Appointment #27 – The start of round 2

Went in to find out what the next round of Invisalign has in store for me today.

Invisalign has apparently changed their parlance/policy regarding what they used to call “refinements.” For someone like me, with Invisalign Full (as opposed to one of the “Express” versions for small fixes), it used to be that three refinements were included in the overall cost. Refinements are basically when you finish your prescribed treatment, but there are still additional corrections needed. If, after the first refinement set there was still more work to be done you could repeat the process twice more under the same treatment program.

Well, I guess now they’re calling it just “additional aligners” and as long as you are within something like 5 years of the start date, they’re included in the cost. I’m not sure what all this means (like, if you finished treatment after 2 years, but then had some relapsing and your ortho wanted to put you back in Invisalign is that included? Not sure), but you can read more about it here.

So there was a lot of good news today… though really after having 22 attachments (I guess they really only count it as 19 since the teeth with two bumps only actually count as one attachment?) and 44 trays for the first round pretty much anything would be good news! Tray count is 20, so that’s what, like 9-10 months? That’ll fly by! And I only have 8 attachments, most of which are in the back: upper and lower first molars, top first bicuspids, and top lateral incisors. How very symmetrical! The ones in the front really aren’t very visible. They’re a different shape than the ones I had on those teeth the first time and they’re kind of down near the outside bottom corner of the tooth. Tried to look up what its purpose is, but not having much luck so far!

The attachments went on with about as little fuss as the last two times I had them done. The worst part is having your mouth stuck open for so long. There was one attachment that didn’t stick the first time, so the assistant had to redo it, but all in all pretty fast and mostly painless (there’s one tooth on the right that gets a bit sensitive from time to time so I wasn’t totally loving the clean-up process when she got to that tooth, but it didn’t last long).

After the attachments went on I put in my first set of aligners. I noticed that power ridges are back on the upper central incisors… interesting. They feel a bit weird, but I’m guessing that’s partly just because the old aligners that I’d been wearing as retainers lost some of their strength over the past few months!

I am definitely anticipating some tooth tenderness over the next few days with the tightness I’m feeling now, but glad to be back on the road to progress. While I’m really happy with how far I’ve come, it’s good to know that they’re going to get even better!

I know I promised a photo post last time, but I really will do it this time! Soon!

Appointment #26 – Smooth teeth!

I haven’t forgotten about this blog, but had some unforeseen delays in my treatment that had nothing to do with my teeth…

I was supposed to get my attachments removed back on July 2nd and everything was going swimmingly until I went out to my car to leave for my appointment and… the car didn’t start. I called AAA to come give me a jump and called the ortho office hoping they would tell me to just get in ASAP, but of course, no… they rescheduled me for the next available appointment which wasn’t until… August 6th. And then I had a work meeting scheduled for the 6th, so ended up having to reschedule yet again.

That means I ended up wearing tray set #44 for two months… ew. And I’m not done with it yet. But more on that in a minute.

Needless to say I was thrilled when this appointment finally rolled around, even though I was a bit nervous about the actual attachment-removal process.

The ortho assistant took me back almost immediately and put me back in the chair. She asked if I was feeling done or if there were things I still thought could be improved and I told her that there were a few things I was hoping could be worked on. (I wonder if I had said that everything was okay with me if they would have still looked to see if there were improvements to be made or if they would have just let me make the decision.)

I was bibbed and handed safety goggles and the assistant went to work sanding off the attachments. It felt… basically like when they polish your teeth at the dentist except with no polishing paste and with a hell of a lot of dust! But it didn’t hurt at all. The worst part was the dry mouth from all the dust blowing around. After she finished up the bottom teeth she had the orthodontist come over to work on the top teeth. I guess the assistant thought that with the number and placement of the front attachments that it would take too darned long with her tools and the orthodontist could use the high-speed buffer. Which definitely went faster, though it sprays water which can get a little messy. There was one tooth that felt a bit sensitive, but the ortho backed off on that and said that the assistant could do that one. She then handed the reins back to the assistant to do the finishing with the slower buffer.

Before she did that, though, she did take a look around to see what she thought they would want to fix with the next round. Thought it was kind of weird that she didn’t ask me what I was concerned about, but okay. She rattled off a few things in dental-ese, but I think it was all the stuff that I was concerned about: the lower lateral incisors need to be rotated, the upper canines need to be intruded a bit more, some adjustment on the bite, maybe some things on the front teeth (I hope, because they’re not quite straight yet). I didn’t see the assistant or anyone writing this stuff down, so I certainly hope that they know what they’re going to do!

The assistant finished cleaning up the attachments, then sent me off to rinse and clean up.

She did another round of photos… they must keep each patient on a separate memory card or something because she was playing with the camera and commenting on how much better my teeth were looking, especially the canines. I assume she must have had the photos right there to compare.

After the photos they did the iTero scan. While we were waiting for it to finalize and let us know if there were any parts that needed to be rescanned before submission the assistant asked if I still had my final tray. To which I was all… “Ye–esssss?”

So… turns out that instead of making me a set of retainers they are just having me wear this last set of trays. Yeah, the ones I’ve been wearing since mid-June. Blah! On top of that, the trays have 10,000 (okay, maybe not quite that many) bumps from the now non-existent attachments. Here I was all excited to finally have smooth teeth and yet I’m still going to look like I have braces when I’m wearing the trays!

But, whatever, it’s not like I won’t be getting more attachments in a month or so anyway, so I’ll suck it up. And when I do take the trays off it feels soooo nice to run my tongue over my teeth and not encounter any bumps. I can still feel a few tiny remnants of the attachments, but they’re very minor and I’m not going to worry about it until I get to the end of this journey.

Next appointment is scheduled for Sept. 17th when I’ll go find out the verdict on how many more trays/attachments I’ll be dealing with. Will put up a picture post before then so you can see the progress. It really is pretty remarkable!

Appointment #25 – Last three sets

Went in to pick up the last three sets off aligners for (this phase of) treatment. Hard to believe I’ve been doing this Invisalign thing for over a year and a half now. It’s definitely become routine. The excitement of new trays is still there… somewhat. But it’s nowhere near as fun as it used to be and I’m ready to just be done.

Except… I don’t feel like I’m near done yet!

The assistant gave me set #42 and I noticed that the package said that this was an “overcorrection” set. Which to me means that they thought that my teeth could have been set at #41. From what I can find on the internet about overcorrections, it actually means that the orthodontist predicts that certain movements might not be achieved, so they put in a couple extra sets of trays that aim to move the teeth beyond the right spot in the hopes that it will end up being just right. Or something…

But whatever “overcorrection” means, I look at my teeth now and say, “Nope, these are not done!” Are they 10,000x better than they were in October 2013? Of course! But with all I’ve been through I was certainly expecting something much smoother than I’ve got currently.

Who knows, maybe these last three trays will put things right. This is one of the few trays that was immediately uncomfortable. Usually any discomfort doesn’t kick in for me until a day after I switch. These were difficult to even put in. So maybe the ante is being upped and I’ll be super-happy in 6 weeks. But…

Assuming I’m not, I did ask both the assistant and the orthodontist about refinements. They said they won’t make any decisions until I complete the next three trays. Which I understand, but there was also kind of this unsaid comment that made me feel that they were thinking, “Well, what’s wrong with them as they are?” and that kind of irked me. Maybe they’re used to dealing with kids who probably don’t have a whole lot of opinions on their teeth other than, “When can I get these stupid braces off?!” And yeah, I want to be done with this, like, last year. But I’d also like to have my teeth look good, not just better.

Anyway, I’m probably overreacting. I’ve had kind of a hard time dealing with the fact that the orthodontist I dealt with in the beginning (the guy who owns the practice and is the Invisalign Elite provider) has been kind of MIA since he hired the new girl. The new ortho is sweet and nice, but also comes across as pretty green. I’m okay with the fact that she is just out of residency and is still getting acclimated, but I miss the rapport I had with the other guy. It’s frustrating knowing that the only thing she knows about my history is what she’s read in the chart.

Oh well, must keep the faith and take it one step at a time, I suppose. We are still going through the original plan and it’s not like braces where the ortho is making decisions at each visit. She’s stuck following the game plan that was made long before she got there.

So I got my last three sets and then made my appointments for six weeks from now. It’ll be a two appointment day with a long one in the morning and a short one later in the day. The exciting news is that all the attachments will be coming off! They will put on a totally new attachments, as needed, in the refinement phase. So that means I should get at least 4 weeks or so of smooth teeth! Hoping I can get in a whitening treatment during that time. I feel like my teeth are looking disgustingly yellow in spite of my constant brushing (I’ve heard complaints from other Invisalign wearers that the attachments, or at least the glue, does stain). They’ll talk to me then about refinements and do another iTero scan and do molds for retainers. The second appointment will be to pick up the retainers. I’m not thrilled to know I’ll be dealing with the Essix retainers they make in-house again, but it’ll be short-term, at least! (When I’m totally done I will be getting the Vivera retainers that Invisalign makes; I’m assuming those fit better than the in-house lab ones.)

So, that’s that. Will definitely be posting pictures then!

Appointment #24 – The home stretch

Well, that’s what the ortho assistant said, anyway. And it’s true, I’m now on tray set #37 out of 44, so based on that we are getting towards the end. But I look at my teeth and think, unless there are some drastic changes coming in these last 8 sets, I am going to request refinements if the orthodontist doesn’t suggest it first.

That’s not to say that my mouth hasn’t made some drastic improvements over the past 17 months. It definitely has and I smile far more confidently now than I ever used to, even with attachments on nearly every tooth. But a lot of teeth still seem to be out of alignment and based on the amount of time it’s taken to get this far, I doubt that the next three months will be enough to finish the job.

Anyway, the actual appointment was mostly one of the straightforward ones where I go in and the assistant hands me a batch of new trays and the orthodontist checks everything out and I make my next appointment and leave. I did have one concern, though. I happened to be poking my back teeth with a fingernail the other day and noticed that one of the first molars on the top seemed to have a horizontal ridge. I pulled out my mirror to look at it and couldn’t tell if something was going on with my tooth or if it was just the attachment on the tooth that made it feel like this. It didn’t hurt or anything, but having learned my lesson about keeping quiet about my concerns from the canine debacle I made sure to mention it.

The orthodontist took a look and said that there was “flash” from the attachment, which I think is the excess glue/cement stuff around the actual attachment. She asked the assistant to get her one of the burr wheels and cleaned it up along with another attachment. Of course, I’ve had those particular attachments for nearly the entire duration of treatment, so I have no idea why I never noticed this until now, but at least I know that my tooth is okay and I got the flash cleaned up on top of that.

I left with trays 37-41 and an appointment at the end of May when I’m assuming I’ll get the rest of them. Will be curious to see what they say then, whether refinements are a foregone conclusion or whether they’re going to make me wait until the end of tray set #44 to determine next steps. In the meantime it’s back to the grind!

Tray #33 – Three-quarter mark!

Trapped inside during a blizzard and switching to tray set #34 tonight, so figured I’d post some pictures now that I’m three quarters of the way done.

Here’s my starting point — pre-Invisalign (but post-Carrière distalizer)

The one-quarter mark after tray set #11:

The halfway point (tray set–you guessed it–#22)

And today

I’m beginning to see some light at the end of the tunnel here. The overlapping front tooth is no longer overlapping (look at that gap!). It still has to be straightened up some and brought back in line with its partner, but when I look at the first trays and see how much those front teeth have rotated I’m quite impressed. I was bummed to realize that the wear on those two front teeth is such that they will forever look crooked even when they’re not, though. I don’t know whether they’ll be able to file them or not; the (formerly) front-most tooth has a craze line in it and I fear that filing it might end up causing it to break, but fingers crossed that there will be something they can do to improve the final cosmetics.

The fangs… I swear, they are going away, aren’t they?! When I look at the original trays it’s amazing to see how much those babies have rotated. There’s still a fair amount of progress needed to get the right side canine (on the left in these pictures) to get in line, but I feel like the new attachments are helping that and I’m finally seeing a bit of improvement. This is only the second tray with the attachments on the top incisors, so I expect that this will be on the move quite a bit in the next few months. The left one still needs some help, too, but at least it doesn’t look freakish to me anymore.

As for the rest of the teeth… I’m shocked at how much the back teeth have moved, actually. The biting surfaces are even and the teeth that had been a bit rogue are all in the arch now. Funny, I never even noticed that they were crooked when I started, since I was so focused on the social six (or twelve, I guess, if we’re counting the bottoms), but when I compare the old trays I see that they were.

Hard to say how much work will get done in the final quarter of treatment. I’ve never seen my ClinCheck so I don’t even have a vision in my head. I still anticipate that I’m going to need at least one round of refinements after this, but I suppose I’ll just have to wait and see. But I am feeling a bit more hopeful than I was a few weeks ago that the end point will at least look good, if not perfect.

And finally, two more pics from today so you can scrutinize the new attachments: one with trays, one without.

You can see that the attachments are, unfortunately, way more visible with the trays on than without, but on the plus side, at least the four across the front look bracket-ish. I actually had someone ask the other day if I had “clear braces” (granted, this was a person who recently finished up treatment in traditional, ceramic braces herself). It was a relief to know that at least one person looked at me and said, “Ooh, braces” rather than, “Ew, WTF is up with her teeth?!”

Next post will probably be in March after my next appointment. Not sure if/when I’ll do another picture post before #44. I can’t think of any major milestones to mark (unless my ortho has some sort of surprise in store for me before then), so I may just leave the pictures a mystery until the “final” (which I doubt will be truly final) reveal. We shall see. Until then, happy straightening!

Appointment #23 – Attachments galore

Well, if 18 attachments weren’t enough, I now have 22! Four new ones were put on my top incisors and let me say this has rendered my Invisalign far less invisible! But at this point I’m so eager for these damned fangs to go away that if this is what it takes, then fine. Bring it on.

Getting the attachments on was far quicker than the first go-round, that’s for sure! The assistant put in the lip stretcher, dried my teeth, painted on the etchant, and then put in the template tray. Cured the attachments with the blue light, pried the tray out, then sent me to the sink to rinse. Once I came back she cleaned up the attachments with the sanding wheel thing and then sent me back to the sink for one more rinse. I looked in the mirror while I was at the sink and couldn’t see the attachments so was pretty stoked. But the lighting back there is pretty dim.

When I got back to the chair she handed me set #32. They went in pretty easily. One of the orthodontists took a look and said the trays looked like they were fitting perfectly. The assistant handed me four more sets to get me into mid-March. Appointment made and on my way…

And of course the first thing I do when I get to the car is to take a look in the vanity mirror and, ugh, yeah, this is the point where I kind of wish I just had traditional braces because this Invisalign thing is now just making my teeth look 10,000 kinds of weird. At least braces would look like braces and people would know what I was up to. Unless you know about Invisalign and its attachments then you probably just think I have some really weird teeth.

With the attachments I’ve had before now you really wouldn’t notice I had them unless you were really up close and personal, but these are noticeable from more of a distance. Argh. Oh well. Only six months of this. I got through nearly four months of Carriere distalizers and elastics, and this isn’t nearly so bad, so… keeping my eyes on the prize.

The other obnoxious thing about the extra attachments is that it makes removing the top tray a lot more difficult. I can pop off the sides as easily as before, but where they used to just slide out once I got the sides off; now they’re stuck on the front teeth and I have to do some wiggling to get them off. I’m hoping that once the attachments wear down a bit that they’ll slide more easily.

Six more months, six more months.

On the positive side, the arrival of attachments means that I’m done with power ridges now. The ones on the bottom trays actually vanished with set #27. Those incisors didn’t need as much tipping as the top ones, I guess. So that’s something, right?

Will save a picture post until I finish tray #33 in four weeks so I can mark the three-quarter point. Hoping for some more visible progress by then!

Appointment #22 – Round 2 of IPR

So that whole, “The spacers don’t really hurt?”

Yeah, I spoke too soon.

Ouch.

They hurt. Kind of a lot, actually. Glad it was only 24 hours of that crap!

Went in this morning and it was the new ortho who was doing my IPR. I didn’t mind, but got a little nervous when the assistant asked her “Do you want me to highlight which teeth are being done?” and she was all, “Yeah, that would be great!” I’m sure these conversations happen all the time, but could you not do it right in front of me? Makes me question whether I’ll be walking out with all the wrong teeth filed!

Anyway, it was fine. The spacers got popped out and she used the drill file thingy for those spaces. I thought that was all that was going to be done, but I guess not, because then she busted out a manual file strip and worked that through some of the front teeth. I was trying to keep track of which ones, but was having a hard time.

I was worried that it might hurt based on how my lower jaw was feeling from the separators, but it didn’t. I had a couple brief moments of sensitivity, but almost as soon as I noticed them it went away. The worst part was that my lower lip got a tiny bit shaved up in the process.

While I wasn’t expecting all that IPR, I was kind of glad for it. I’ve had some black triangles opening up between the bottom front teeth, so this should help them fit together a bit more snugly.

The assistant brushed a fluoride treatment over the teeth that had been filed and then handed me the bottom tray from set 31. Ow… that HURT to put in. The assistant was like, “Does it usually hurt that much?” Um, no, but all my teeth have been shoved around over the past 24 hours, so… this isn’t going to feel great! Hello! The top tray went in smoothly, though.

This was the only set of trays I got today. I have to go back for set 32 because they need to put on more attachments. Which I knew. Kind of annoying the way all the timing worked out, but these things happen. In a way I don’t mind because for the past year I’ve just been going in, having them take a quick look in my mouth, and hand me more trays. Meanwhile, they’ve been continually charging my credit card for treatment (last payment was in October, though! Glad to have it paid off!). I know a lot of the work is upfront in making the plan, but it still makes me feel like I’m getting my money’s worth to go in and have them Do Stuff.

Of course, when I went to schedule that appointment it worked out that the day I’m scheduled to go back is already completely booked up. School vacations and all. So I have to wait until the following Monday. I hate setbacks.

So…

I’m currently afraid to take this bottom tray out due to the pain. Might actually go for a bit of ibuprofen when the time comes. They’re feeling better than they were when I first put the tray in, but I know that will all change when I try to remove them!

Feels like this is turning another corner in treatment, though, and hopefully this signals the start of things really lining up properly. See you in two weeks!

Appointment #21 – Separators: Round 3

Quick appointment today – just had three separators inserted in advance of IPR to take place tomorrow.

They’re all on the bottom again. One between the canine and first bicuspid on both sides and one between the first and second bicuspids on the left.

I’m not sure if it’s just that the separators have been inserted between progressively smaller teeth, but it seems to have gotten easier each time I have this done.

There was no pain going in. Maybe a millisecond of pressure, but that was it.

And they don’t hurt now, just feels weird. The bite feels a little off, of course, and my tongue is continually poking at them. They stick out from my teeth, so that’s kind of annoying. But it’s only 24 hours I have to deal with it.

The ortho assistant apologized that they were blue. They are towards the front of my mouth. But… again, it’s only a day and luckily I’m working from home today and won’t have to be talking to a lot of people.

And, since this also marks the ending of tray 30, and thus the approximately 2/3 mark, I figured I’d put in some pictures.

The beginning:

One-third mark:

Two-thirds mark (with a glimpse of separators!):

It’s kind of disheartening looking at this, because it feels like my smile really doesn’t look any different from tray 15 to 30. I know changes are happening. I see them in the trays, it’s just… ugh, I see this and think, I only have 14 more sets after this! Are my teeth truly going to look straight by then?

Keeping the faith that my ortho team has it all under control!

Appointment #20 – Gearing up for a busy December

Went in for my most recent check-up yesterday.

Assistant handed me tray set 27 and went to review my plan so she could figure out how many more sets to give me.

Apparently I have more IPR coming up on my lower teeth with tray 31, so they ended up giving me just four sets total this time: 27-30.

Then I have TWO appointments for the IPR because they’re doing the two-step process again where I go in on one day to get spacers placed between the teeth that are being shaved, and then return the following day to have them removed and the IPR performed. I’ve never heard of this being done elsewhere, but this is what they did when I had IPR between trays 5 and 6, so I assume it will be much like that. It worked out fine then, so I’m not too anxious about it, though I was kind of hoping I was done with IPR. It’s not bad, just not my favorite thing. Oh well.

The assistant also said something about me getting two more attachments with tray 32. I knew I had more attachments coming up, but thought it was going to be way more than just two. The plan I saw back at the beginning had them on just about every tooth except the second molars in the very back. And as of now all 8 front incisors and one bicuspid are still naked. Maybe she miscounted? Or maybe they’re putting only adding two more at tray 32 with the rest of them later? Not sure.

Also… what a pain in the butt that IPR and additional attachments are one tray apart rather than coinciding. Sounds like I’ll be visiting the ortho’s office quite a bit in the month of December! Guess I’ll have to wait and see how it all plays out.

The new ortho (who is now brace-free herself!) came by to take a look before I left and said that everything seems to be tracking as it should. Good news for now.

I almost (almost) feel like the finish line is coming into sight, but obviously still have a few more hurdles to cross before I can see it clearly.

One year Invisaligniversary!

One year ago today I started on the Invisalign portion of my orthodontic journey.

Here I was proudly wearing my first set of trays!

Invisalign Tray 1

And here I am today wearing tray set #26:

Better? I think so!

Here’s a picture to compare those two sets of trays (Click on it if you want to see it bigger):

And here’s a comparison of the teeth, sans trays.

Then:

And now:

The really exciting thing with this tray is — I don’t know if you can tell from this pic — but for the first time I can see the entire medial edge of my right central incisor without having to turn my head or anything! The left tooth is still in front of the right in the arch, but it’s no longer overlapping. Finally! I’m so excited.

The gaps that had been opened with the distalizers between my lateral incisors and the canines have closed down tremendously. There’s only a tiny one remaining on the left; the one on the right has farther to go, but it’s much smaller than it had been. The fangs, as you know, will be one of the last things to get fixed, unfortunately. I should know more after my appointment next week.

My bottom teeth are doing very well. Still some minor crowding, but overall they’re very close to where I want them.

I remember the relief I felt on that first day knowing that, as bad as my teeth looked at that point, things were on an upswing. Each tray was one step closer to the smile I wanted. I still have 17 more sets to go and who knows if that will be the end or just mark the beginning of the next phase of Invisalign (refinements), but I know that I smile much more confidently now than I did a year ago and that’s huge progress in and of itself.

Stay tuned for updates from my upcoming ortho appointment next week!