Real Questions Every Adult Will Have About Invisalign Treatment

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Man smiling  Courtesy Image

What makes you feel more confident is a matter of personal preference. For some that means honing in on physical fitness or leveling up in their career. For others it’s investing in a better grooming regimen. If that’s the case, you might want to start with your smile.

Most Americans fall in one of two categories: You either had braces as a kid, but neglected to wear your retainer after (guilty), so your teeth have inevitably and tragically shifted; or you never had ’em growing up, and now you’re able and willing to do something about it.

As an adult, you’d be hard pressed to commit to braces. But Invisalign treatment is a much more appealing option. Thinking about taking the plunge? Here are some of the most common questions you can expect to have, answered by Ken Cooperman, D.M.D., of Chambers Street Orthodontics.

How Much Does Invisalign Treatment Actually Cost?

It differs case by case. A lot of it depends on who’s providing your care. The cost tends to be a bit higher in New York City and major metropolitan areas, but I would say between $3,500-$8,000, comparable to the cost of braces, depending on the severity of the case. It doesn’t have anything to do with the number of aligners themselves either. Some more intricate cases might involve removing certain teeth or pairing several rounds of Invisalign treatment with jaw surgery, because we’d be interacting with an outside surgeon.

What Are the Attachments and Accessories?

We try to show people what these are going to look like so nobody gets a surprise when they’re just expecting aligners, and suddenly we’re talking about attachments or filing in between the teeth to create additional space. The attachments are tooth-colored ridges that are adhered to your teeth like braces brackets; they snap into the aligners for a tighter fit to make sure the teeth are continuing to move the way we predict they will. Invisalign treatment is primarily based on a computer predictor.

 Do You Need the Attachments?

There are some movements that are never going to occur without those attachments. If we need to rotate a tooth, attachments increase the efficiency and to try to minimize the lack of movement so the prediction stays as close as possible to reality. Attachments make a very significant difference on the quality of your treatment result.

What’s the Average Patient Like?

It’s a mix. When I was a kid, I had braces, and wore my retainer for a year, then thought I was done, per my orthodontist’s instructions. Everything was fine until I was in my late 20s and suddenly my bottom teeth started moving again so I needed round two. So we get many, many people who approach us about Invisalign treatment who once had braces and need to correct some changes. But there are a very large subset of patients who just didn’t have the opportunity, or the wherewithal, or the interest to have orthodontic treatment when they were younger, and now they want to look their best. The one thing that’s very consistent, at least in our practice, is the concept of long-term retention in that once you achieve your treatment results, you want to maintain it for the long-term. You can’t just use a retainer for a year because nobody wants to come back for round three.

Say Someone Is Going to a Cocktail or Holiday Party. What’s the Lesser of Two Evils: Leaving the Retainer Out or Keeping it in and Drinking Clear Alcohol?

I would say that it’s 100 percent better to take it out for a short time: Have your fun, rise your mouth and/or brush your teeth, then put it back in. Even though we want people to have them in as close to 24 hours a day as possible, you’ve got to have a life. If you end up missing eight hours because you went out for a long dinner, then had drinks with friends, that’s OK. You’ll just keep that set of aligners in for an additional day. But if you’re doing that all the time, then that’s when you start having a little bit of trouble. Try to be consistent and then make up for lost time at the end of that aligner.

Will Brushing My Teeth 5x a Day Ruin My Enamel?

It’s not going to destroy your enamel unless you’re using a very hard toothbrush or you’re exerting excessive pressure. You want to be thorough, but gentle when you’re massaging your teeth and gums. The greater risk as opposed to destroying the enamel, would be over-brushing the gums and causing recession, which means the part of the gum that normally covers the root of your teeth is going down. All in all, you want to brush your teeth often, because you want good oral hygiene to keep your teeth and aligners clean.

What Do Clients Say Is the Hardest Part About the Treatment?

I think it’s the getting-used-to period. When you first put them in, many people have a lisp. Sometimes it takes people a couple of hours to get used to them, and sometimes it takes a couple of days or weeks. The other one is that it can make your mouth sore. You might have to eat softer foods at the beginning of each new aligner. And sometimes the aligners will scratch the inside of the cheeks a little bit, or people who are prone to active ulcers will get canker sores. Then the biggest challenge is integrating Invisalign aligners into your everyday life. People are used to just grabbing a handful of crackers, but you can’t really do that anymore: You need to pop the aligners out, snack, then brush your teeth, so getting into that rhythm is hard.

How Do Invisalign Aligners Compare to New Mail-Order Aligners?

I know there used to be some type of limited partnership between some of these do-it-yourself orthodontic organizations, which were using Invisalign’s older technology that’s entirely dependent on computer generation. We started having patients coming in and saying, “I spent this money with this mail-order orthodontic company, and I’m still unhappy with the way my teeth look.” There are no x-rays taken before or during treatment. We’ve actually had a case where someone came in with a large cyst in their jaw that had to be surgically removed. In short: Do it the right way. You want an expert—a human—to diagnose what’s going on with your gum and bone health. It’s less expensive, yeah, and some patients are willing to take that risk.

Are There Any Conditions That Could Be Worsened or Aggravated by Invisalign Treatment?

I don’t know about worsened, but when a patient comes in with a pre-existing TMJ situation [dysfunction in the jaw joint that causes pain], we’ll typically send them out to a specialist to have that diagnosed and taken care of before they come in. I don’t think there’s an association between the exacerbation of TMJ symptoms and Invisalign treatment, but who wants to be the test case? I don’t think I would like to explore that particular relationship personally. The same goes for people who wear night guards for grinding their teeth and chronic pain. If you have a severely, rotated tooth, Invisalign treatment might not be appropriate either, because there’s just not enough surface area that’s showing and the aligner might not be able to grasp the tooth and get the change we want. In that case, we’ll say you might need traditional braces for a couple months after. But those cases have decreased significantly.