stay in properly there is a need to make a small groove in your tooth. Anything that changes the structure of your tooth is not temporary. Instead, he should have suggested something like a dental flipper. These are less expensive and don’t necessitate any changes to the teeth.

Second, he wasn’t able to properly bond the Maryland bridge. That is much less of an advanced procedure than the dental implants you need. You need to look for a dentist with dental implant training and experience. That training needs to be post-doctoral.

One other note, the dental implant crowns can be made any color necessary to match your teeth. You should be aware that whatever color is made is permanent. Once it is bonded on, no changes can be made. If you are considering teeth whitening at some point, then I suggest you do it before having your dental implant crown made. This way it will be the right color for the permanent smile you’d like. If you decide to wait until after the crown is placed and then whiten, you will have to replace the crown for it to match.

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.

Dentist Won’t Give Me a CEREC Crown on a Front Tooth

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I have to get a dental crown on a front tooth. My dentist has the CEREC machine but tells me he won’t use it for front teeth. I don’t understand that. Shouldn’t that be my choice? I’d really like to have it done in just one day.

Carol

Dear Carol,

porcelain block for CEREC crwons

I think what your dentist is trying to tell you is that it will not look the way you want if you do it on a front tooth. CEREC crowns are milled from a single block of porcelain. That means the crown will be uniform in color. If you look at your front teeth in the mirror, you will notice they are not uniform. The level of translucency changes as you go from the top to the bottom of the tooth.

More light hits your front teeth than others. This means all those subtle differences are more noticeable. If you want a beautiful front tooth, that matches the one next to it exactly, you will be better off letting your dentist do a traditional crown. These are made from several varieties of porcelain, which enables the dentist to shape it with all those varying changes in translucency.

Dental Crowns and Tooth Color

One other thing you need to be aware of is the permanency of color with dental crowns. While they can be made any color you’d like, the color is permanent. Your natural teeth may pick up stains, but the porcelain on your crowns is more stain resistant.
The color they are made is the color they’ll stay.

If you like the current color of your teeth, then no worries. You can move forward, confident you will be happy with the color your dental crown was made. However, if you are considering getting your teeth whitened, the time to do it is before you have your crown made.

If you decide to do teeth whitening later, your natural teeth will whiten, but the dental crown will not. The only way to get it to match your new color is to replace it. Having the whitening done ahead of time will save you money.

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

Is there a Benefit to Invisalign if Everyone is Wearing a Mask?

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I’ve been setting aside cash in my HSA for Invisalign treatment. It’s something I set up at the end of last year. Long before coronavirus was a thing, I worked out what my co-payments would be and broke it up across the year so that I could start treatment at the end of this year. I’m 37 and work in an office setting, so for me, the big draw was that I wouldn’t be stuck with a face full of metal braces as an adult. I know some people do, and I certainly don’t think anything less of them for it, but I really wanted to keep things low key for myself.

Now COVID is in full swing and I’m still working from home. If my job gets moved back to the office, I’m told we’ll all be wearing masks all day. That in mind, nobody will ever see my teeth anyway. That’s a bit of a bummer, isn’t it? If this becomes a “new normal,” there may be no reason to do cosmetic dental work like braces because nobody will see your smile anyway. The point being, at least during treatment, chances are nobody will know what type of braces I go with. The traditional metal ones are a bit cheaper and I could probably start with treatment now if that’s what I’m going with. But, if I hold out for the clear ones, I’m going to give it a couple more months. Is there still a benefit to using the clear ones or should I just jump in with the metal?

Thanks,

Debra

Dear Debra,

Invisalign Aligners

Great question! Lots of adults prefer the clear aligners simply for aesthetics, but there are quite a few other reasons to choose them over traditional braces as well. First, I’d like to address a separate issue. Braces often get lumped in with cosmetic dental treatment, but that’s a bit misleading. When your teeth are misaligned or crowded, it’s difficult to clean between them no matter how careful or diligent you are. That ultimately leads to cavities and gum disease. Orthodontics can be a vital tool in the long-term health of your teeth and gums. There is also an issue of a misaligned bite leading to TMJ Disorder and migraines.

That said, let’s look at five more ways clear aligners may be the better way to go.

Invisalign may move your teeth faster.

Traditional braces are cemented to the front surface of your teeth. That’s where they apply the pressure required to get teeth to move. Aligners give gentle nudges along a greater surface area, which means they can usually move teeth faster. Some cases with Invisalign are done in half the time as traditional braces.

You’ll have fewer dietary restrictions.

Ever try eating a tough steak, corn on the cob, or caramel with braces? It’s a nightmare! If you manage to do it without breaking anything, you’ll still have your work cut out for you when it’s time to brush after. Conversely, you can remove aligners when you’re ready to eat and brush uninhibited after. Eat whatever you like…even popcorn.

It’ll be easier to clean your teeth and gums during treatment.

Braces can be a great tool, but a lot of people have difficulty cleaning around them in general. To that end, it’s quite common for people to develop stains or decalcified spots on their teeth during treatment. One of the most common questions cosmetic dentists get after teens finish braces is how to get rid of the spots that developed.

Additionally, many also develop gingivitis, where their gums become inflamed and will bleed when brushed. This is more because it is difficult to get floss or floss picks between the braces, so plaque builds up and bacteria flourishes. Again, you can remove clear aligners, so you won’t have this battle on your hands with Invisalign.

Aligners are usually more comfortable and result in fewer dental visits.

True, there will always be a bit of discomfort as you swap out aligners, just as you’d have some discomfort during orthodontic adjustments, but at least with aligners, there’s no metal digging into tender tissues and no wires that can snap and poke you. This also means you’ll have few, if any, emergency dental visits. Considering treatment may go faster overall too, you could spend a whole lot less time in the dental chair.

You Can Simultaneously Whiten Your Teeth.

An underused benefit to aligners is they can double as teeth whitening trays. This enables you to straighten and whiten your teeth at the same time, giving you a mini smile makeover at a fraction of the cost.

Clear aligners are still a great choice, even if you’re the only one who will ever know you’re wearing them. Best of luck to you!

This blog is sponsored by East Cobb Dentist Dr. Cristi Cheek.

How Often is the Dentist Necessary During Invisalign?

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I live in Alaska and the nearest Invisalign dentist to me is over two hours away. Would it be absolutely necessary to return every two weeks for new aligners? That would be quite a hardship with me for work.

Rose

Dear Rose,

Braces side by side with Invisalign

Much of how often you’d need to go to the dentist will depend on two things: First, the philosophy of the dentist and second, the complexity of your case. Each dentist is a little different in how they handle the distribution of Invisalign aligners. For instance, some dentists will only want to see the patient once a month and prepare them two sets of aligners. Others are more sticklers.

Given the distance you have to travel and the state you live in, I suspect your dentist will be rather flexible. The exception being, as I mentioned earlier, is if your case is more complex. Some teeth don’t cooperate as well as others. In that case, it would be in your best interest to see him or her more often.

That doesn’t mean it has to be in person every time. With today’s modern technology, he could probably do some of your check-ups through Zoom. Ever since the coronavirus hit, many of us have had to adapt to doing things a bit differently and are becoming quite adept at distance treatment.

I cannot speak for the particular dentist you will be seeing, so please bear in mind this is not me saying you can go less often. I’m just saying it is possible.

A Fun Side Benefit to Invisalign

I don’t know if your dentist has mentioned this to you yet or not, but I thought I’d let you know a little benefit to using Invisalign that has nothing to do with straightening your teeth. Because the aligners are custom fit to your particular bite, they can double as teeth whitening trays. This will allow you to straighten and whiten your teeth at a fraction of the cost. Your dentist can provide you with the professional strength teeth whitening gel.

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

What Do You Do with HUGE Front Teeth?

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I am at my wit’s end. I really want to do something about my smile, but everything I read about smile makeovers talks about making teeth bigger. My problem is my two front teeth are too big. Plus, they stick out from the rest of my teeth. I look like a beaver in need of braces. I’m about to think my only option left is to have the teeth extracted and get dental implants that are the look of teeth I want?

Avery

Dear Avery,

Braces side by side with Invisalign

I’m glad you wrote before going forward with your plan to remove your front teeth. There are much better solutions than that. Bear in mind that I haven’t actually examined you and am just going from your description. There may be other mitigating issues I’m unaware of. However, let’s discuss things as if they’re pretty straight forward.

First, you will want an experienced cosmetic dentist. So make sure you check out smile galleries to see what type of results they get with their work. Second, there are ways to trim your teeth to remove the excess structure. Then, you can use Invisalign to get them into their proper position.

Invisalign is ideal for adults because they are invisible to those around you, even at a conversational distance. Additionally, they have a hidden benefit. The aligners used to straighten your teeth are custom made. This also allows them to double as teeth whitening trays, enabling you to straighten and whiten your teeth at the same time. It’s like getting a mini smile makeover.

I don’t know exactly what your teeth look like, so I want to give you a warning. If a lot of tooth structure has to be removed, you may find the dentin becomes exposed. If that is the case, you will want to have porcelain veneers placed over the dentin to protect them.

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