I’ve been functionally done with treatment for almost a year now now. All told, the actual treatment took about a year longer than the original projection… but that’s okay. The refinements stage is the easiest stage; after 40-some trays of initial treatment, 20-some trays of the first stage of refinements, the prospect of 15 more for a second round was no sweat. Refinement aligners are only worn for one week each — who cares if they get stained? That’s more often than I change my disposable contacts! Refinement trays also represent a smaller and more subtle tooth movement each time; any pain or discomfort is really negligible. By that point I was so accustomed to wearing the aligners, and very personally invested in getting the most out of my treatment — besides getting my $5K money’s worth, going through this process made me more interested in my teeth. I made the primarily-cosmetic decision to fix my teeth as an adult, and I became invested in the process. With all the initial worries of treatment behind me, continuing until my orthodontist said we had reached the end was a natural one.

There was only one surprise along the way. Between Refinements #1 and Refinements #2, Invisalign switched to a new primary aligner material, Smarttrack. I did notice that the first aligner of my new refinement set seemed an easier fit when they first put it in at my orthodontist’s, but I didn’t suspect anything was truly different until about an hour later, strolling through our open market, the Strip District, when a rough spot suddenly appeared on my aligner over my center bottom teeth. Was my aligner cracked? Already? Cracked aligners had happened to me once or twice. No problem. With the refinements being so subtle, I would just pop the second aligner in early and wear it for two weeks, rather than one. By the time I got back home, a corresponding rough spot had emerged on the corresponding tooth on my top aligner. I switched to my second set… and two hours later, a rough spot emerged in exactly the same place. I compared aligner envelopes from last round, and sure enough, the new round said “Smarttrack” in the same place the old round said “EX30.”

Suffice to say, I was a bit miffed. I left a message at my orthodontist’s office and did some online research. Other people had indeed experienced the same trouble with the Smarttrack aligners, but usually toward the end of their required time for wearing the aligners. When my orthodontist’s office got back to me, they explained that the Smarttrack material requires a “comfort liner” and that shredding is possible but rare. Indeed, upon closer look, I saw that the rough spots on my aligners were places where the thin liner had broken, as if a small hole had formed in a layer of Saran wrap and was peeling off.

The problem, it appeared, was that the quite indestructible nature of the EX30 aligners had turned me into something of an “aligner grinder.” I don’t grind my teeth when the aligner, or now retainer, are out, but when they’re in, I gnaw away. My orthodontist gave my permanent retainer extra thickness to handle it and made it in-house out of a different material. This turn of events is perhaps not surprising. I have always been something of a mouth-fidgeter. One of the great things about having straight teeth now is that I used to worry at the crooks in my crowded bottom teeth with my tongue when I got stressed. Now there are no crooks to mess with. During the Invisalign process, this tendency must have converted to grinding.

All I can say is that I’m glad I didn’t get Smarttrack until the last stage of refinements. I don’t know if I could have made it through the original course of treatment wearing 42 aligners for two weeks each. With an iron will I did my best to retrain myself not to grind my teeth (I do it when awake and not while sleeping). It worked to a certain extent, but by the last day or two of each Smarttrack aligner, there was usually at least one small bloom of shredded plastic, though mostly on my molars which made it easier to ignore than on my front teeth. I did successfully stop grinding in the front of my mouth.

To the credit of the Smarttrack, I can attest that they certainly are more comfortable. They are very elastic, and I can only imagine that makes them easier to wear during the first stages of treatment. I’m betting they virtually eliminate the problem of aligners being so tight at first it’s hard to pop them out. Being more elastic makes them, not only easier to get on and off, but better able to hold their shape. I could tell that my aligners were nudging my teeth more gradually into place throughout the entire week, rather than shoving them all at once into place on the first night, and then keeping them there for the rest of the wearing period. Also, in the interest of complete fairness, I have a friend who was also going through Invisalign at the time I was wearing the Smarttrack, and he didn’t seem bothered by the little bit of shredding he noticed — in fact, he hadn’t even noticed the change in material until I asked him about it.

All of these good qualities will give people who are worried about or sensitive to tooth pain a great advantage in using Invisalign. This treatment was already gentler than braces, but with the Smarttrack, I can’t imagine a kinder and softer way to move your teeth. Also, if the other claims of Smarttrack are to be believed, the process may even happen faster, since the new material moves teeth more efficiently and effectively.

Grinders beware. Where people who grind their teeth actually did better with the EX30 than their non-grinding counterparts… Smarttrack is a whole new ballgame. I’m not sure if they will even make a set of EX30, but if you grind your teeth, I would advise asking your orthodontist if the old aligner material is still available for your treatment.

Otherwise, I’m settling well into post-aligner life. I got my permanent retainer in December 2013. It is indeed much thicker than the aligners. When I first put it in at the orthodontist’s office, it almost made me gag, but I’ve gotten used to it. In fact, I sometimes wear it out on errands in the morning or over the weekends. I couldn’t wear it to work — the way it effects my speech is more noticeable than the aligners, but not so noticeable that small transactions and interactions at stores would draw anyone’s attention. Despite the thickness of the retainer, my powerful grind was enough break my top tray after six months of wear. My orthodontist made me a new one at the time, but it looks like I will definitely be needing to replace my retainers on a regular basis as time goes on in order to continue good retention.

Overall, I’m very happy with the result of my treatment. My advice to anyone researching Invisalign is to go ahead and do it… with the caveat that you use an Elite Provider. My doctor in the Pittsburgh area is King Orthodontics. If you are a Pittsburgher, make them your first and last call. Anywhere else, go to an Elite provider, even if it involves a little inconvenience to get there. Experience and customer service make the biggest difference in this process. I am very glad I opted for Elite over even the Premier Preferred providers I looked into. Please, if you’re considering Invisalign, do the research, don’t go to a dentist, and don’t go to someone who specializes in metal braces. Elite providers specialize in Invisalign –go there!
 
 
 

This past December, I finished my initial course of Invisalign treatment. Overall, I am very pleased with the results so far, it’s just that the initial course of treatment didn’t get my teeth all the way to straight.

But that’s okay. I knew it was likely I would need refinements because I did lots of research before deciding to do Invisalign, and my orthodontist kept me informed of that possibility all along the way. I’ve come this far, after all, and I didn’t want to stop short of my teeth getting as straight as possible. And why would I? As I’ve blogged before, Invisalign has become such a regular and unobtrusive part of my lifestyle that I honestly don’t care how long it takes. I’ve invested this much time and money into my teeth, why wouldn’t I want to keep going?

For this reason, I advise anyone undergoing Invisalign to make sure that refinements are included in your originally quoted price. My orthodontist is an Elite Invisalign provider, and I suspect such is the norm among Elite providers, but I did read in my original research that some doctors charge extra for refinements. Ask about refinements during your initial consultation, and if your doctor charges for them, go someplace else. Chances are you’ll need them and you don’t want to get this far and get stuck paying additional fees to complete your treatment.

Refinements are fundamentally a new course of treatment. When I went in for my December appointment, they removed my attachments and took new impressions of my teeth as they were so far. I actually sort of complained that they were removing my attachments, but my doctor explained that I might need a different scheme of attachments for the next round.

And boy did I! Apparently it’s all the rage to have double attachments, now. Maybe it was all along, and I just didn’t get them the first time. The reasoning behind the double attachments is supposedly that two smaller attachments can move the teeth more effectively while being less visible.

Good thing, because when I showed up for my new attachments and first set of refinements, I discovered that I would have two teeth with double attachments, one of them being my right front tooth! Aside from the fact that they were initially pitched too far inward, my front teeth have always been my straightest teeth, as far as I can tell. Add to that, I DID NOT end up with attachments on my lateral incisors (the teeth on either side of the front teeth), which were the very teeth that were most misbehaved during my original treatment!

Since I’ve been happy with my treatment so far, I decided to go with it and accept the attachments the way they were (also, my mouth was already propped open with dental gear and my teeth prepped when the doctor walked in to put on my attachments). I did ask, once the attachments were on, why I didn’t get any on the lateral incisors, and he said that apparently the Invisalign computer thought my teeth would move well enough without them… an answer that didn’t exactly make me feel like he was really taking charge of my treatment… but then said if the incisors weren’t moving properly, we’d re-order refinements with attachments there.

Whatever… as I said, I’m in this for as long as it takes, and I was anxious to get started on my new course of refinements. At first, the lateral incisors were fitting snug in the new aligners, and then inevitably they fell behind, but not by much. There were stages in my initial course of treatment when the laterals were so far behind that I could feel the air trying to force through the gaps in my aligners when I spoke loudly in busy group classes.

Overall, I like the refinement stage better than the initial course. My orthodontist had me changing the aligners once a week for refinements instead of every two weeks and the changes were so incremental that any pain or discomfort was negligible. Changing every week somehow makes me feel like I’m making more efficient progress!

I continue to go about my life with Invisalign just like I did before. When people ask me about what it’s like to wear them, I often describe the experience of wearing Invisalign to the experience of wearing shoes. When you’re going about your day in a comfortable pair of shoes, you don’t spend much time thinking about the fact that you have shoes on or consciously aware of the fact that you have shoes on, but when you stop and think about about it, you can feel your shoes. Now if they’re uncomfortable, new and not-yet-broken in, you are thinking about them and irritated by them (like a new set of aligners with rough edges you haven’t had a chance to file down yet), but a comfortable pair of shoes isn’t going to register in the front of your brain as you wear them, likewise your aligners won’t either.

For the most part, I go about my days not thinking about the Invisalign and with people not noticing them. My work environment is one where most of my colleagues and regular students already know about my Invisalign, but we do get a steady stream of new folks in the door. Rarely someone will notice them, but I just explain that I have Invisalign, and it doesn’t bother me at all for them to know it. So what if I have braces? The main drawback of people “knowing” you have braces is the sophomoric or nerdy “metal mouth” look. I have the braces of the future; it’s like Star Trek, right? Some people who have known me and worked with me this whole time are surprised when they only just find out. I happened to mention it to one of my students, and it turned out he had had Invisalign himself, and that he had even been an Invisalign pioneer, one of the first people to get them back in the late nineties. I still can’t figure out if he never noticed them, or was just too polite to comment (he’s that sort, the kind who says “excuse my language” when he exclaims “bloody!”).

We had a professional dance champion and dancing coach in the studio a couple months ago who also is undergoing Invisalign. She outed me immediately (not that I cared about being outed) to my first student of the day. He noticed them for the first time and was surprised he hadn’t noticed them sooner. He spent at least one lesson kind of staring at my braces, but since then he only occasionally comments on them, sometimes to ask if I even have them on because he can’t see them. It was interesting working with the coach that day because I got to hear some of her experiences with having Invisalign. She says to my one student, referring to her and me, “We have Invisalign, that’s why we lisp.” I blinked and didn’t say anything, but frankly I don’t think I lisp at all. Maybe I’m living in a fantasy world, but I honestly can’t sense a lisp on any words I say, except maybe the word “lisp”! Occasionally when I’m tired or a little inebriated, I sense a greater tendency to mess up my words when the aligners are in, but when I’m enunciating as normal and not speaking lazy, I don’t think I have any sort of lisp. Friends, feel free to disabuse me of this notion. The coach also asked me about my aligners and whether they get stained by the end of the time I have them in. I told her it depends on how much coffee I drink. With the refinement stage, honestly, I care about stains not at all. With the aligners in and out in one week, it’s not an issue at all.

The coach also wondered if I get dry mouth while I’m teaching. I wasn’t able to answer her fully because my next students just walked in, but the answer is no… and due an apparently peculiar phenomenon that it doesn’t appear she has experienced. Over the course of time I’ve been wearing my Invisalign, my mouth has come to produce excess saliva. As a result, I don’t notice a difference when the aligners are in, but I definitely notice when they are out. I assume my mouth will go back to normal once treatment is over, but for now, I have saliva to spare.

Another thing I experienced for the first time this round was a set of over-correction aligners. The last three sets were marked as over-correction. My orthodontist didn’t really explain over-correction in detail, only to say that I didn’t really have to wear them, but gave them to me anyhow. I looked it up online, out of curiosity and found that over-correction is much as it sounds… the aligners actually target your more troublesome teeth to move them further than perfect. Rotate them a little more than ideal with the knowledge that once the attachments are off and treatment is done, these teeth will revert at least a little. This strategy makes perfect sense to me, and I’m actually comforted by the thought that Invisalign has built in this protection against tooth reversion, but perhaps unsurprisingly, many folks online are FREAKED OUT by the prospect of over-correction and very upset when their orthodontists tell them about it. Now, I have to admit that the over-correction aligners were harder to get in. I had to put them in after wearing my old set for at least a half hour (I usually put a new set in after I eat dinner), and then it did take some pushing of the new set into place, and sometimes much chewing of Aligner Chewies to get them settled to the point where they wouldn’t pop out on one side or the other. The over-correction did hurt more than the rest of the refinement aligners, but no more than the average aligner in the initial treatment. Once again, internet Invisalign patients seem to be freaking out for nothing.

My refinement course of treatment was 24 aligners, and I just finished last week. While I continue to be happy with my results, they aren’t perfect just yet. My orthodontist offered that if time were an issue we could fix them up within a few weeks with clear traditional braces, but what’s another six months or so? One of our students who has done Invisalign in the past, got talked into six weeks of clear traditional braces by her doctor and hated them. I told him just not to be stingy with the attachments (I actually said please put some on my laterals!) and he resolved to make the next round of refinements, however long they take, finish the job. At this point they look great with my aligners in, and they just need a few more tweaks to look just as great with the aligners out. If I had known when I started that it would take at least a year longer than the orthodontist first quoted me, I might have been concerned, but now that I’m in the midst of it, time is no issue. It’s hard to imagine my life without Invisalign.

On to the next round!

I’m currently wearing my 31st set of aligners, and it’s been just over a year since I started the Invisalign process. I couldn’t be happier with my result so far, it’s been a much easier process than I ever imagined when I started, and while I’m excited for the final results, I find I’m in no rush for the treatment to end, as Invisalign has become such a way of life for me that I don’t imagine my day-to-day existence being appreciably different without it.

Am I the exception to the rule?

I went to my orthodontist earlier this week, and he praised me for wearing my aligners with dedication, said that my teeth are moving great, filed my bottom canines a bit and sent me on my way, intoning with encouragement, “We’re in the home stretch!”

The appointment left me wondering, though, why this process is apparently so much different for so many other people. My orthodontist said that he could tell by looking at my teeth that I was wearing my aligners fastidiously; other of his patients apparently experience frustration and disappointment when the Invisalign doesn’t move their teeth effectively. According to my doctor, they aren’t wearing their aligners according to the schedule.

Problem is, I don’t think I’m that great about wearing my aligners either. Now, I’ve never gone a whole day without them, I’ve never lost an aligner (though I came close once when I pulled them out of my mouth and tossed them into a corner while sleepwalking), I’ve never gone on a trip and forgot to take them along (seriously, people walk out of the house for vacation without realizing they aren’t in?)… but I’m supposed to wear them a minimum of 20 hours a day, and I don’t really think I’m doing that. Honestly, I just don’t keep track, and if they end up being out for more than four hours, I don’t sweat it. There was at least one time when fell asleep when they were surely out for 12 hours straight. Whenever they’ve been out for an extended period of time, the aligners are tight going back in, they even hurt a bit, but I just use my chewies, chew them back in place, and move on.

On the other hand, I guess I’m pretty good about wearing them during the week; it’s only on weekends that I find myself in situations where they might be out for hours at a time. I frequently leave them out for as much as 6 hours at a time, usually because I eat watching TV and then fall asleep on the couch (I’m somewhat narcoleptic). During the week, though, my routine is pretty set, and so I suppose they stay in the minimum 20 hours.

It’s partly because I do A LOT of stuff with them in that other people wouldn’t. When I first got my aligners, the orthodontist’s assistant told me that I could take them out if I needed to do any public speaking. I teach dance for a living, often to large groups of people, and if I took my aligners out whenever I did public speaking, it would be absurd. I recently taught a lesson to a large crowd, probably fifty people, and the idea of taking out my aligners never crossed my mind.

I recently read an article on the Invisalign Facebook page about a teen undergoing Invisalign treatment who essentially “saved up” hours by wearing her aligners around the clock so that she could go to prom without them. My reaction was pure bafflement. I think that my teeth actually look better with the aligners in! I often say that I “feel naked” without them. If I attend an event with food or a meal, it’s the easiest thing in the world to pop into the ladies’ room to take them out… and we women usually retreat back to the restroom anyway after dinner to touch up our make-up, right? That’s the perfect excuse to clean your teeth and put them back in. Sometimes I even like having the excuse to leave a boring conversation at the table.

I have also come to drink most anything with the aligners in. When I first started, I was conscientious about drinking only clear liquids when I was wearing the aligners… but then I got over it. The only time I ever take my aligners out to drink something is when I have hot coffee in the morning. Otherwise, I drink caffeinated soda on car trips, whiskey & coke at the bar, beer after work with the girls, iced coffee when I’m sleep deprived at work, wine at studio parties… all with my aligners in. Unless I’m going to eat something, I don’t take them out. Are my aligners stained at the end of two weeks? Of course. Are they so stained you can tell it when I’m wearing them? Nope. The only way I know they’re stained is when I see them side-by-side with the new aligners at the end of two weeks.

So, maybe I am being good about wearing my aligners? Maybe I’m not? I just take them out when I need to, put them back in when I get a chance, chew them back into place when I leave them out too long. Shrug? It’s just not a big deal for me.

But maybe my experience isn’t typical? I have remarked in previous blogs about how so many people complained and whined and bemoaned the process in my online research, but my experience was no big deal. When I went to my orthodontist earlier this week, he recommended doing a little more filing between my bottom teeth. He prefers to do it progressively, as he sees the teeth move, rather than all at once, like Invisalign recommends. He contends that Invisalign usually over-estimates the amount of filing needed. After recommending a bit of filing on each of my canines, he asked if it would be okay with me, with enough uncertainty in his voice that I felt like he honestly expected I might say “no.” I know people online cry trauma at their experiences of having their teeth filed, but it’s been an utterly neutral experience for me. This all makes me wonder, are most people just really big babies about their treatments, or am I having an easier than average time?

A few weeks ago I was at an electrolysis appointment (now, getting your hair follicles individually burned off one-by-one… that’s something to whine and complain about!) and I happened to mention to my electrolysist that I had Invisalign. It was at least the third or fourth appointment I’d had with her, and she was more than a bit surprised at my revelation, saying that she’d had patients in the past with Invisalign, and that she could very clearly see the aligners, and their speech was very cleared affected. I couldn’t imagine why or how. I’ve only ever had two people notice my Invisalign without previous knowledge; one was a mother looking into getting Invisalign for her kids, the second was a new student taking lessons with me as a single (i.e. I was dancing with him) who caught a glimpse of a small shadow created by one of my attachments and asked if maybe I had lipstick on my teeth. Most of the time, even when I point out my aligners to somebody, that person squints and strains and has a hard time even discerning them from my teeth until I point directly to one of my attachments, and even then, sometimes give up and say they can’t tell. What Invisalign was my electrolysist seeing? Was this some earlier version of the Invisalign treatment from the 90’s? Did these people have some sort of shoddy orthodontist planning their progress? Am I just an exception to the rule?

The mystery of how my Invisalign experience differs from others may never have an answer. I feel like I’m a misbehaved Invisalign patient, but maybe other people are infinitely worse than me. Based on my experience, I cannot imagine how any Invisalign patient who is earnestly motivated to fix his/her teeth (reluctant teens, on the other hand, probably would have trouble) and contracts with an experienced orthodontist, could possibly have less than good results. Seriously, what’s going on here?

I’m about halfway through my aligners now (20 of 42), and really over two thirds of the way to getting my top, and most visible teeth, to substantial completion (note in my Invisalign projection movie that the top teeth stop moving around aligner 30). My orthodontist has purported to be very impressed with how well my teeth are moving (of course, maybe he says that to all the patients), but there has been one–not unexpected–hitch in the process. My top lateral incisors (the teeth on either side of the “two front teeth”) are a little behind the curve. My orthodontist predicted as much at the beginning, warning me that those laterals would be the hardest teeth to move. He recommended getting attachments on them, and I opted out for the sake of my eternal vanity… not a decision I regret, as there will still be the opportunity to get attachments on them for the much-shorter duration of refinements after the initial treatment. But as a result of not having attachments, those laterals are falling noticeably behind. Luckily, after the initial lag, they don’t seem to be falling increasingly behind. They are sore right along with the other teeth after a new aligner set goes in. At the advice of my orthodontist I concentrate on the laterals with my aligner chewies whenever I put my aligners back in. The laterals continue to move… they’re just under-achievers.

Going into this process, one of the things I was most concerned about was keeping the aligners clean. I can deal with pain, I can fight through discomfort, but when I read an article online called 18 Things I Wish I Knew Before Invisalign, I was admittedly a bit spooked. One commentator in this compendium said “Kiss your social life (and romantic life) goodbye until the trays are gone. They give you bad breath, make you speak oddly, discolor your teeth…” which is more than a little frightening for a confirmed bachelorette. Additional research led to many online forums where people complained of perpetual odor despite reportedly heroic efforts to clean the aligners.

I decided to go ahead with the aligners, despite my fears, armed with a number of alternative strategies for cleaning. When I first started wearing my aligners, I was uber careful about cleanliness. I never, ever drank anything that was not a clear liquid when I had them in. I brushed my aligners with a wet toothbrush (I read online that toothpaste can etch the plastic of the aligners, creating space for bacteria to grow) whenever I took them out, soaked them in hydrogen peroxide whenever they were out of my mouth, cleaned my teeth thoroughly with a floss, then Listerine, then brushing regimen every time before I put them back in. I soaked them in generic Polident inside my sonic cleaner a couple times a week.

This strategy worked out swimmingly. I had absolutely no problem with odor or plaque build-up… or really anything. I think I even have better morning breath with them in than I did before I started Invisalign. I smelled my old aligners in a side-by-side comparison with the new ones when it was time for a fresh set. No difference. Certainly, this cleaning system was conscientious, but by no means heroic. I couldn’t understand what all the complaints were about.

Since my initial days of Invisalign, my cleaning is still conscientious, but it has certainly become more relaxed. Depending on the circumstances, I drink a variety of beverages with the aligners in. I generally stay away from heavy stainers like coffee and tea or red wine, but I’m not shy about most bar drinks and sodas. One of my bar staples is whiskey and diet, though I’ve had everything from whiskey rocks to margaritas, caipirinhas and Sam Adams Cream Stout with them in (though, not all on the same night). My sonic cleaner broke, and so I still use it as a place to soak my teeth, but I threw away the batteries and never turn in on.

Only once did an aligner ever come out of the two weeks looking noticeably stained, and that was when I spent nearly a whole week in Las Vegas at a dance competition where I drank a lot of those aforementioned whiskey & diets and where I had forgotten to bring my peroxide and never bothered to do a Polident treatment; I was particularly misbehaved about my cleaning regimen because I was always down in the ballroom (and thus a 20 minute walk from the elevators to my room) when meals were served, and so the aligners usually just got popped out and stuffed in the case, and then lightly brushed before being put back in (onto clean teeth, of course!). There was a noticeable difference between that aligner and the new one, but the stain was only evident in contrast to the new aligner, not when they were on my teeth.

Going back to the predictions of doom (“They give you bad breath, make you speak oddly, discolor your teeth…”) to the Invisalign user’s social life, I can handily dispel each prognostication. While my aligners might have become discolored in Vegas, my teeth certainly did not. In fact, my teeth are whiter than they have ever been with my thorough and frequently cleaning enforced by the Invisalign process. As for speaking oddly, I have never had a single problem, and I speak for a living. When I first put the aligners in, my orthodontist’s assistant assured me that there was enough wiggle room in my required aligner-wearing time each day that I could feel free to remove them if I had a special circumstance, say… if I had to do some sort of public speaking. I was polite enough to make no comment, and not to bark back that I’d have to leave them out all day, because as a teacher at a dance studio, my whole day is public speaking. Since getting my aligners in the first place, my job has become even heavier on speaking, as I spend much of my day doing meetings and interviews with new students. I forget they’re in most of the time. I only ever notice during large classes when I have to yell over music in the next room at the top of my lungs, and sometimes the force of air tries to go through the aligner. Otherwise, I forget I have them in more easily when I’m speaking than when my mouth is closed.

Finally, the dreaded bad breath has never been an issue. In my job, I’m already very sensitive to breath and smell aesthetics. I pop a mint before every 40 minute lesson, just as I did before Invisalign. I asked my co-workers to be brutally honest, when I started the Invisalign, if they noticed any change in my breath, so that I could be vigilant about fixing any Invisalign-related hygiene problems. Well… those co-workers constantly forget about my Invisalign, offering me snacks and food throughout the day. Sure, my breath gets stale if I haven’t done any sort of cleaning or had any sort of beverage for several hours, but that would happen without the Invisalign. As for my social life, it’s going just fine, thank you. I have locked lips with more than one gentleman without his realizing that I was wearing the aligners… no complaints from them so far.

The process moves along slowly and steadily. The movement of my teeth is still annoyingly incremental, but that’s par for the course. All of the other scare stories I read about the process seem like over-blown whining now that I’ve lived through twenty aligners.

I’ve been wearing my Invisalign about six months now, and I think I’ve build up enough “cred” as an Invisalign patient to speak with a bit of authority on the process of living with aligners.

Entering the Invisalign process, I was worried least about the pain. I knew it was going to hurt sometimes; if my teeth are moving, they’re going to be sore. Having worn Invisalign through 15 aligner cycles, I can say that the pain is about what I expected, and most of the time even less. In 15 cycles I’ve had to pop Advil maybe twice, three times at the most. I find actually like a little soreness. Sore teeth tell me that my aligners are working when the visual evidence is often frustratingly incremental.

The aligners hurt most (if at all) during the first couple days of a new cycle. Makes sense, right? A new set of aligners means new tooth movement. Usually the soreness lasts a day or two, but each aligner is different. Some hurt more than others, some don’t hurt much at all. With set 14, I experienced residual soreness for almost a whole week, but with 15, my teeth are pain-free only two days after the new aligner.

Using my powers of observation, I’ve managed to come up with some strategies to minimize the pain of a new aligner set. The most painful set was, oddly enough, the first. That was because I got it on in the morning before work and had to take it out for lunch only a few hours later. In my experience, the new aligner set doesn’t hurt going on, but rather, it hurts the most the first time you take it off. The sooner you remove a new aligner for the first time, the more your teeth will hurt… especially when you put the set back on.

In order to minimize the pain of the new aligner set, my very successful strategy has been leaving the new set on as long as possible. Once, I even left a new set on almost 24 hours before taking it off for the first time (I was on vacation). Ordinarily, though, I can manage to wear a new set 14 to 16 hours before taking it off the first time. My job is second shift, so my hours are a little skewed, but the same strategy could easily be mapped to a 9-to-5 schedule.

When I get home from work, I make dinner, I take my aligners out and I clean them in a Polident bath with the new aligner set while I eat. I get home around 10:45pm, so I’m usually done with dinner and ready to put the new set in by midnight. I pop in the new set, gnaw on my aligner chewies awhile to make sure it’s good and tight (a note on chewies below), I go to bed and then I endeavor to leave them on as long as possible. Yes, this means eating no breakfast. I’m not a big breakfast fan to begin with, though I do enjoy coffee most mornings. I skip it the morning of my new aligners and drink hot water instead. This strategy also means I can’t brush my teeth in the morning. Oh the humanity! Actually, it’s not really a problem. I do an extended rinse with hydrogen peroxide (with the aligners still in) to kill bacteria and then do a light brush over the aligners with a wet toothbrush. If I need to get close to people during the morning and early afternoon (e.g. if I have a lesson or meeting), I pop a mint and get no complaints.

I’m usually ready for lunch (remember, my schedule is second shift) around 3:00pm or 4:00pm. I take out my aligners for the first time, and while my teeth are usually a little sore, it’s much better than if I had taken them out earlier (I once removed a new set for my morning coffee and regretted it). As I said earlier, I’ve only taken two or three doses of Advil over 15 sets. Once was the very first aligner, once was on the first day of the aforementioned aligner 14, and once was… well, I don’t remember specifically, but I’m allowing for the possibility of a third just for the sake of over-estimation.

Otherwise, the aligners are comfortable… okay, I’ve said that before, but after adjusting to them as a way of life, I think it bears repeating. If asked about the precise sensation of wearing Invisalign on a daily basis, I would be most inclined to compare the wearing of aligners to the wearing of shoes. Wearing shoes is comfortable, but noticeable (unlike, say, the wearing of soft contacts). If we’re not thinking about the fact that we are wearing shoes, then it’s not in the front of our brains, but if we stop to think about it, then we can definitely feel our shoes. They’re not uncomfortable, but they’re there. Same with the aligners. They don’t disappear onto my teeth like contact do onto my eyes, but they’re comfortable.

The only significant trouble I’ve had with comfort is my own bad habit of grinding the aligners when I’m tense. It’s not bad for my teeth (the aligners are protecting them, after all), and it’s not bad for my aligners (some doctors online even say grinding your aligners helps the Invisalign process), but it’s not a picnic for my jaw. I don’t realize when I start doing it, but once I start it’s hard to stop until I have an opportunity to take them out and start over. I’ve trained myself not to grind so much, but on occasion I still do. It’s a bigger problem toward the end of the aligner cycle when the aligners aren’t so tight. I don’t grind when the aligners are new and the fit is hard (i.e. the aligners feel “hard” on my teeth because they are tight), but as my teeth move and adjust to the new set, the aligners feel “softer” and I am more prone to grinding them.

Otherwise, my Invisalign process has been smooth sailing. After 15 aligners, I have really experienced no problems, save for my own grinding and an occasional rough edge (which can just be filed down).

One note about new aligners, however. I remember when I was first researching Invisalign, one blogger said that from one aligner set to the next, they just stopped fitting. One aligner fit, the next one didn’t. In this instance, the orthodontist has to retool his/her strategy, take new impressions and order a new set of aligners. I know this can happen, and I’m not worried about it, except insomuch that it may add additional time to my overall treatment schedule.

That said, I can’t help but wonder if such retoolings can be avoided with the avid use of chewies. For at least the last four aligners, they have not fit my teeth when I first put on a new set. I pop them on as best I can, but with my fingers alone, I can’t get them to sit snug to my teeth and snap to my attachments. Perhaps an Invisalign retool is on the horizon for me, but for now, I have had great success simply chewing the aligners in place with my aligner chewies. I say once again, I’m not sure how people go through Invisalign without the chewies. If it weren’t for chewies, I would probably not be able to get my new sets for fit right away. So, hooray for chewies once more!

No aspect of Invisalign treatment inspires more trepidation than the tooth attachments, also called buttons or bumps. I experienced more than a smidgen of trepidation myself. Last Tuesday, after five weeks of wearing the aligners (three of those with aligners that had the attachment wells, or “bumps”), I finally got my attachments put on my teeth!

Before I go into details about the attachments and the process of getting them on, let’s flash backward to my first week of “bumpy” aligners. I related in my last Invisalign blog that I had mixed feelings about the aesthetics of the bumpy aligners. In the meantime, I’ve gotten pretty much accustomed to them, aesthetically. People don’t really seem to notice. Most of the time, when the subject of my Invisalign treatment comes up in conversation among people “in the know” (i.e. people who I’ve told about the treatment), people can’t tell whether the aligners are in or not, and don’t notice the bumps until I specifically point them out. In fact, my orthodontist’s assistant had me flat on the dentist chair and under the lights, ready to prep me for the attachments, when I said, “Should I take my aligners out?”

The biggest hurdle I faced the first week of my bumpy aligners was mouth irritation. My mouth, being unaccustomed to bumps on my teeth, got irritated at the places on the inside of my lips where the bumps rubbed against them (for some reason only on the right side of my face). I got canker-like stores and it took about five or six days from the start of the irritation for it to heal, and luckily I didn’t have the attachments actually on my teeth, so I could take my aligners out during periods of heavy conversation to keep them from getting further inflamed (unlike actual canker sores, they felt fine when the aligners weren’t on). And so, my mouth had the opportunity to get accustomed to the bumps without a 24 hour barrage of irritation.

Also in the time since my last blog, my orthodontist posted the animation of my treatment projection. Check it our here.

Now I come to my appointment Tuesday where I got my attachments. I was in the middle of aligner three, which was good, but not typical. Because my orthodontist was on vacation last week I had to wait five weeks rather than four to get my attachments. As a result, I was fully adjusted to the present aligner, so I don’t have to deal with getting used to a new aligner on top of the addition of the attachments.

I had more or less resolved myself to getting all the attachments, even the one on my right eye tooth that I find most aesthetically bothersome. Good thing, too, because the first chance I had to talk to my orthodontist, my mouth was already trussed up with all the appliances for keeping my mouth open and lips peeled back during the attachment application.

The procedure for getting the attachments on was really no big deal. Many Invisalign bloggers online seem to weather this experience with much physical and emotional trauma. I don’t get what the big deal is. They propped my lips open with plastic spreaders (not something I’d like to wear every day, but by no means uncomfortable for the space of 15 minutes). The orthodontist’s assistant cleaned the surfaces of the teeth where the attachments would be put on, inserted pads and suction to absorb excess saliva. She tried to put in a tongue guard to keep my tongue basically caged up, but I couldn’t bite down with it on, so she took it off and basically told me just to keep my tongue out of the way, which I did with little difficulty.

The assistant then did some mysterious preparatory things including, I believe, putting glue on my teeth. Then the orthodontist came in, literally put them on (via a template which is fundamentally a softer version of my current aligner) then left again. I respect his wanting to be involved and being the one to “put on the attachments” officially, but I think the assistant probably could have handled sticking these templates on my teeth. From there she “cured” the attachments with some manner of light on a small hand-held wand. Once my attachments were properly cured, she removed the template and set to cleaning up the glue. This is the only part of the process that I could imagine anyone would find unpleasant, but unless one has a severe dental phobia, I can’t imagine why. She used some manner of vibrating instrument to clean away the excess glue that got between my teeth and other places it shouldn’t been. Interestingly enough, they glue was not cleaned off the outer fronts of my teeth, leaving my teeth feeling a little rough; she said it would come off bit by bit as I brushed my teeth and took the aligners on and off. She also polished my attachments so to smooth out rough edges. I was told that they would smooth ever further as I take my aligners in and out.

All in all, no where near the traumatic process that so many bloggers have bemoaned. At no time did I experience any discomfort above and beyond that of an ordinary teeth cleaning.

Now for the aesthetic issue. First of all, I had a minor misunderstanding about what the attachments would look like. When the orthodontist originally told me that they use “clear” material for the attachments, I pictured clear like glass. Well, this “clear” material is actually a “foggy” clear so that it appears to match your tooth color while still looking like a part of your tooth. On the upside, it blends in fairly well, and doesn’t look like a glass bead on my teeth (which I had imagined). On the downside, it is opaque-ish, and so you can easily catch sight of it when you catch it on a side angle, rather than looking at it straight on.

The bottom line is, it looks less obvious that I expected with my aligners off, and it is a little more visible when the aligners are on, but not really that much more than when the bumpy aligners were on my bare teeth. The aligners fit a little tighter with the attachments, and it is a bit harder to get them off (I broke the tip on one of my retainer “outie” tools trying to pop the bottom ones free). They certainly aren’t the “vice grip” one Invisalign patient described in my online research. My experience leads me to the conclusion that most Invisalign bloggers are either overly dramatic or woefully misinformed about their treatment such that all of these events prove to be so shockingly traumatic.

It strikes me that a lot of Invisalign patients who blog or comment online really overemphasize the bad parts of this process. Many times these “traumatic events” are the results of bad research (“OMG I never heard of these attachment things before my doctor put them on!”); in this day and age of the Internet, you have no excuse not to do extensive research before making a decision to undergo an expensive, cosmetic, medical procedure. I’ve known fundamentally what to expect at every stage of the game, with the exception of the Aligner Chewies (which are, frankly, one of my favorite parts of this experience).

Most of all, especially in regard to the attachments, people seem to be enormously self conscious. Now, I don’t claim to be a stranger to self-consciousness about the attachments; I did enough research and asked enough questions beforehand that I knew I could opt out of having attachments on my lateral incisors (the teeth on either side of my “two front teeth”). I was not at all pleased when my doctor insisted on having attachments on my top eye teeth, but now I’m glad he did insist. The attachments aren’t as noticeable as I had feared, and my eye teeth really do need rotation; the left eye tooth is one of the teeth I find most aesthetically bothersome.

This process has led me to some conclusions about human nature. We all think that people are playing a hell of a lot more attention to us than they really are. Before I started the process to get Invisalign, I never noticed people’s teeth. Now, it’s one of the first things I notice about a person (because I’m currently obsessed with teeth as a result of this process.), but the majority of people aren’t paying close enough attention to see little bumps on my teeth. Lots of people have all kinds of crazy and funky things going on with their teeth (I know, because now I pay attention), but most people are too busy thinking about their own lives, their own concerns and their own self-conscious hang-ups to scrutinize my teeth, or anyone else’s for that matter. Even if they do notice the bumps (which are a lot less visible than ANY other type of braces, including the ones that go inside your teeth), they probably won’t register the fact long enough to care. This is coming from a person who works in a profession where my teeth are extremely visible. I talk and smile with people at close range when I’m dancing, and that’s a whole lot more teeth visibility than most people experience in their daily lives. If people don’t notice my attachments, whose are they going to notice? Perhaps if you need attachments on all your top front teeth, but again, they are so much less visible than even clear braces!

And so, in the wake of getting my attachments, I have taken a decidedly “embrace my braces!” attitude. As I mentioned above, I got my attachments put on halfway through my time wearing the third aligner. My teeth had already gone through the initial move, stopped aching and had grown accustomed to the third set when I got the attachments put on. After a day with the attachments and the same aligner, my left eye tooth (the protruding one) was hurting anew, so I know the attachments are doing important work that the aligners could not accomplish on their own. Again, this pain isn’t some excruciatingly traumatic event, it’s just initial soreness that abates after a day or so.

In sum, attachments aren’t as bad as everyone makes them out to be, most people aren’t paying as much attention to your teeth as you think they are, and I feel like I’m finally a full-fledged Invisalign patient! It doesn’t get any worse from here.

About two months ago I started the process of researching Invisalign braces in order to straighten my teeth, a task left undone in my teenage years because of the relative aesthetic acceptability of my teeth. They were never horrendous, just a bit crooked, the bottom and rarely visible half of my jaw being much moreso than my top teeth, the crookedness of which you probably wouldn’t even notice unless you were specifically interested. I won’t go into details of my research and decision process here; if readers are interested I can blog about that later.

This week I received my first set of aligners (Invisalign straightens the teeth gradually via several sets of clear aligners each worn for two weeks at a time), and so it occurred to me that for the first time in this already seemingly extensive process, I actually had a real product to review. Invisalign blogs abound on the internet, and while I don’t feel the need to contribute further duplicate information to the blogosphere, everyone’s experience is different, and I read many a blog entry as I was researching Invisalign and found them helpful. Starting a completely separate blog for Invisalign seems like overkill, and since I already have a blog in which most of my entries review a product or service, it seemed only logical to include commentary on my Invisalign experience here. After all, Invisalign is probably the most expensive purchase I’ve made in my adult life, second only to my car (unless you count my Bachelor’s Degree).

I went to my orthodontist, King Orthodontics downtown (those who know me know that I wouldn’t be caught dead in that bastion of suburb-o-phobia Wexford unless compelled there for my job, which unfortunately happens sometimes), on Tuesday this week to get my first two sets of aligners. I will wear each one for two weeks.

I wasn’t sure whether I would actually keep the aligners in all day Tuesday. Research online and my orthodontist himself advises putting a new set of aligners in before going to sleep at night and taking some Advil so to sleep through the initial pain of tooth movement. Each new set of aligners moves the teeth incrementally during the first couple days and then allows them to set up in their new positions for the rest of the two weeks, before they are moved again.

I had prepared for this day vigilantly, not only by doing research, but also using my custom teeth whitening trays (obtained from a do-it-yourself kit on Amazon) to “practice” by wearing them for a few hours at a time. The custom teeth whitening trays certainly weren’t ideal, and I knew that they were only an approximate preview of the Invisalign. The teeth whitening trays, despite being custom, aren’t as well fitted or trimmed, aren’t as tight, are much softer and gummier, not being made of the same material… but it was the only way I had to “test out” wearing something like an aligner before making the decision to go forward with Invisalign.

My first impression upon putting in the first real Invisalign tray was that they were much more comfortable than I expected. They are light and don’t take up as much space in my mouth as the teeth trays. The edges along my gums are well-trimmed and don’t rub my lips at all. The teeth trays made my lips dry when I spoke, but the Invisalign trays don’t seem to have any but the most minor effect on the dryness of my lips or mouth, which I was worried about, as that is a common side effect. I may have a bit of a lisp, but honestly, I think I’m probably the only one who can hear it. My co-workers forgot that I was getting my braces that day until I took the aligners out at lunch.

So, based on the initial comfort of the aligners, I decided to keep them in for the rest of the day. There was certainly a feeling of pressure, as the aligners did fit tightly and were indeed moving my teeth (as I found out at dinner), but no pain, so I kept them in.

It was all well and good until after lunch. The aligners must be taken out for meals so that they don’t get unnecessarily dirty and, well, because it’s just more pleasant to eat with your bare teeth than with plastic coated ones. It’s recommend that only clear beverages be consumed white the aligners are in. This means water, cold or hot and, I’m assuming… vodka? I imagine clear sodas like Sprite or tonic would be okay, too, but I wouldn’t want to go too long after that before cleaning my teeth and my aligners. The aligners are tight but not water-tight. Saliva and water gets into the aligners (up close you can see bubbles between the plastic and the teeth), and I wouldn’t want to leave a sugary beverage to sit in my aligners for too long.

Teeth must be cleaned before reinsertion of the aligners after a meal, as thoroughly as possible with brush and floss (I use some sort of mouth rinse, too, either Listerine or hydrogen peroxide). It was at this point the pain became noticeable. When I first put my aligners back in after lunch, they hurt. Not terrible soul-rending pain, not even equivalent to a bad headache, but sore, definitely sore. They had only been out for a half hour, but those teeth–slippery critters–had endeavored to make their way back to where they’d been in the morning. The pain was the least of my worries when I signed up, and it’s still nothing I can’t handle. The soreness is mild, just persistent.

It was good I had an hour or so before my next lesson. I took some Advil, of course. I also found drinking hot water to be soothing. Before Invisalign, I drank hot tea throughout the day at work. No matter what time of year, it’s always cold at work. In the summer, the air conditioning is cranked up, in the winter, the heat is kept minimal so that people dancing won’t get too overheated. When I’m not dancing, myself, I’m always freezing, and so I drink hot beverages. When I knew I’d be getting Invisalign, I figured I could get rid of my tea bags and started in with hot water alone. I was worried, of course, that hot water might damage my Invisalign, but the patient consultant at my orthodontist’s office assured me that hot water is okay to drink. As it turns out, the hot water is also soothing to my teeth when they’re sensitive (which is good, being that it’s one of the only things I can drink with the aligners in).

The other thing that helps is the aligner chewies my orthodontist provided in my starting pack. This was the one aspect of Invisalign I hadn’t heard about before my orthodontist office gave them too me. They aren’t actually made by Invisalign, and some people may go through their whole treatment without using them, but they supposedly help aid in tooth movement by making sure the retainer is seated on the teeth as well as it possibly can be. It is a rubbery plastic cylinder that you chew on with the aligners in. When my teeth are sore, it does hurt to chew them, but once the aligner is better seated, the soreness abates a bit. I suspect it might also help stimulate blood flow to the teeth and gums, perhaps similar to a teething child, after all, no other chewing (eating, gum, gnashing of teeth) is really happening when the aligners are in. I’ve since Googled the chewies and found that some people online constantly forget to use them, but I’ve found that my aligners don’t feel quite snug until I bite down on the chewie for a bit. I only use one chewie at a time; two is too much for my mouth.

The longer I had my aligner in, the less my teeth hurt (perhaps that was also the Advil kicking in), but by the end of that first day, the aligners had begun to wear on me at bit. Not in the sense that I couldn’t stand then and wanted them out (in fact, I was kind of dreading having to put then back in after dinner, considering the soreness I had earlier), just more of an “itch,” a feeling that it would be kind of nice to have them out for awhile, sort of like reaching the end of the day when you’ve been wearing an effective strapless bra (sorry non-cross-dressing men, you’ll have to think up your own analogy). Certainly a lot better than my “trial runs” with the teeth trays; I could only really stand them for a couple hours at a time.

I got home, made myself some dinner and resisted taking the aligners out until the last possible moment. Now my teeth were sore in a different way. I noticed it with my first bite of food. I had to chew my food gingerly, working at it softly or else I would get a sharp sting of soreness. It was really no matter, just had to eat my food slowly (good for me, because usually as soon as I stop eating I fall asleep), and the further along I got in dinner, the less they hurt. The other thing I noticed is that I would have to be careful about closing my teeth completely. My teeth weren’t in the same place anymore. Some teeth would collide, top to bottom, in an unexpected way if I closed my jaw without thinking.

Shortly after dinner I did the whole cleaning regimen and popped the aligners back in. I was worried about sleeping through the night, but the aligners actually got more comfortable as I slept. They were probably the most comfortable they had been in twenty four hours when I woke up in the morning.

They’ve been generally better since, though sometimes still a little sore (nothing requiring even Advil). I can tell I’m slowly growing accustomed to them, though when I’m not talking, drinking or using the chewie, my jaw muscles get a little tense. I suspect that this resting tension will stop as my mouth comes to realize that these aligners are the new status quo of my teeth, at least for the next year and a half.

Unfortunately my Invisalign transition is not over, even when I become accustomed to wearing the trays. In another four weeks I get my attachments, small nodes of glass that will be placed on certain of my teeth to aid in rotation. Until then, I persist with tray one!