31 Yr Old Invisalign Top Ceramic Bottom Jaw Surgery - Montreal, QC

I am at the beginning stages of fixing my teeth. I...

I am at the beginning stages of fixing my teeth. I have crowding and will need orthognatic jaw surgery to correct an underbite. I have started Invisalign (with 6 attachments) for my top teeth (dec 2013) and started ceramic braces for the lower (feb 2014) I also needed three gum grafts to fix receding gums which delayed the lower braces. Then I had my bottom two wisdom teeth removed (feb 2014) I already had my top wisdom teeth removed when I was younger. I am supposed to wear 32 trays of Invisalign (18 months) then will switch to ceramic braces on the top (and bottom) during and 6 months post jaw surgery. I am not a big fan of any of this but must do it. I am glad I wasn't talked into ceramic braces by my orthodontist for the top teeth after seeing my bottom teeth with braces. I'm so far pretty happy with Invisalign. The ceramic braces I definitely prefer over metal ones they are untouchable except for maybe pronouncing a few letters. But wow. Having braces is no cake walk. With food getting stuck in there and flossing, Invisalign you just have to brush your teeth more often and not snack but taking them off makes that pretty quick. I'm not that happy with Invisalign's claim to be invisible. The spit bubbles and attachments are pretty noticeable. But they definitely beat braces. Ceramic or metal. I actually wanted to get lingual braces behind my teeth but my orthodontist who is a lingual provider actually said he wasn't that confident in them, plus they are not a great option during jaw surgery in case a bracket becomes dislodged while your jaw is wired shut. So far I haven't told anyone I have braces, and seemingly nobody has noticed. I've been training myself to not show off my crooked teeth for so many years, so hiding my orthodontics is not much different. I guess that will change once I have ceramic braces on the top. It still seems like a long road ahead but I look forward to having a big confident smile.


Just checking in to see how you're doing :)
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Hello and welcome!  I've already PM'd you, but I want to follow your review so I'm commenting here as well.  

I am extremely interested in the gum grafting procedure, if you could speak a little more to that?  And the state of your teeth that precipitated having this procedure done.

Thank you so much for joining our community!
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If you want to know about gum grafts: The gum graft procedure is not very fun. It was recommended by my orthodontist before the braces could start. It is done in my understanding for one of two reasons: To cover an exposed tooth's root, or in my case because of thin gums. All three of the grafts i had done were around my canines. The two bottom and left top one are quite crooked and actually protrude more than other teeth. Before moving those teeth with braces the orthodontist wanted to make sure there was adequate gum coverage. So I was referred to a periodontist to perform the procedure. What they do (maybe skip down a few lines if you have a weak stomach) is use local anesthetic (freezing) then slice a small piece of tissue from your palette, make a few small incisions to the area receiving the graft, and then stitch the tissue on to that area. They then cover the area and the palette with a putty to protect it. All in about 45 minutes and you're ok to drive after that, Afterwards you can't eat solids for around 3 days, then only soft food until around day 7. Then after a week stitches are removed and a few days after that you are tender, but if you eat carefully you can eat pretty much anything. I had to wait two weeks after that before getting the next procedure done ( they only do one tooth at a time) and go through it all over again, and then again. It is not a very fun experience. You leave there thinking it's not so bad, next stop is the pharmacy, then the freezing wears off. You have to be careful not to touch your palette while brushing, eating, talking cause it hurts. The putty that they put on seemed to stay on the area around the tooth for the week until the stitches are removed, but the putty on your palette pretty much falls off right away or within a day. And that's when the fun begins. Try eating even liquids without it touching your palette. Not easy. And you feel it. Then once it starts getting a little better, you think you can eat boiled vegetables or semi-soft food , but if you don't chew it just right or a piece happens to hit that spot. Ouch. So anything that you can't completely mush up is out. Like meat. That was quite a process to chew. I had ibuprofen triple strength that I took every 4-6 hours. Peridex mouthwash, some Tylenol with codeine, then this viscous liquid that I could apply to the palette ( think had some form of cocaine in it) to numb the palette. That you apply then spit out. The first time was the worst, ( I think the slice in the palette was a little too deep) but each time I had to keep taking Advil every 4-6 hours even through my sleep for about a week. I noticed that acidic foods were more painful. Coffee (even cold) hurt, but I fought through that. I thought bananas would be good, but nope. Acidic? I don't know. Pasta sauce hurt. I thought fruit smoothies would be good, but nope that hurt too. Anything that could not easily be chewed down to a total mush. Like I mentioned meat was dangerous. I had a lot of boost, then I noticed it was more about food you could completely chew up before swallowing. Bread, cake, doughy stuff, ice cream yogurt, boost. Pretty much nothing really nutritious. I'm pretty sure I lost weight and definitely felt run down from not eating well and restless sleeps. But it's only for about 7-8 days. I found the best thing to do was bring a toothbrush and mouthwash with me everywhere for that week, and use it after eating anything, but also when you get any plaque in your mouth. Keep your mouth clean. At night I would wake up in pain. But I found keeping it clean by brushing (gently) and mouthwash was equally as important as any painkiller. I had my wisdom teeth on the bottom removed 6 days ago, but after the grafts that was a breeze. I stopped taking painkillers (I had oxycotone!) for the wisdom teeth after day 2. Mind you I think it was a pretty simple procedure they were completely out and I think came out in one piece. I think. I was pretty out of it when I left that place. I don't mean to scare anybody off of getting it done if you need it done. It's only a week. I took the day off the day of the procedure and was back to work the next, with a few extra bathroom breaks to spit blood and clean my mouth. If I were to do it again I would ask the periodontist or dentist for a little extra putty to take home, or something similar they would recommend to cover the palette area. But it seems pretty hard to get anything to stick to your palette that will actually stay. If you need it done good luck, I'm sure you'll really enjoy that carrot on day 8-9.

7th tray

7th tray of 32 of Invisalign. It seems the most movement is with the back teeth. This tray never gave me the regular pressure and sore teeth other trays have when I first put it in. Visually I still don't notice any difference. The next tray is the 1/4 of the way mark.
I have not had my bottom braces adjusted since being put on in February. One bracket came loose. Got put back on.
My bottom wisdom teeth were pulled last month. Still need a jet to clean out the holes left.
I heard about acceledent on this site. A product that speeds up the time of braces by up to half! And my orthodontist is a supplier. (One of the first in Canada.) I asked him about it. He seems to advocate it. So I'm going for it. For around $1000, less time in braces, why not. 20 minutes a day of sticking some weird vibrating gadget in my mouth. Meh. I can deal with that.
My next appointment is in April, and I should have it by then.


I just started my Invisalign too. I got the Acceledent and it's been good so far. I'm surprised that your dentist suggested you to get gum grafts done before the treatment, as your gums will shift along with your teeth during your orthodontic treatment. Sounds like red flags to me.
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Hi. I found this info on your gum graft very helpful as I am suppose to have one on my lower tooth. The periodontist wants to do a frenulectomy first which is actually being done on 4/15 and then the graft in two months. You're review only confirmed my fears though...the pain of it all.

Tray 13/32

I'm moving along with Invisalign. I actually received up to tray 17 my last visit. 16 will mean half way! I also started using accelendent around tray 8/9? I forget. Now I am changing trays every 10 days. The orthodontist says things are progressing well.
My bottom teeth with the ceramic braces are really a mess! There are expander and they haven't engaged two teeth yet. So everything except those teeth are really moving forward. Which because I already have an underbite is not that cool.
Still am a fan of Invisalign. It's so much easier to deal with than the braces on the bottom! It's a real mess down there right now, and not easy to clean.
The latest good news I heard from my ortho was that I won't have to wear braces after my jaw surgery! I will have to during the procedure and for a few weeks after but then can switch back to Invisalign again for the final stage which I hear is 3-6 months.
So right now I really have no idea when the surgery will happen. I will be done Invisalign in December? But I think the braces will take longer. So maybe February? I guess I should ask my orthodontist.
I'm definitely a little worried about the underbite surgery. I have seen pictures of people after and read reviews. And it looks crazy! They are really swollen and it takes a long time to be able to eat and talk etc... I'm not sure what I'm going to do with myself for that month or so. Become a hermit in my apartment? go somewhere south and relax. I won't be working. that's for sure.

So in summary. Things are looking worse than ever. I'm getting weird gaps in my upper teeth. And some real wild teeth on the bottom. But I guess things have to get worse before they get better.

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Hi!  Welcome back, and thank you so much for the update!!!  I checked in on you a couple of months ago and was afraid you wouldn't come back.  But so glad to see you :D!

Congratulations on getting AcceleDent.  That's nice that you won't have to wait as long before getting the surgery.  But it's even better to know that you'll be able to go back to Invisalign post-surgery!  You're the perfect authority on whether hygiene is easier with braces or Invisalign, since you have both :D.  Not that I have any doubt, having lived with someone who had braces.

Are you using the AcceleDent on your bottom arch as well?  I know it's supposed to work for regular braces.  We have at least one person in the braces community who is using AcceleDent.
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Tray 17/32

Over half way there! I now switch trays every 10 days with Acceledent. My orthodontist gave me up to tray 23. So that is 3/4 of the way! I haven't figured out exactly when I am supposed to be done Invisalign but think it should be in November or December. That will be less than a year treatment, but then once I have jaw surgery I don't know how long it will take. I have no idea when the braces on the bottom are supposed to be done. I guess these are things I should be asking my Orthodontist? I forgot the last time I was there. They had put spacers on two of my bottom teeth initially on teeth 23 and 26, so the wire was not connected to those brackets. But at the last visit they had made enough room that they could now engage those teeth. I think with an underbite and bottom braces pulling forward my teeth I think it accentuates my underbite. Still nervous about undergoing the surgery, but I will deal with it when the time comes.


Definite progress all around!  I'm so happy to see things are going well so far on this journey.  We can't really see if there's been any accentuation of the underbite since there's no before picture :).
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Dr. Paul Korne

Very friendly clinic. Maybe a little too friendly. The clinic is an open concept without walls separating you from other patients and staff. I Thought it was a little strange and that I would prefer to go through this more anonymously but hell we're all on the same boat.

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