Orthodontics Today - all about braces and orthodontic devices

The Invisalign system is one of the most modern ones used in orthodontics, redefining all this treatment. Now, you can forget about the normal braces, the ones made of ceramics or even placed in the “back” side of the teeth. Invisalign straightens your teeth by using some plastic “mouthguard” like trays, you change every 2 weeks, for as long as needed till the end.

If you want more details about Invisalign, please read our presentation article. Now, we’ll try focus on “how it’s made”.

Any orthotontics treatment starts with the initial consultation and this doesn’t break the rule. Your orthodontist will check you with great care and, should you “qualify” for Invisalign, you’ll be ready to undergo the first step to the trays: your molds.

For the Invisalign specialists to really be able to create your UNIQUE trays, they will need perfect impressions. So, don’t be scared if your orthodontist is that determined to have them perfect. They are needed this way, since your entire treatment for all these months will depend on them. At Align Technologies your impressions, the information about the course of treatment and all other initial materials, will be taken by other specialists in orthodontics.

They will make a positive out of your dental impressions; the plaster molds helping them see your teeth in their normal form. Because your orthodontist was so careful with those impressions, now, the Align Technologies specialists almost have your “teeth” there, and you won’t have to travel thousands of miles just so they can also do your consultation.

The plaster models are checked again and “cleaned”. Any residue or imperfection is manually checked and solved, so that the plaster can enter the other stage: 3D processing. State of the art scanners are able to create a three dimensional version of these plasters, and these can now be processed on the computer.

A barrier coating is applied to protect it from the possible damage it can take on the next stage. Once sealed, the models get placed into a chase, then in a mixture of urethane resin and hardener. They spend some hours in a vacuum pressure chamber the resin hardens and makes them look as blocks.

Each tray gets into a destructive scanning machine. This removes paper thin slices 3000 of an inch, while a digital camera takes two dimensional images of each of these slices.

The computer gathers more than 300 such images to create the 3D model.

These materials get sent to the technicians, who check once again if all is correct, the teeth and also the bite as the patient has it. The graphic designers will use a proprietary 3D application to cut each tooth and save it as a separate geometrical unit. The teeth are now separated and re-grouped on each arch in the position they will have once the treatment is complete.

From the initial stage to the final result, there are many intermediate stages that make up the entire treatment. These are carefully considered since the treatment is different for each patient and the entire orthodontic process needs time. As in traditional braces case, we cannot have straight teeth over night, so all these stages are just the normal tooth movement created with each aligner till the teeth are straight and the bite corrected.

The quality check process is next, so that all the process, the teeth movement, prescribed treatment etc. are correct.

The orthodontist who takes care personally of the patient is the one to decide if the treatment is a “go-go”, together with the patient him/herself. This application form is called “clincheck”

After all the treatment was checked and approved the aligners will be created. A series of models are created of photo sensitive thermo plastic, each of them will then be turned into an aligner. The thermo plastic sheet is pressed over each model by the use of heat. Trimming comes next so that the aligners come half a millimeter under the gum line, reducing the chances of sores and making the removal easier for the patient.

The aligners are polished and disinfected in a series of cleaning tanks, each set being then packaged, labeled and shipped to the prescribing orthodontist.

And, if you want to see the film, here are all these words in action

The retainers are the orthodontic devices we use in order to keep the teeth in the new place they are. Many patients think that braces are all it takes for a perfect smile and hearing they have to wear a retainer for months/some years is getting them almost depressed.

When we end our orthodontics treatment we get the teeth into the position and alignment perfect for a healthy bite and even a beautiful smile. But they still tend to go “back” and this happens most of the cases if a retainer is not worn properly. This is why wearing the retainer is as important as keeping those braces or Invisalign trays into place. It helps the teeth “learn” the new correct place and makes the treatment a success.

Our reader wanted to know if there are any ways he/she can renounce the retainer by getting his/her teeth stronger. Well, the problem is not about your teeth strength, but the jaw bones and gums since they “house” your teeth.

You will wear your retainer as long as needed. In some cases it’s just few months (for a less complex case) or maybe some more months or even few years. In such cases there was a very complex orthodontic case and this is needed to “secure” that wonderful result you had.

By definition the retainers are not as “tough” to wear as the normal braces and in many cases it’s just an overnight thing. I wore a retainer for 2 months (one that looked like the Invisalign trays) when waiting for my Invisalign. I had to wear it just at night and it wasn’t that hard at all. I got used to it and didn’t mind it as much as I anticipated before.

If you “survived” all the braces treatment stages I can’t believe you can’t make it with the retainer. It’s a simple device to be worn, in some cases (if bonded) it’s just a small “wire” glued to the back of your teeth. You won’t even notice it. If it’s a mobile device (the one to be taken off and then placed again), even if a tad tricky (since you have to take care of it too), it’s still something you will be able to manage.

Just think that by wearing your retainer you’ll have that wonderful smile forever. You’ve been through many things, sure you’ll make it

The entire bracing thing took place on June 1st. I was a bit scared of all I have to go through, but also knew almost anything a normal person (not an orthodontist) can know about this entire thing. With all the knowledge and patience in the world I was able to face the thing that will change my life forever.

Sure, the orthodontic treatment is GOOD and USEFUL. I knew that and this was the reason I chose to go through many months of teeth straightening treatment.

The “day 2″ though was a huge punch into my confidence.

I expected pain since Damon is a very aggressive system (in the good sense of this word) and works fast. Sure, the changes in the teeth can become slightly painful.

Woke up in the morning with the same pressure feeling I had in my teeth since last night. No pain, just pressure. I then clench my teeth, as a normal person should. In the end I wasn’t gonna keep my mouth slightly open as I woke up with.

AUCH!

Cursed, shocked of the pain coming out of nowhere. “Jesus, how can this hurt like this?” I though to myself, noticing that not touching my teeth was good. No pain there, only when I pressed the lower teeth to the upper teeth, meaning closing that mouth and clenching them.

Cute, let’s see how we eat and brush.

The brushing was interesting to say the least. I was trying not to put too much pressure on my teeth and it worked pretty well. Expected more pain, got less than thought I’d get. I was brushing with care, not forcing anything, being very gentle and thorough.

And then .. I ate.

Or something like this. The pain I felt when putting pressure on my teeth was serious and I just didn’t want to face it anymore. Sure, a simple painkiller would solve this, but I was stubborn. No medication, I wan’t to feel it. And feeling it I was.

My grandmother and her sister ate better. I ate some mashed potatoes (I mean really mashed), drank some milk and ate pudding; all kinds of meals a toddler is getting used to. No solids. My teeth were in perfect shape theoretically, but painful when pressing. So, no pressing.

Even if I expected to starve that day, I wasn’t in such case. There are so many things you can eat in such occasion and the “mashing” and “mincing” are two things that make almost anything edible even for an orthodontics patient with new braces on.

My second day in Damon wasn’t that bad. As I went to sleep, trying to keep my lower and upper teeth from getting in contact with each others, I realized my pain wasn’t that serious and the discomfort pretty bearable. I was looking at 7 months with the metal braces on and I knew THIS DAY was the worst of all days and that I CAN MAKE IT.

Attitude means a lot in such a situation and I was looking at months of braces with a positive attitude. Nothing happening to me from now on could be as bad as this day was and this day wasn’t that bad at all. And it could have been a good day if I wasn’t as stubborn as to not take any pain medication. But I wanted to feel it. To sense how my Damon braces are starting working to make me have a perfect smile.

Since this is an orthodontics blog too, not just a collection of articles about this, I thought it’s a good idea to test the “member” section and also tell you about my personal journey into the “straight teeth” world.

My orthodontics journey started 1 year ago. On June 1st, I was there, ready to start my new life. I read ALL I could about this, so I kinda knew what to expect. I knew my age (almost 29 at that time) wasn’t a huge deal, that my treatment would be a “weird” one (7 months in Damon 3 to solve some of the lateral issues and then Invisalign since I didn’t want to show braces at this age) and that this WILL CHANGE MY LIFE.

I was ready with all this. Crooked teeth were a big issue and some of my problems weren’t quite “usual”. I liked my “special” status, but knew this complex case was also trouble.

My orthodontist set the meeting and I was ready to get braced. On the “International Children Day”, I really felt like one.

I knew it’s a good idea to use the toilet before (being on that chair for 2 hours is not that “cool” for one’s bladder, so I used it. I was then ready to start this, thrilled to see how many “cool” things I’ll have. I am a strange person, curious and thrilled to try all this. I know it’s sounds pretty weird, but I couldn’t wait to see what they’ll do to me.

Etching was placed on the teeth, then washed out. It was sour, it’s an acid. Then they placed bonding (tastes like Super Glue) and the brackets on the molars and bicuspids. These were the teeth to be braced only. Then the archwire was put there, the “sliding doors” closed (Damon has self-ligating brackets, so no need for ligatures) and then some power-chains tied on some of the brackets to close a gap I have.

I was talking funny, but felt pretty good. A wire was poking my cheek, but it was cut short then. I felt a small pressure on my teeth, but I was pleased to see I made THE FIRST STEP towards a perfect smile.

– to be continued –

The orthodontic treatment is started because of our misalignments and malocclusions. The teeth are not straight and this can cause problems when it comes to oral hygiene and also the bite. Some patients also face pain in the jaws, others don’t have this problem, but still consider their teeth to be ugly.

The “ugly” teeth can be caused by many possible problems:

• imperfect tooth shape. They are either too bit or too small, showing too much gum or too little and this might offer a look you are not pleased with
• there might be cavity problems, tooth colorations and other issues that need the dentist’s attention
• the teeth are not aligned as they should and this causes that “ugly” look.

As you can see here, there are more possible issues you might face and more causes for your imperfect smile. Orthodontics takes care of your tooth alignment and bite, the others (if they are to be blamed too) will be fixed to provide you the look you want.

Even if we think that orthodontics is meant for beauty (and this is the idea we get from all those perfect smile advertisements), in the end this is a “side” result of the teeth being aligned in a healthy way. Your orthodontist is concerned with your crooked teeth since this is a health problem, but the result is a very good looking one.

So .. yeah, orthodontics and braces if you will can fix your ugly teeth. Any system you’ll use (you already have the information here about all kinds of braces and aligners) will straighten your teeth and give you that perfect smile. And, if needed, the other issues will be taken care of (if the “ugly” teeth weren’t only caused by the orthodontic treatment).

The dental care and cosmetics area is so well developed now, that you’ll always achieve excellent results.

Many of the Invisalign patients expect a treatment that’s very easy and with no problems. Even if, compared to the metal braces or other orthodontic treatment systems, Invisalign is easy to get used to, it still requires a lot of discipline and care. For an Invisalign user the first problem that might appear is the unpleasant smell of the trays after few days of wearing them. THIS IS NORMAL, but still we can do something about it.

If we were to think about the causes we can mention the plaque built up on the trays (as it builds up on the teeth), eating/drinking with the trays on, improper teeth brushing and tray cleaning.

The phenomenon can be kept under control with a STRICT hygiene routine. Invisalign requires a lot of discipline (here, I said it again) so do expect to have a proper cleaning schedule. Here are some of my tricks to minimize the Invisalign aligners small to almost zero smell. My trays, after I clean them and brush my teeth are sparkling clean and my mouth keeps a fresh “taste” for a lot of time:

• I NEVER EAT ANYTHING with the trays on. If I want to snack, I remove the Invisalign, eat at ease and then BRUSH teeth, CLEAN trays and I am set again.
• I don’t drink ANYTHING but mineral water with the trays on. If I want soda or coke, I remove them and maybe also snack a bit, since I made the “move” with them again
• I never wear the trays on dirty teeth. I have the toothpaste/toothbrush set with me all the time. I have more sets (at home, at my BF’s, in the bag, the laptop case). If I want to eat and don’t have the “set”, I purchase it and then eat/brush. If I don’t feel like brushing I don’t eat. Just drink some water and wait till I get somewhere I can eat and clean my teeth afterwards
• my Invisalign cleaning is pretty simple: I brush the trays with my toothbrush and rinse with clear water. Some use a lot of solutions, I found out that plain water is just OK as long as I clean them after each removal or better, before putting the trays on again.

With a good brushing schedule my trays are clean, they stay on clean teeth and there is no smell. In the first weeks I used mouth wash as a cleaning solution. The minty smell remained on the trays and made them smell pretty “funky”. For the second set I started using ONLY water with great care when it comes to brushing the aligners. It seemed to work perfectly. They are always clean and the smell is not there anymore.

How do you handle this?

One of our readers was searching for information about Invisalign not working: “my invisalign doesn t work”. I would like to say this is nonsense and all treatments work perfectly, but there are still possible problems. Any orthodontic treatment requires a lot of changes in our life style and TIME.

I see 2 options in our case: 1. our reader is having Invisalign for a short time (just some weeks) or 2. maybe we are talking about a finished treatment that wasn’t that successful as we’d wish.

Let’s try to see both possibilities:

1. Invisalign doesn’t work overnight.

If we were to compare Invisalign with metal braces for instance, we’d have to admit that metal braces SHOW results faster. The braces are stronger (you also feel more discomfort) and the first moving teeth start showing after some weeks. I had a tooth moved 7 mm in just 3 months, was shocked

Invisalign on the other hand DOES work, but the results are not visible that fast. THIS DOESN’T MEAN YOU WILL NOT HAVE STRAIGHT TEETH. Just look at the presentation you get with your treatment: the result is what you are waiting for.

2. What can make the treatment go wrong?

There are some possible explanations: the treatment wasn’t well planned (a tad hard to believe since the Invisalign system is well thought and you’ll have your orthodontist follow your case through it. After you start wearing the Invisalign trays you’ll also be under your orthodontist control, so any problems should be spotted as fast as possible.

The Invisalign aligners HAVE to be worn as much as possible. Many patients try to “skip” some hours, but this will affect their treatment. The aligners have to be on the teeth for as much as you possibly can, nothing less than 20 hours a day (try even more). The treatment depends on you a lot, so you can ruin the results or have the treatment succeed.

From what I was able to see myself and also read from other Invisalign patients, the Invisalign orthodontic treatment has a HUGE success rate if:

• you have a good orthodontist and are under his/her observation so that any problems can be noticed soon
• you wear your aligners AS MUCH as you can
• you let some time pass. You won’t see results in Invisalign in just weeks, let few months pass and then you’ll see the change.

Just think that every 2 weeks you are putting a new aligner in your mouth, a new aligner that is DIFFERENT from the previous one. You feel this by the pressure in your teeth (sometimes a small pain) and the fact you have difficulties putting the aligner on. This means IT WORKS: you teeth changed position and the aligner forces them into a new one. Stick to the treatment and you’ll be just fine.