More in the Invisalign Q & A series.

This is the continuation of a series of answers to questions found commonly on the internet about Invisalign.

Because Invisalign is relatively new (first used in the USA in 1999; available in Australia in 2002) there is not a lot of scientific literature studying the technique. 

So, most lay people have to rely on information obtained from internet searches or hearsay, and these sources are unsubstantiated.  They may be right, but 87% are just plain wrong.  How do I know it’s 87%?  My evidence can be found here.

So, these are some more of the questions that I have seen, and the answers I might give.

Remember that what follows is still only my personal opinion but it is based on 32 years as an orthodontist, over 10 years as a lecturer/senior lecturer teaching at the University of Queensland, 10 years using Invisalign, and having treated my wife, and all 4 of our children!

Maybe you can find answers to some of your questions here or on other pages on our website (Hint: Use the Search box at the bottom of each page, or look through our Wiki page).  If not, feel free to use the Contact Us form.

Can Invisalign be used on teenagers?

Usually, yes. 

Originally Invisalign needed all the permanent teeth through (except wisdom teeth).  Since then, “Invisalign Teen” has been developed, which can be used if some baby teeth are still present.  For more information, have a look at our Teen page, or the Invisalign Teen website (opens in a new window).

Of course, the big factor is CO-OPERATION!  Teenagers can be (stop the presses!) unreliable.  Interestingly, the same is true for adults.

We find it extremely weird but teenage girls make up the worst group of patients in terms of co-operation.  You would think they would understand that Invisalign treatment paid for by their parents is way better than waiting and paying for their Invisalign themselves - or braces at any age.  Still, around 5% of our teenage girl patients seem unable to reliably carry through the whole treatment!

There are some teenage problems that can get a better result (for reasons other than non-co-operation!) with fixed braces, but not many.

I’m having problems with my Invisalign retainer.

Well, to be pedantic, the question usually is referring to an “invisible” retainer.  These look like the Invisalign Aligners, but are made in dental practices and labs all round the world.

There is a retainer made by Invisalign, called a Vivera retainer, but these are uncommon in Australia.  They are relatively expensive, and similar retainers can be made in Australia for similar or lower cost.  This is a report from the view of an orthodontist having treatment.


Most problems with invisible retainers come from failing to follow the instructions that came with them.  Generally you need to wear your retainer/s full time (except for eating and drinking) for the first few weeks.  Then at least 12 hours per day or night for the first year. 

After this, continue to wear them as needed – this might be every night, or every second/third night, but must be enough to keep your teeth straight.  This varies from person to person.

When your retainer breaks or gets too gross to wear, get new ones made immediately.

Important note – teeth never stop moving in a living person.  Stop wearing your retainers and your teeth will move.

More information on retainers can be found in this page.

Bottom line – if you are having problems with your retainer, call us ASAP.

What is this ‘filing’ that you have with Invisalign?

This has many names – filing, enameloplasty, slenderising, interproximal reduction (IPR), discing, aproximal enamel reduction (AER), and even stripping, to mention a few.  We say “IPR” because it’s easiest to spell.  It is a technique that has been used with orthodontic treatment for over 100 years, and involves removing a little tooth enamel from the sides of one or more teeth.

The good news is:
•    It is not necessary for most patients.  In the early days of Invisalign there was a lot of IPR done/needed.  Now it’s much less often.
•    It does not hurt, or change the shape of teeth visibly.
•    It does not cause decay, weakness, or tooth sensitivity.  This has been extensively studied scientifically over many years.

It is done usually with hand-held strips, coated with very fine diamonds.  This feels like fingernail filing. 

There are also mechanical versions for quicker or more extensive IPR –

We generally use it to gain more space for crooked teeth.  We have three ways to make space:

1.    Expand (spread out) the teeth.  Here you can see this –

 

2.    Make the teeth a little smaller (if expansion can’t give us enough space).  We also do this if the teeth are poorly shaped, and would not look nice after simple straightening.  Like this -

3.    Extract one or more teeth.  This is a last resort, if we can’t get enough space from options 1 and 2.  Here is an example  –

And, all this will be discussed in detail before and during any treatment.  Never be afraid of IPR – nor of asking questions!