Monday, February 14, 2011

Invisalign Problems

"Nobody knows I'm wearing Invisalign"

Despite its popularity, Invisalign treatment has had a mixed track record of not only producing beautiful success stories, but also of being associated with horrendous failures.  This orthodontic appliance system requires a number of critical steps to be accomplished before the finished result can become the desired result.

Problems can be attributed to the aligners themselves, the treating doctor and the patient.  These problems include:
    Patient cooperation - not wearing the aligners the proper amount of time
    The presence of crooked teeth at the end of treatment
    The presence of height discrepancies between adjacent teeth
    The presence of "open bites" or even wrong bites on the back teeth
    Teeth that lean the wrong way
    The inability of the orthodontist to do subtle finishing details

Orthodontists struggle with overcoming these Invisalign problems and will use traditional braces as a fail safe mechanism to produce a properly finished orthodontic result.  In the hands of a general dentist that has no formal orthodontic training, patients are many times left with an unsatisfactory result and the parting remark of "Well, that's the best Invisalign can do".

In order to finish their orthodontic problems properly, about 50% of my Invisalign cases required traditional braces after the aligners.  These patients were understandably frustrated with the progress and effectiveness of Invisalign.  Only after a short period of braces were they finally satisfied with their smiles.

Personally, I don't like working with any orthodontic appliance system that only provides me with a 50% chance of success.  Add to this the patient frustration and you begin to see the point.  I do realize though, that many patients are sold on this system despite the problems.  On mild crowding or spaced teeth, maybe this is the right tool to use, or maybe not.

As a side note, Invisalign is constantly working to overcome or minimize the short-comings of their orthodontic appliance system.  Nevertheless, there is no fix for problems associated with poor patient cooperation or seeking Invisalign services from a dentist that is not an orthodontic specialist.  On the bright side, I do look forward to using an improved version at some time in the future.

J. Staples DDS


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