Battersea Rise » Invisalign Invisible Braces

The Social Six

elliot — Sun, 06 Dec 2009 09:57:58 +0000

Well it’s a starting point for some and a finishing post for others. Cosmetic dentistry courses keep pushing the idea of the ‘social six’ – the six front teeth that if sorted would keep most patients happy.

So go look in the mirror and take the test. What do your front six teeth, top and bottom say about you? Crooked, stained, worn, chipped, old crowns? The beauty of the social six is that they are relatively inenexpensive to sort out, much less than for a full makeover.

So if you don’t like your teeth and you want to start improving your smile, that’s where to start. You can always work backwards can’t you. Soon you’ll realise it’s the best investment you made in yourself.

Making Invisalign work better 7 – Don’t ‘Ugly Betty’ your kids

elliot — Sat, 05 Dec 2009 12:56:25 +0000

Hopefully the days of making teenagers wear fixed braces for a couple of years, often with extractions and headgear are nearly over. Most hate it and it’s now unnecessary.

My experience for every patient, at every visit, is that they ask ”when can the braces they come off”. The FREE price tag of the NHS may be hard to resist, but Private Orthodontics should be all about invisalign. Last year I placed about 100 teenagers in fixed braces, all done Privately. This year I will be treating all teenagers with invisalign. I may need to use a sectional fixed brace for a week or two to perform the odd movement that invisalign won’t work for in addition to the invisalign treatment. But that sure beats the confidence sapping treatment that teenagers hate. Why should they have to put up with yesterday’s technology?

The great thing with treating teenagers with invisalign is that the teeth move really well, better even than with adults who the system was conceived for. And because of the very real threat that they have of fixed braces if they don’t wear the braces, they comply brilliantly. Again, usually better than the adults.

So if you hear that your child “isn’t suitable for invisalign”, they probably are. Or that “they need extractions”, think again. They probably can be treated without. And they’ll thank you for it.

And if children aren’t ready for braces at all my advice is to relax. There is no ‘missed the boat’ feeling about invisalign as they can have the treatment at any age.

Making Invisalign work better 6 – Goofy teeth. Treating without extractions or headgear

elliot — Sat, 05 Dec 2009 12:30:21 +0000

An overjet is the amount that the upper teeth protrude in front of the lower teeth. If teeth stick forward at an angle then they can be retracted with invisalign. Simple. Some tooth volume can also be removed by interdental reduction between the teeth. Then the teeth are retracted back to reduce the overjet. Again, simple.

However the biggest changes come when the upper arch, which is narrower than the lower is widened. This allows the lower jaw to be freed to come forwards, which it does naturally or with the aid of twin blocks bonded to the invisalign appliance. Orthodontists experienced in orthopeadic orthodontics will rountinely build this into their treatment plans. An advantage of this, apart from the better aesthetic result is that the temporomandibular joint is aligned properly with the lower jaw.

This is advanced treatment that I routinely carry out for my patients, being particularly effective for teenagers who might have been told they need extractions or fixed braces with headgear. I have the cases to prove it works so I wonder why other orthodontists still use old fashioned methods. Still if the patients really want teeth out and braces and headgear for two years that’s fine. All referals welcome.

Making Invisalign work better 5 – Erupting teeth

elliot — Sat, 05 Dec 2009 11:59:00 +0000

Experienced orthodontists will know all about using elastics and buttons to erupt the back teeth. Too compilcated for the Blog to be detailed here but advanced training Invisalign courses will train non orthodontists. Again it behoves the patient to choose a dentist with orthodontic training to get the best possible outcome when doing invisalign.

More usual though is the desire to produce level front teeth (the lateral incisors are often shorter than the central incisors). Three choices exist to get level front teeth. Firstly porcelain veneers can be added to the shorter teeth to make them look longer. Secondly buttons and elastics can be used to erupt the smaller teeth with unpredictable results. And thirdly a partial fixed brace can be placed for a week at most to erupt the teeth as desired. Most patients will be fine with the idea with a brace for what is often just from Friday afternoon – Monday morning.

Making Invisalign work better 4 – Attachments

elliot — Sat, 05 Dec 2009 11:40:37 +0000

Attachments are shapes that are temporarily added to teeth to help with movements such as rotations. They are fine when on the back teeth, but do patients really want or need them on the front teeth? Attachments on incisors ruin the ‘invisible’ braces tag. So the trick is to see if they can be placed on the inside where they don’t show. Obvious really but no one else seems to do it. Also the need of attachments is age realted. Large rotations can be achieved without attachments as long as the patient is young enough, use aligner chewies and good about wearing the aligners. And for our older patients, even attachment won’t always untwist a twisted canine. Applying them in these situations prevents the seating of the aligners progressively throughout the treatment. Better to leave them off and concentrate on those movements that do work.

Making Invisalign work better 3 – Better impression techniques

elliot — Sat, 05 Dec 2009 11:27:35 +0000

Bad impressions slow the whole process down so here’s a few tips for perfect impressions every time:

Always check the position of the wisdom teeth. Invisalign trays are not long enough to capture most wisdom teeth. The trick is to overload the trays at the back and mould then support the heavy body material with your fingers until set. Then when you apply the light bodied material it will be trapped in the first impression and get a good result first time.

Mix the heavy body material quickly or the seperating wafer won’t stick to it and will dislodge on insertion.

Check the size of the tray in the mouth first. Really narrow arches require the smallest trays. These are inevitably too short so you overload the back and support the heavy body material as when dealing with wisdom teeth as outlined above.

When using the light body for the upper arch Ialways start off with my patient lying flat. Dry the teeth so the light body sticks to them, apply the light body then sit the patient up before placing the tray in the mouth.

For patients with a bad gag reflex use an anaesthetic spray to entirely numb the soft palate before doing impressions.

Heat the light body on an anaesthetic cartridge warmer. This speeds the setting time making it more pleasant for the patient.

Making Invisalign work better 2 – Age matters

elliot — Sat, 05 Dec 2009 11:10:03 +0000

Just as any orthodontist knows (time to mention that dentists doing invisalign should also be trained with fixed and orthopeadic orthodontics if patients are to get the best treatment) the older the patient the less easy it is to move teeth. Now I’ve treated teenagers right through to a couple of 70 somethings and everyone in between. And whilst you can always get improvements even with much older patients, younger patients with softer bone treat better with a full range of predictable tooth movements. The trick is to realise this and to plan your treatments accordingly. Do you really expect to get much intrusion with older patients? Are you really going to try to rotate canines and heavily twisted premolars annd molars? It just wont happen, so I focus on the movements that will, and bingo! – great results and happy patients every time. The system is great, you just have to know how to use it.

Making Invisalign work better 1 – Alinger Chewies

elliot — Sat, 05 Dec 2009 10:56:10 +0000

I came across this tip years ago and it has made all the difference to treating patients with invisible braces. Basically when you insert an aligner it seats about 90% of the way. Which means that it is not pushing the teeth exactly as the computer predicted, so the resulting movement per aligner is poorer than anticipated. Subsequent aligners progressively fit less and less with the typical end result being less than predicted at clincheck. The solution to this is to use Aligner Chewies made of soft rubber to seat the aligner more fully, EVERY time the aligner is put in the mouth. The resulting fully seated aligner pushes the teeth as the computer predicted aligner after aligner, meaning that better results are achieved in less time, with fewer refinements at the end of treatment.