I'm half way through the Invisalign treatment - main objective being to narrow the gaps in the upper teeth. Had no issue whatsoever with the lower teeth but I do wear the trays on those too. Now, it seems like I have developed a couple black triangles right in the middle and adjacent spot on lower teeth. Will these spaces be taken care by continuing the treatment (through the end)? Is this a negative side effect of the treatment? If so it is really diminishing the whole value of Invisalign.
Black Triangles at Mid-point in the Treatment
Doctor Answers (4)
Straightening teeth can cause "black triangles"
It is common to have the dreaded black triangles appear when crowded teeth have been in existence for a number of years and then straightened. The gums may have receded slightly as one ages, then the straightening causes the roots of the teeth to move more apart from each other causing the black triangles. This happens because the contact of the teeth are at the widest part and when straightened cause the teeth to take up more room or move apart from each other. The same gum material that was present before straightening, when straightened, cannot fill the space and thus you have the black triangle as a result. The most ideal way to handle this is to "slenderize" the teeth by taking a small amount off the contact areas of the teeth (called Interproximal Reduction) so that the teeth can be moved closer together (with Invisalign or braces) and still kept straight. This reduces the volume in the space between the teeth and helps to get rid of the black triangles. I hope this is helpful to understand the problem and see the solution.
Will black triangles disappear ?
I believe that if the treatment is completed then the end result will remove the dreaded black triangle. A lot of this depends on the health of your gum tissue and the position of the teeth. In a study they found that if the contact point of the 2 adjacent teeth was 5mm or less from the crest of the bone under the gingiva you will always have a papilla or a triangle of tissue. If you have gum disease or long slender teeth will contact points that are far away from the bone level then your chances decrease. Did you have gum disease before? Are the teeth full of old restorations? These are questions that are important to know.
Black triangles with Invisalign treatment
Black triangles result from adjacent "wedge-shaped" teeth touching each other at the widest point of the wedge. Normally the gums fill in the area below this contact point, but if the gums to do not fill that space a black triangle results. This is a result of the architecture of the gums, and orthodontic treatment with either braces or Invisalign does not cause the gums to recede from a space they were previously occupying. Aligning teeth or bringing them together if they were spaced can make the black triangle "appear". There are ways of eliminating these triangles, and you should talk to your doctor about this issue. There may already be a plan to reduce the triangles later in the Invisalign treatment.
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It is impossible to address your concern without seeing your teeth and treatment plan.
However, if you bring it up with your dentist now it is quite possible that if it is an unintended consequence of the treatment, he/she has a better chance of remedying it sooner.
Hope this helps.