Progress Weeks 3-4

Tray two is done and I'm halfway though tray 3! Two down, 22 to go. Below are the pictures after tray two, posting them a little late, but equal intervals from the last progress post. I'm starting to see like one or two teeth moving, but other than that not any major differences. I can definitely feel a difference.

Tray two has been somewhat annoying with headaches and lockjaw. Based on my progress so far into tray 3, I'm expecting things to get more annoying/painful. It's not killer - maybe an average 4 on a pain scale of 1 to 10 when it hurts - but the headaches are inconvenient. Sometimes they try to rage on me when I'm tired or trying to work.

Front View

Top View

Bottom View

No painkillers for you! The dentist is being totally lame about giving me the pain medication I need. Taking 4 advil at a time (800 mg) does very little and any less does nothing. Not really keen on taking that much advil all the time. It's bad for your workout progress and for your tummy.

My previous dentist gave me vicodin and muscle relaxers for some jaw pain which helped tremendously. They want me to come in to talk to the dentist, because if I look him in the eyes and say the same thing, that will be more effective. I'm going in next week for my attachments so I figured I could suffer until then rather then go to the dentist 20 times each month. My dentist's office and I talk almost every week. They're always messing something administrative up, but damnit I like the dentists.

I've been a pretty good girl.
I've worn my trays for between 20-22 hours every day and have flossed almost every night. :) I've been a little more lax about drinking non-water things with the trays in. I keep my trays clean though so it hasn't been an issue. Yay progress.

Cleaning Your Trays (and Your Teeth)

It should go without saying that you should clean both your trays and your teeth if you want to avoid bad breath and cavities. I'll make no assumptions and just give you the run down on what seems to be the easiest way to stay fresh, clean, and keep your trays see-through.

A note about toothpaste and mouthwash: My dentist recommended that I not use any sort of whitening toothpaste when brushing my trays due to it's abrasive nature and potential to cause damage to the trays. That said, it's totally OK to brush your teeth with whitening toothpaste. I was also advised to not use mouthwashes with alcohol before putting the trays on because alcohol can dry out the trays and make them brittle. I'm not going to cover mouthwash here. If you use it, get the alcohol-free version of your favorite kind.

Daily Routine - Brushing / Flossing

You'll need:

1. Two soft-bristled toothbrushes. One for home and one to take with you every where else.
2. Toothpaste.  If your usual toothpaste has "whitening action" you'll also need one without.
3. Floss. I like Oral-B glide. Crest also makes a glide floss.

Morning Brush: Your mouth is going to be full of funk, your trays are going to be in, and you need to brush to be clean.

1. Try leaving your trays in and brush them with non-whitening toothpaste.
2. Spit and rinse, not pop out your trays.
3. Brush the insides of your trays with the remaining non-whitening toothpaste left on your brush.
4. Now brush your teeth with the toothpaste of your choice.

Midday Brushing: You'll be brushing to get the food out of your teeth before putting your trays back on after you eat.

1. Brush your teeth and trays (inside and out) with non-whitening toothpaste.
2. Floss if you're amazing. I only floss at the end of the day.

Final Brush Before Bed: You'll be prepping your teeth for an overnight stay with the trays on. You don't want to leave anything in there. Brush well!

1. Brush your teeth with the toothpaste of your choice.
2. Floss like you mean it, leave no gunk behind.
3. Brush your trays (inside and out) with non-whitening toothpaste and pay special attention to get all the crevices.

Technically if you flossed the night before you should be set so you don't have to floss in the morning. Pay attention to white cloudy stuff on the insides of your trays. This can be brushed off. Also pay mind to any roughness you feel on your trays while you're wearing them. Brush these parts thoroughly before bed.

Weekly Routine - Soaking

You'll need:

1. A cup or a glass big enough to hold your trays.
2. Retainer Bright cleaning tablets.

Easy to find on Amazon.com

About once a week (or when the trays starting to have a smell about them - ick!) I'll give them a soak in the Retainer Brite. You can find lots of sellers on www.amazon.com. I think I paid around $25 for 64 tablets. I think 36 tablets would last you way longer than 1 month, assuming you're brushing your trays.

The instructions are printed on the side of the box. Cleaning is a snap and takes less than half an hour. I've pasted some images of the process below.

Instructions printed on the side of the box.

Take out a Retainer Bright cleaning tablet.

Put the capsule in warm water

It gets pretty fizzy! Toss in your trays.

Wait till the water is clear and then you're done!

Don't forget to rinse your trays after you take them out of the solution. If you notice they aren't as clear as you were hoping, it could be related to needing to brush the trays OR torquing the trays. The trays get bend when you bite down while they're in your mouth or when you remove them. This can cause the plastic to look more white towards the end of their cycle. Cleaning them won't help this. Just try to be careful of bending them.

Progress Weeks 1-2

Tray one is done! 1 down, 23 to go. Below are the pictures after tray one, I don't see much of a difference. Tray one gave me little to no pain. No one has noticed my trays so far. Very cool.

Front View

Top View

Bottom View 

Tray 2 is in! On Monday evening I put in tray two. It's been pretty painful for the last few days. I've had a headache going since Tuesday. Poppin' lots of advil which is helping some, not a ton. The top tray is giving me the most pain, but surprisingly comes off pretty easily. The bottom tray is less painful, but is nearly impossible to get off. Makes no sense!

Today is day 3 of my second tray set and it feels like my teeth are all over the place every time I put the trays back in. It seems to take at least 20-45 mins before I feel like my teeth are lined up inside the trays again. Definitely encourages me to keep them on for longer.

I've been a good girl!
I've worn my trays for between 20-22 hours every day. I've also been flossing almost every night. :)

My Treatment Overview

Since I started Invisalign I've had three sets of trays created. Below are the details of each, including alterations to the teeth completed to assist the treatment. In summary, my first treatment had almost a year of trays, attachments and teeth shaving. As I went through the plan the dentist changed the amount of teeth shaving based on my comments and the actual results. After my first treatment, I got my attachments removed. My second treatment was cut short because the trays were starting to fit sideways on top. I'm currently working through my third set of trays.

Treatment 1 - Start July 2012

Treatment length: 24 trays (48 weeks)
Attachments: Added to 11 specific front teeth after 6 weeks (or first 3 trays)
Teeth Alterations: Interproximal reduction (shaving of the tooth enamel to create space between the teeth)

• Teeth Shaving at 13-18 weeks of treatment (or after 7ish trays)
• 7 reductions on the top teeth of .5 millimeters
• 7 reductions on the bottom teeth of .2 millimeters

The video below shows the expected transition start-to finish and attachment locations (in red). The arrows point to where the teeth shaving (interproximal reduction) will occur.

Treatment 2 - Start July 2013

Treatment length: 15 trays (30 weeks)
Attachments: Removed! I wanted them off after my first treatment. My dentist worked the removal into my treatment plan for round 2. Basically it just takes longer
Teeth Alterations: None. The teeth shaving expected on the top teeth in Treatment 1 was changed after it seemed that the amount completed on the bottom was too much.

Terminated after 10 trays: My trays were starting to fit sideways. I thought it was just because I was slacking on wearing them, turns out the trays were fabricated in a wacky way due to the mold of my teeth.

Treatment 3 - Start August 2014

Treatment length: 17 trays (32 weeks)
Attachments: Nope
Teeth Alterations: None. 

These fit great.

First Appointments - What to Expect

If you're looking to get started with invisalign treatment I suggest you get the ball rolling. Depending on your current dental health and the availability of your dentist, it could be any number of months before your trays are ready. Expect to go in for multiple appointments. I've outlined the process below.

1. The Initial Consultation:  The person(s) in charge of your invisalign treatment will meet with you and look at your teeth. They'll tell you if you're a candidate and whether they think you'll need teeth removed or interproximal reduction (i.e. teeth shaving). You should also get an idea of the treatment length to expect.
2. Dental Exam: If you're confident that you're a candidate for invisalign, you should try to schedule the dental exam on the same day as your initial consultation. I was able to do this and saved myself a  trip. Expect a standard exam. If you have cavities, a broken tooth, gingivitus, etc. expect to come in again to correct these issues before your treatment can start.
3. Correcting Existing Issues:  You'll usually need to fix any existing problems with your teeth. How strict this rule is  depends on your dentist. I got away with just a thorough cleaning. Why correct problems? If you've got a cavity going, invisalign is only gonna make it worse. Think of the invisalign trays like incubators.  If you've got a broken tooth, not only will it be hard to predict how your teeth are going to move, but the tooth could break even more which will ruin the fit of the trays.
4.  Mold of Your Teeth: The dentist will take 2 molds, one for upper and one for lower. They will send these to Invisalign. Think of this as the initiaion of your treatment.  The molds will be turned into digital models that will be used to create your invisalign plan from start to finish.
5. Treatment Approval: After your molds are taken, it will take a few weeks before the treatment plan is ready. Usually this is a video that Invisalign sends to your dentist. I had the dentist email me a short version of the video so I could approve it. Technically, you can authorize the dentist to complete the approval, but this seems dumb. You want to be the one approving the final state of your teeth. I only got to see a short version of the video. To view the full video I would have had to go back to the dentist's office which seemed odd to me. Apparently Invisalign has licensing issues or something that prevents this. You would think since you paid for the treatment you'd have rights to YOUR custom plan, but not so much. Work with your dentist and try to get this emailed if you can't take off work to go in and approve.
6. Tray Fabrication: When you've approved your plan it can take 1-4 weeks for your trays to be fabricated. The dentist will call you when they're ready. You'll need to go in (again) to reeceive your trays and other goodies including cleaning instructions, holders, and chewies. Don't expect to get more than 6-8 weeks worth of trays (3 or 4 sets).

Before you receive your trays, you'll need to sign a waiver that says that a number of bad things could happen to your teeth. AWESOME. This disclaimer is really to protect the dentist from anything that goes wrong with your treatment. If you don't understand any of the terms, be sure to ask what they mean.

In total, I was able to get away with 3 visits to the dentist to get all of this stuff done. I did steps 1 & 2 on my first visit, 3 & 4 on my second visit, approved and asked questions all via phone/email, and then went into get my trays on the third visit. Expect to need to go in at least 3 times if you're lucky!

Progress - Before Invisalign

These are my before invisalign pictures. I take pictures after I've completed a tray - about every 2 weeks. Click here for a full list of my progress posts so far. My teeth tend to look more crooked in photos, so the images show an extreme version of any imperfections. My teeth aren't horribly mangled, but they're crooked in lots of little ways.  I can say with confidence that there's room for improvement. 

Notice twisting and crowding in front 6 teeth on top and bottom.

Crowding on top

Crowding on bottom

Right view

If you read my "About Me" you know that I'm looking to correct the crowding in my front upper and lower teeth. The crowding hasn't caused any major issues like pain or cavities yet. I do have minor plaque buildup on the bottom teeth when I go in for cleanings. Based on past dentists visits, the crowding is expected to increase over time, so I consider this both a preventative and cosmetic treatment. Can't wait to start seeing some progress!  :)

Is Invisalign Right for You?

Will it suit your life style?

Depending on current condition of your teeth, you might be worried that you aren't a candidate for invisalign, but what you should consider first is: Will it fit your lifestyle?

Did you know...

• You'll be wearing the trays around 22 hours a day.
• You can only drink water while the trays are in.
• You should brush your teeth every time you eat/drink non-water liquids before putting your trays back in. Technically you're also supposed to floss.
• You won't be inclined to pull the trays on and off a lot. It can be kind of a pain.
• You will be going in to the dentist every 6-8 weeks just like with other treatments.
• If your dentist doesn't see that you are making the progress you should be, they won't give you multiple trays at a time and you may have to go in more frequently.

If you're like most people, you don't floss every day and you don't tote around a toothbrush and toothpaste with you either. If you aren't someone who can commit to drinking water most of the time or can't commit to brushing pretty regularly, invisalign isn't for you. If you have to eat constantly or think you'd lose your trays as much as you lose your car keys, you're not a candidate. The trays are $50 a piece to replace and can take weeks to re-fabricate, making you treatment even longer.

Reality Check: No one is perfect.
The recommended rules can't be followed 100% of the time. If you can't get to the sink or forget your toothbrush, you can manage until you are reunited with your bristly buddy. But let's be honest. If you aren't willing to commit to the rules 95% of the time, you aren't going to get the results.

Don't waste your time and money if you don't think you can live up to the treatment expectations. Invisalign is a good option - don't get me wrong - but it requires you to be more diligent than braces, which are permanently attached.

If you're responsible, committed, and ready to start a 1-3 year journey then buckle up. For your hard work you'll be rewarded with the benefit of few of people noticing your corrective trays. :)

Will it suit your teeth?

It's the next logical question.You'll be surprised how many cases are treatable by invisalign. It can actually correct most types alignment issues. I've seen corrections on overbites, underbites, gaps, crowding, crossbites, and even some pretty serious cases of malocclusion (think of teeth that look like a mountain ridge.) For more info on malloclusiion check out the wikipedia page. Ultimately, your provider will decide if you are eligible. No two dentists are the same, so don't be scared to seek a second opinion if one dentist doesn't think you are a candidate.

For more details go to invisalign's official site a list of treatable cases, including images and additional details.

Cost - Is it expensive?

I'm sure the first question you have is, "Is it expensive?" The short answer is, not as expensive as you'd think. The cost of Invisalign has come down considerably since it came out. At many dental offices the cost is comparable with braces. You can find reasonable prices if you shop around. Skip the dentists who charge too much and want you to pay up front. I found a great dentists office with reasonable prices and more high tech equipment than I knew existed!

Cost

There are generally two types of invisalign treatment for adults - invisalign express and full invisalign. Below are some average prices and quick overviews.

• Invisalign Express is for adults needing very minor adjustments and whose expected treatment length is about 5 sets of trays. Expect to pay around $1500.

• Full Invisalign is for most adults who want corrections. This is what I got, and my treatment length is 24 sets of trays. My quoted price was around $3300, but I got a discount for pre-paying in full so I paid $3070.

Payment Options

I'd been postponing treatment because I thought hadn't saved up enough. To my surprise, the financing options were very flexible. My dentist offered an interest-free 20% down and the rest of 12 months, or an 15% interest plan over 24 or 48 months. If you're low on cash and are willing to pay interest, you can get away with paying less than $100 per month. Not bad.

Cost Breakdown

The dentist advised me that if I lose or break a tray each one costs $50. Please note, this is for per individual tray, top or bottom. The math works so you pay around $1000 for the appointments/design cost and the rest for trays. For 24 tray sets (24 x 2 x $50) = $2400.

What Insurance Covers

Any decent insurance plan will have some coverage for orthodontic treatment. Expect to pay up front to your dentist and file a claim with your insurance after you receive your trays. My insurance plan covered about half the cost of my treatment. Since it was a lifetime max amount, there are few options to spread the charges over different calendar years. If you're looking for additional coverage, most dentists will allow you to add a secondary insurance plan. Talk to your dentist about this, if your yearly dental cost is high, it might be a good option.

I'll be frank, there could be a couple months between your initial payment and when the trays are actually fabricated. This will delay your claim. Then expect insurance to take a while to fulfilling the claim. If you're looking to pay in full, best to save up and expect the cash back in a few months.

If you don't have insurance, you can still pay out of pocket with a payment plan. The options are that flexible.