It used to be that only teens were considered for orthodontic alignment. It seemed that it was worth investing in the appearance of a teen’s smile, which usually meant “train track” braces. In the last few decades, however, more and more adults have sought orthodontic realignment of their teeth, as well. And now there is an option that can provide adult orthodontic realignment in many cases in a more esthetically pleasing, virtually invisible way (Invisalign). Why Should I have Orthodontic Treatment? The purpose of orthodontic treatment is to alter the position of the teeth to optimize a person’s appearance and smile, and function. Ideal tooth position can be affected by genetics (natural skeletal structure, eruption of teeth) and environment (oral hygiene, accidents, activities that can affect proper alignment of teeth).
Malaligned teeth can make a person’s smile look off-center and asymmetrical, while compromising a person’s ability to bite, chew and speak (impaired biting and chewing can lead to other digestive issues as the stomach needs to work harder to break down bigger pieces of food than it was originally designed to).
Orthodontic treatment is usually part of an overall comprehensive treatment plan, sometimes involving other dental practitioners such as general dentists and oral surgeons to try to get the best result possible. Each treatment plan is custom made for each individual patient, since each patient’s needs are different and respond to treatment in different ways. In all, a comprehensive orthodontic treatment plan can last between 1 and 3 years depending on the age of the patient (which affects the thickness of the bone, which in turn can make it more difficult to move teeth) and the extent of the treatment required to bring about the best results.
Orthodontic Treatment Options Obviously, “train track” braces are still available and many people still use them. Instead of straight black, however, many come with the option of colored bands to go around the brackets and even different colored or clear/transparent/white brackets.
Many of us are also familiar with retainers which are usually used to help “maintain” orthodontically repositioned teeth in their final position once the main braces come off.
Then, there’s Invisalign. Invisalign is actually a series of appliances called “aligners” made from clear plastic or acrylic and are custom-made for each individual patient. “Each aligner is designed to move the teeth a maximum of about .25 to .3 mm over a 2-week period, and is worn in a specific sequence…. Excellent compliance is mandatory since the appliance has to be worn a minimum of 20 to 22 hours a day and each aligner should be worn 400 hours to be effective” (JCDA).
Your dentist will take X-rays, photos and impressions of your teeth which will be used to create a 3D image of your teeth, which will then be used to determine and devise what kind of and how much movement is required. Regular follow-up with your dentist will be necessary to make sure that the teeth are moving as planned and that you are complying with the treatment requirements.
Invisalign Considerations Invisalign might be indicated as a treatment option in cases of:
- Mild malaligned malocclusions (1 to 5 mm of crowding or spacing)
- Deep overbites when simple moving the teeth inward will resolve the issue
- Full arches where crowding is due to tipping of teeth and not due to a narrow skeletal formation
- Mild orthodontic relapse following traditional orthodontic therapy treatment
Contraindications to Invisalign treatment include cases of:
- Crowding and spacing more than 5 mm
- Skeletal discrepancies between the front and back teeth greater than 2 mm
- Discrepancies in the positioning of the front teeth along the midline
- Teeth that are rotated greater than 20 degrees
- Open bites – anterior where a clear line is visible into the mouth because the upper teeth don’t close down over the lower front teeth; or posterior – where the molars don’t touch
- Teeth needing to be moved outward
- Teeth that are tipped more than 45 degrees
- Teeth that have short crowns
- Arches where there are multiple missing teeth
As mentioned, each patient’s needs are unique and what will work for one patient will not necessarily work for another patient even if they present with the same or similar dental alignment challenge or issue. Your Wellesley Dental Arts orthodontist will be able to discuss orthodontic treatment options with you, including the possibility of including Invisalign, along with the associated costs and estimated time of completion.
- Why you should get orthodontic treatment, American Association of Orthodontists
- Understanding your treatment options, American Association of Orthodontists
- Clinical Limitations of Invisalign, by Xiem Phan, BSc, DDS, & Paul H. Ling, DDS, MDS Ortho, MOrth, FDS, RCS. Journal of the Canadian Dental Association
- Treatment Process, Invisalign