Seems as though Invisalign is suffering from some credibility problems, and there is a lot of misinformation out there on the web. Let me take a few moments of your time to address some of the more common urban legends about Invisalign.
First off, let’s recognize that someone who is just learning to bake bread will not do it as well or as consistently as my Aunt Verna who did so almost every day for decades. The same applies to making a sculpture, building furniture… and making smiles. Having provided orthodontics for forty years, I recognize things that work and don’t work, and after many thousands of patients through my office, I have seen good orthodontics and bad orthodontics. There are many methods and materials that can be used to get to the same end result in talented hands. The secret is to know “where you are going”.
Patients expect a certain result from me, so I need to use what works. Most adults and most teens get Invisalign because it will do the job and do it much more comfortably. Personally, I expect the same results from Invisalign that I get from using braces. I have all the brackets and wires I need to switch, if necessary, but rarely used.
Let’s go through the rumors –
“Invisalign costs more.” “I can get braces cheaper.”
Our fee for Invisalign is less than braces on a full case. It is possible that a very small correction that could be made with braces would cost less than Invisalign, but that is because there is a minimum charge to me from Invisalign to construct the aligners, though the additional comfort of Invisalign may be well worth the difference in cost in those cases.
“Invisalign is the same wherever you go.” “It gives everyone the same smile.”
In our office, every single Invisalign case is individually set up by me. I tell the technicians exactly what I want to have happen to every single tooth in every single appliance. The computer simulation that is used to do this is under my control. One of the things that make Invisalign attractive to less experienced dentists who do not have the orthodontic experience I have is that Invisalign has staff that can set up the case for the doctor using some treatment “defaults” without any input from the doctor. This may be where the rumor came from.
“They have to grind off your teeth to use invisalign”
Any form of orthodontic treatment may call for some reshaping of teeth, usually to make the lower teeth and upper teeth mesh properly in the end. It is not unique to invisalign. It is also a technique that may help avoid the need to extract teeth to make room.
“Invisalign is slower”
Actually, it seems to be faster in most cases. On average, cases take under one year to complete. Part of this is because the aligners can be programmed to do different types of movements on different teeth at the same time. One tooth can rotate, one can be extruding, one can be tipping, and one can be standing still, all in one appliance. It is virtually impossible to create an orthodontic wire that can have every single tooth doing exactly what is needed at every treatment phase. The Invisalign computer CAD/CAM technology makes this a cinch. But here again, everyone is different. Complex problems take longer no matter what system is used, but with Invisalign, you change your appliance every two weeks whereas braces usually only get altered monthly. Gentle pressure actually moves teeth faster and more comfortably. Wires can involve excessive forces.
“Invisalign doesn’t move the teeth as well”
There are some movements that Invisalign does not do as well as braces, such as closing a gap where a tooth has been removed to make space to straighten teeth – something we rarely do. When you fasten a wire and bracket to a tooth, you can move it anywhere and pull as hard as you want. Invisalign “grabs” the tooth, too, but not with as much force, so some types of movement are more difficult (though it usually means it just takes more time but the movement is more comfortable). The excessive forces are what tend to make braces hurt at every wire change (besides the brackets making hamburger out of the inside of your lips). We also may add some “braces-like” features to the Invisalign appliances, depending on the needs of the case. Sorry, we can’t use headgear. (I bet you are really disappointed to hear that.)
“Kids can’t have Invisalign”
The Invisalign Teen version of this system is designed to work with kids having their permanent front teeth and their first permanent molars (middle school age), just like most “braces treatment”, and is quite effective in the cooperative younger patient. The duration of treatment depends on how fast the Tooth Fairy gets her job done – just like braces. The big advantage is how clean the kids can keep their teeth during the treatment – you can’t remove braces to brush and floss normally. Speaking as a cosmetic dentist, one of the most common reasons for folks spending thousands on veneers as adults is because of the numerous fillings and acid damage they ended up with because they really didn’t keep their braces clean for two years during a time in their lives where sugar was regular and brushing was not.
Braces are great. We still use them when they are needed. In making a decision about braces vs. Invisalign the bottom line for you might be speed, comfort, price, and ease of personal oral hygiene. The bottom line for me is a great result and the happy patient.
I wouldn’t offer Invisalign if it didn’t do both.
Dr. Robert L Knudson DDS
