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All Good Until the Attachments Went In... - Chicago, IL

When I got my first set of trays...

  • 18 Nov 2010

When I got my first set of trays (pre-attachments), I was thrilled. I thought, this is it? There's nothing to this! And was very happy and relieved. Everything about the process was better/easier than expected.

Then a couple of weeks later I went in to get my next three sets of trays and have the attachments (8 total) put in. This changed everything.

I had no idea that the process of attaching the buttons would involve buffing my teeth rough and acid etching the enamel. Had I known, I think I would have opted out of the procedure altogether. I'm 44 and I've had some tooth sensitivity issues before, so the idea of voluntarily eroding the enamel with acid...well, not exaclty appealing.

I'm now a little afraid that what was done to those eight teeth may have caused permanent damage. Not only was the process on the chair extremely unpleasant, but to say that my teeth (as my ortho warned me) would be "a little sensitive" for the next few days, would be akin to warning someone they might get "a little headache" from diving into an empty pool.

For the first couple of days, the lightest touch of the softest brush, with the gentlest toothpaste, would send such deep electrical shots of pain through those teeth that I would literally tear up and break into a sweat. It felt like I may as well be brushing the raw nerves directly.

Things are better now (10 days later)--but still, not great, and not anywehre near normal. I still have to be very careful and ginger in brushing those eight teeth.

Again, my biggest worry is that maybe the acid etching went too far, or that maybe my already-sensitive teeth were poor candidates for this process, and that now the enamel is permanently compromised, and that these teeth will always be weakened, and will always hurt.

I'd really love to hear the thoughts, insight, advice (reassurance?!!) of the smart people on this board.

Thanks so much.

Well, it's been about a year and I just had my...

  • 7 Oct 2011
Well, it's been about a year and I just had my attachments removed.

As happy as that makes me, I'm a little worried that (much as I feared) the surface of all eight of the teeth that had attachments on now feels different than it did before--and different than the surface of the rest of my teeth.

The fronts of the former "attachmennt teeth" are decidedly rough, and have lost all that glossy shine and smooth texture that normal teeth have. I was hoping this wouldn't be the case, but those teeth were, after all, bathed in acid and physically buffed rough prior to the attachments going on. I'm not an expert, but it doesn't surprise me that tooth enamel doesn't magically regenerate itself after such treament.

For now, the teeth look ok (the ortho's office polished them after removing the attachments), but I'm really afraid that they're going to be much more prone to staining from here on.

I fully concede that not everyone has experienced such a reaction to the bonding of the attachments, but I now suspect, more than ever, that the process went a little too far in my case. Of course, no one at my ortho's office will acknowlege this, or offer any help. Just one of the many frustrations I've had throughout this process. I sincerely wish better luck for others.
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I don't have sensitivity related to the attachments, but I didn't even realize I was getting them until I went in to pick up my 3rd set of trays and got a terrible shock. My teeth are not even very crooked, but I got 14 attachments, including two on my upper front incisor, plus some sanding between teeth. If I had known about the attachments ahead of time, I probably would not have moved forward with Invisalign. Or, at least, I would have thought of it more like those clear braces than as something truly "invisible" like it is promoted. I wanted Invisalign specifically because they promoted how I could take out the aligners for special occasions and look "normal".
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Got my invisalign attachments yesterday, I'm in the middle of Tray 5's. AGONY!!! From the minute she started putting them on my top teeth, I couldn't believe how painfully sensitive my top teeth became.
When i got home, I could not eat at all on my right side from the sensitivity..went immediately to go brush my teeth like I usually do, and would have rather stuck a needle in my eye! Coouldn't, and still can't even TOUCH my teeth with a toothbrush, jump through the ROOF!!! Ridiculous, afraid to take them off and eat since them, as I'm petrified to brush. How am I supposed to keep those teeth clean at all? Listerine even kills me! Called ortho, they said rinse with salt water. gee thanks.
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Hi Debbie,
So sorry this happened to you too. I can only tell you that the sensitivity WILL go away eventually (although it took about 10 days in my case). In the meantime, try this-- go to the drugstore and get yourself some enamel-restoring/protecting toothpaste (Sensodyne makes some, their gentlest kind is their kids version), and some enamel restoring rinse (like ACT). I turned to those a lot and it really did help make the pain subside. And keep bringing this up to your ortho. I really think it's important that providers understand that, while it may happen only seldomly, some people do experience a really adverse reaction to the bonding of the attachments. Good luck to you!
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Whew!
Glad to hear someone else thought this was painful!! I'm reading all of these reviews that say "Didn't feel a thing", "I liked the way it felt", "Barely knew they were on" and I'm thinking "Yikes! I'm a total wimp! Do I lose my Blue Belt in Kung Fu for this?!"

I'm glad to hear more folks being honest about their experiences. Don't sand-bag for the newbies, people! Let us know what we're getting into!!
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Nina, How is your teeth sensitivity doing now? I just got my invisalign put on yesterday with attachments on every tooth (some with attachments on either side). I'm having the same issues with sensitivity! I can not brush by my gum line and I'm freaking out that if I can't brush there my gums are going to get bad. I'm going to call my ortho today and ask about why my teeth are so "raw" at the gum line. My only hope is that this won't last too long! Thanks, Katie
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Hi Katie-- I'm so sorry this happened to you too. I have a feeling we are in the minority. Don't worry too much about the sensitivity, it did eventually go away entirely (in about a couple of weeks). But I am interested to hear more from you about how your "attachment teeth" end up looking. The reason I ask is I'm convinced now that those teeth suffered some kind of permanent enamel damage. Not only did I have the weird initial reaction, but now many months later, there doesn't seem to be anything I can do to get those teeth to look like they did before. They are rough and discolored and they don't respond to anything (any amount of physical polishing, or chemical whitening) that I or my dentist, or my orthodontist have tried to return them to their original appearance. I have to say, this has been one of the most dispiriting parts of the invisalign process for me. Here I paid $5k to make my teeth look better, and I'm ending up with 8 front teeth that look a fair bit worse. I wish you better luck.
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Hi Nina,
Luckily my sensitivity is getting better after a week, but it definitely isn't anywhere near normal. I'm sorry to hear about the appearance & texture of your teeth that had attachments! I would think the cement they use for the attachments would be removable without damage or problems, ultimately restoring your teeth to their natural state. I won't know how mine will be affected until I'm finished with the invisalign process in about 18 months. I will certainly let you know what happens with my experience but keep me posted on your situation. I sure hope it gets resolved :)
Katie
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I have six attachments across my front teeth. Unsightly, attractive, and inconvenient.

This is my third long-term iteration with invisilign and all they have succeeded in doing is making my formerly straight upper teeth crooked.

For me, this was a huge mistake. I hope others have better success.
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Attachments are garbage! I used them for my own teeth. They failed to work. Made things worse and made taking the trays out impossible!!!

I did a refinement without attachments and I love invisalign that way. I never use attachments for my patients now. Doctors can never know how bad they suck unless they get them for themselves.

Ask for no attachments, see how things go. refinements are free with the full invisalign case so it won't cost more.
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Wow, Dr. Bilello, this is the first time that I hear such an unequivocal opinion against the attachments from an actual user AND practitioner. I so wish I had been given the choice in the beginning...

So far I've gotten nothing but the brush off (from my dentist and orthodontist) when I point out that my teeth (the ones with attachments) look so dramatically different than they did before (visibly discolored and rough). In your opinion, could the process of getting the attachments on (the buffing and acid etching) have caused this kind of enamel damage?? It seems obvious to me, but I can't get my orthodontist to even acknowledge that he notices the change.

And most importantly, is there anything that I can do to restore those teeth?!!

Thank you in advance for any help or advice!
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There would be no enamel damage from the attachments. The acid etch doesn't do damage. The bonding agent and the composite can be a little yellow. Those will not harm your teeth. Maybe your tooth brush or tooth paste are too abrasive. Those are the number one causes of sensitivity and enamel, gingiva damage. No sandy tooth paste.

To remove the attachments the doctor uses a special drill bit that can only cut the attachment and not the enamel so don't worry about that.

Most dentists/orthodontists use attachments with invisalign. Invisalin pushes them to. I just don't like them and won't use them unless after a first round, one tooth doesnt move as it should, which hasn't happened yet. I may use other things to get teeth to move like elastics and lingual buttons, lingual braces, but that is rare.

IPR stripping is needed in some cases after careful analysis of the clincheck.
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Thanks so much for the thoughtful reply, Dr. Bilello. That's the most reassuring answer I've gotten so far.

My attachments are still on, so it sounds like it is the composite/bonding agent that's making those teeth look discolored. Good to know.

I'm also less worried about the removal process now that you've explained it so thoroughly.

Now, if only I could convince my orthodontist to remove the attachments early (I still have about six months of treatment left). I'm definitely requesting that at my next visit.

Again, thank you for taking the time to respond, this is very encouraging.
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My teeth have significant appearance changes since having the attachments removed. I especially notice the change on my front tooth, which had a tiny attachment toward the top, but a ton of sloppily applied bonding agent over the entire tooth. The ortho did not use any magnifying eyewear when removing the attachments and also assured me that the tool (some type of bur) was incapable of cutting through enamel. He never polished them, just used his bur to remove all of the bonding agent and the attachment. After he was finished, my teeth were dry, dull, scratched and completely devoid of shine. I went to two different dentists, desperately seeking a solution. They each polished them with different procedures. While the polishing did restore some shine, it is an odd, unnatural, cloudy shine. The worst part is that the procedure removed all of the natural grooves my teeth had such that they are abnormally smooth and no longer match the other front teeth. The flattened look catches the light even more and really stands out to me. They also have a slightly different coloring. All of my other teeth have a thick, white/creamy, natural appearance and the teeth that had attachments are more transluscent. Upon very close inspection, you can see all kinds of marks, dents, gashes, scratches, and swirls so there is no way that the tool he used was incapable of cutting into enamel since it clearly did in my case!!! He removed the entire top, glossy layer of my tooth, such that the tooth looks carved or peeled. I am extremely concerned, not only about the altered appearance, but about the long-term and how the reduced enamel will hold up. I am so upset about it! Has anyone here had any success restoring the natural apperance to their teeth? I have been using MI Paste Plus, but it has not helped yet. Any advice would be so appreciated!!
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Het, (unfortunately) I can relate to everything you describe. The different feel and texture, the "flattened", unatural look, the loss of gloss and shine, all the etch and tool marks left behind by the removal process. But, I can do you one worse (and please forgive me for bearing the bad news, maybe you'll have better luck). The "compromised" enamel is not holding up well. There are areas of these former attachment teeth, strangely, it's the areas AROUND where the attachments used to be-- in other words, the areas of the teeth that were treated with the etching solution, but were left exposed and NOT covered (and maybe protected?) by the composite-- that have fared the worst. Those areas are so rough, and so prone to staining, that they will require some kind of radical cosmetic solution in the near future, probably veneers. But alas, I can't even begin to think about any of that yet because I'm STILL in refinements (63 trays and counting), two and a half years after I started a treatment that was supposed to be done in one year. To say that this has all been a big dissappointment is really an understatement. To say that it's been a horror show, well, that begins to do it some justice. I've found that it's hard to get providers to even admit that it's possible to have enamel damage from the etching solution and the process of attaching and detaching the composite. But I'm looking right at it, and you can see it clearly in all the before and after pictures. My dentist finally ventured a guess that my previous provider (the one who put on the attachments) might have used the wrong solution on my teeth, one that's more highly concentrated and reserved only for use on crowns and other prosthetics. Perhaps that happened to you too? If you do find something that works and improves the look of your teeth (short of veneers), please share, ok? Best of luck to you!
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Hi Nina,

I am glad to hear that it is getting better. You must really do have sensitive teeth for the attachments to make you react that way. I had 13 attachments put on 3 months ago and hardly felt anything afterwards. Maybe it does have something to do with age, and your sensitive teeth sure does not help. I am not too sure. The only pain I had was the pain/pressure that you want to feel. (the pressure of your teeth moving, which attachments help big time with)

Lucyann, I would not worry. This is a rare thing Nina went through. Most people seem to not incur side effects such as these. (from what ive read and heard throughout the last year or so of researching invisalign)

After Thanksgiving, I will be starting tray 9 and trust me, it gets a whole lot better.
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Oh, Lucyann, I hate to be an alarmist, and I don't want to worry you unnecessarily, so two things:

#1- It's been a couple of weeks now, and the hyper-sensitivity in those teeth is waaaay better. Almost totally normal now (but for a few pings here and there). I started treating the problem with "enamel-restoring" toothpaste and mouthwash, and I think that really helped.

#2- my fear was (is) that my teeth were maybe in some way NOT like everyone else's, and so reacted differently than most people's. (I've read very few complaints about this problem). I'm pretty sure I'm older than you, and I've had sensitivity issues before, so maybe my teeth were too "soft" for this to begin with.

Please don't worry too much. Other than those few days of crazy discomfort, the rest of the process has been pretty much trouble-free (including living with the attachments).

Good luck to you!
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I have only got my first set of trays and I am feeling alot of sensitivity in my teeth. It is so uncomfortable but I saw that you mentioned about some mouthwash and I wondered what kind you got. Thank you

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I'm having my attachments put on on 30th November, this has me a little worried now :os
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