Write a review

Current results after arch expansion and Invisalign with attachments and bands - Okemos, MI

How I went about straitening my teeth with...

How I went about straitening my teeth with invisalign is a little different from most reviews that I have looked at. After searching the web A LOT I couldn't find anyone that had completed adult arch expansion before starting invisalign. So here is my story and pictures. I hope this helps someone make their orthodontic decisions easier because I could not be HAPPIER with how this turned out so far (and I'm not even close to being done!).

Why did I do what I did?

First, I will start by saying I highly recommend going to an orthodontic specialist and not a regular dentist, especially if you have sever crowding like I did/do. Because when it comes to making major decisions for fairly sever cases, you want to make sure you are solving the WHOLE problem, and not just picking and choosing what ortho work gets done.

Starting off, I had severe crowding. To say my mouth is "small" is an understatement. After doing measurements, we discovered I had the maxillary/mandibular arch expansion of a pre-teen...(I can't remember the measurements)...but basically that meant I could fit maybe two and a half fingers widths comfortably along my top arch. To say it another way, my tongue sometimes felt like it had no room! And because I had lived like this up until I was 23 (When I started), I didn't really think to much of it. But then I started having slight clicks develop. Turns out I was favoring chewing on one side because my teeth were angled in a more efficient way to chew on that side. All because my teeth were crowded. Further more, I'd always disliked my smile because it was like you could only see the first 4-5 teeth.They kind of angled out and blocked the view of my other teeth which made my overall smile look very small.

So when I talked to my ortho about invisalign he says "Yes! you would be a prime candidate case, BUT, give me time to work with you before invisalign and I can give you more than a straight smile." So I figured, if I'm pouring $5000 into an ortho treatment I might as well go all out and do it the right way and in a way that I would be happy with.

EXPANDER:

So we started with an arch expander on my top and bottom. The picture on here is of my bottom expander. You use a key to turn the spring every 3 days and this widens the expander. My top expander had 2 more sets of turn springs (one on left side and one on right) so that it moved the expander length wise.

This expander (like a rapid palatal expander) did two things. First, was to move my back molars back further. Since I still had wisdom teeth, these had to be removed first. Which is good, because they needed to be anyways since they were impacted and sideways. Once those were out the expander had room to push my back teeth further back and create room. Secondly, it was used to tip the teeth back outward and give the outward appearance of more teeth (not just 4-5). By tipping we also created more room. Phase 1 (moving teeth back) took 4 months and phase 2 (tipping) took about another 4 months. Admittadly, this was a long time to go through this. These expanders are hard to talk with in (especially with a top and bottom in!) and I wanted to start invisalign ASAP! But I'm happy that I did expand first, because I took progress pictures every month (highly recommend) and found some amazing differences in teeth straightness just from that! Granted, I went though an awkward phase in Oct-Dec when I developed a gap...

Side story... typically by adulthood your palate has fused close and is no longer readily available to expand (by rapid palatal expansion appliances). But, apparently I had some luck on my side and had some bone expansion up top...even if I did have a wacky smile for a while...

So I used an expander from May 2012 to Feb 2013 and then in March 2013 I got invisalign. I'm currently on tray 5 and absolutely LOVE my results thus far! And I can honestly say, I don't think I would be as happy had I not fixed my arches first. It's amazing how nice a broad smile can look when you started with a really small crowded one. Just a note for the pictures - in each one I'm smiling wide the same way! I'm not all of a sudden smiling "broader" because I'm happier, it's just that teeth are actually showing!

Now, Invisalign is a bit of a challenge for me just because I like to snack (healthy foods) throughout the day. And as you know, you have to brush/floss teeth and clean trays all the time. So far that's my biggest annoyance, but that's not that bad!

I am also wearing rubber bands to help with force generation and pull my upper teeth back so that they are jutting forward over my lower teeth so much. The bands are hardly noticeable and I've gotten used to them so I don't mind them at all. I will say that on the first day, my jaw was sore because I was getting used to the new forces. But after sleeping a whole night with them and getting used to them they no longer feel restricting.

I have many buttons (clear bumps to help align teeth) as well. I think 4 on top and 5 on bottom. They aren't too noticeable unless you are up close. My front right tooth has one if you look in the pictures. The first week with them was the hardest! I don't know why but it seemed about impossible to get the trays in and out with the buttons. But now, on tray 5, I don't have a problem. I don't think it's because I necessarily found a method either because I'm doing it the same way...It is just easier. I think because my teeth are more aligned so it helps.

My awesome orthodontist also threw in free teeth whitening. This is stuff that goes in your trays overnight and makes you look like a movie star when you wake up! It's truly amazing how much a little whitening can do for aesthetics.

Just to give a price rundown of total treatment:
$400 for arch expansion (custom molded palate expander for both arches - included all Dr. checkups and any replacements I needed were free. Which at one point my upper expander broke and I had to have it redone.)
$5200 for invisalign (includes entire treatment, with buttons/bands/checkups, and free whitening)

Tray 6 (pictures with bands)

I thought I would post a picture showing my bands and how they work for me. Everyone that has bands will need them in different places. It all depends on where the Dr. decides the force needs to be.

For me on my left side I have a grey button on my bottom very back molar that the band hooks around and then it comes up and hooks on a cut out of the invisalign on my top incisor. My right hooks on a bottom button about 4 teeth from the center and hooks up on my top right incisor. Unless I'm smiling really wide they are barely noticeable because they go off to the side an back. Some people will have them right across the font teeth or closer to center where they are more noticeable.

The point of my bands are to pull my front teeth back so that the meet up with my lower teeth better. Because my left and right side need different adjustments (left needs pulled back more, while right needs pulled outward) the bands are in different locations to accommodate.

You can also kind of see my buttons. I actually have more than what I posted in my first update. I think 6 on top an 7 on bottom. I still haven't actually counted...most are on my back teeth.

Photos: How bands look when smiling and their locations

Tips and tricks I've found over time - and other FAQs I've had experience with

Well, after 3 months of Invisalign I’ve decided that I’m qualified to share my wisdom with others ;). (Technically I've been doing this whole ortho process for over a year now because taking care of my expanders required the same type of process)

Having bands attachments, IPR, etc. are a special kind of fun that comes with invisalign. Hopefully my experiences will help someone else.

Dealing with ATTACHMENTS:

1. They can be a pain in the rear
2. Outie - Luckily, this handy device known as an “Outie” (Sold on Amazon.com) was invented. Basically it’s like the picks the Dr. uses to pry things off your teeth. Now I haven’t used this myself as I’ve found my trays to come off easier with time, but many swear by this device. The reviews on Amazon are mixed, but it might be worth a try.
3. Coloring - My Dr. gave me teeth whitener to use in my trays and my attachments are not off colored by it (Yay!)
4. I drink coffee and tea regularly and my attachments aren’t discolored. HOWEVER, I also drink a lot of water in between to make sure my teeth are rinsed well.

Dealing with BANDS:

1. Ignore them – They are not too big of a deal. At least for me because they are pretty much out of the way. You will find yourself playing with them though. Stop if you can. You’ll just end up with sores on your tongue…
2. Change ~3x day - Change them when their elasticity wears out. I go about 5 hours depending on how much talking I’m doing. (Morning, lunch, afternoon, bed). If I’m teaching or in meetings a lot of the day I change them sooner sometimes.
3. Have some everywhere - Ask for a couple bags of the bands. Keep some in the car (out of sunlight so that they don’t become fragile), some at work, some at home, and some in a bag you take places.
4. Routine - If you forget to wear them a couple of times, not too big of a deal. Just put them on as soon as you remember and don’t “double up” trying to make up for last time. Little, if any, progress is lost from you not wearing them for a short time, so just get back into the daily routine.

Dealing with routine HYGEINE:

Most (All) of this has been said by others, but here’s my 2 cents.

1. Soak box - Invest in a denture/retainer cleaner box ($5 local stores). I have a yellow one and it does a few things. First, it provides a good (safe) place to soak. By safe I mean you aren’t just putting them in a cup only to have a friend, parents, disgruntled roommate toss it on accident. Also, It’s clearly identifiable and is easy to take to other peoples’ houses and not gross them out by using a cup for your teeth. They also come with a nice strainer so that you can easily rinse your trays.
2. Denture cleaner - Some (including Drs.) say not to use denture cleaner to clean your trays because it will make them cloudy. I use Efferdent and Equate’s version of Efferdent and I haven’t had a problem. I use this at night when I’m getting ready for bed and my trays are fresh and easier to clean.
3. Some type of denture cleaner (or the Invisalign brand cleaner) also helps if you have a lot of attachment sites on your trays. Those can get built up plaque and what not in them and can be difficult to get into with a big toothbrush. Having a cleaner to soak in is hand because it breaks all of that junk up and makes it easier to brush.
4. Travel brushes - Invest in a lot of travel tooth brushes. Their easy to keep in your pocket, bags, car, office, wherever, and you’ll never be without a toothbrush. And you will win the Cleanliest Mouth award from your friends and colleagues.
5. Cetaphil - Use a gentle soap cleanser to clean trays. I use Cetaphil and the great thing about it is that it doesn’t leave a taste behind. I can even use my toothbrush and immediately use it on my teeth afterwards and there’s no residue taste.
6. Brush, floss, swish, floss, etc.

Dealing with IPR:

1. The good - Honestly, IPR isn’t that bad. I had 2 back molars done at the beginning of my treatment and about half way through I will have another tooth done. The grinding wasn’t unbearable (even for someone with major “drill sound” issues) and I didn’t feel a thing.
2. The bad - However, food will get stuck in those spaces! And depending on where those spaces are it is a pain in the rear to get out! I had a back, top molar on each side done. They did about 1mm I think, but it seems to be a catch all because that is right where I chew! So having travel picks/floss comes in handy not only for flossing on the go but for having to pick out those spaces. Gross, I know, but it’s only until the spaces close (time varies by treatment).

MISCELLANEOUS:

1. Chewies - You were given Chewies for a reason. Use them. Trust me on this. Nothing is worse than getting part way through treatment and at your next checkup the Doc saying “You’re trays don’t fit right”. This has not happened to me, but it has to plenty of others because their trays weren’t all of the way on. Just a few seconds of chewing is sufficient. Make sure you get all of your teeth.
2. Pictures - Taking photos every time you switch trays is a great thing. Because when you think there are no results, the photos will usually show you something…even if it’s just the slightest movement in a not so visible tooth. It provides motivation to keep up the high maintenance hygiene and sometimes painful process.
3. Tracing – for those that haven’t taken pictures and want to see your progress a great thing to do is trace each aligner on paper and compare the movements.
4. Whitener – I was given whitener to put in my trays overnight. It’s a miracle product! Not sure how similar products are but after one use it was like a miracle. For mine I had to make sure my teeth and trays were dry and then I put some gel on each tooth indentation of the tray. In the morning make sure you brush trays well. Try to avoid getting it on gums. Depending on sensitivity it may burn a little if there is a large amount of gel setting on your gums all night. Use a Q-tip to go around the edge of the trays once they are back on your teeth to wipe off excess gel that squeezes out

Tray 5 (weeks 9/10)

My aligners are set to change every 2 weeks. I've been on schedule with that so far for the past three months.

Problems being corrected:
1. Overbite
2. Forward projection
3. Crowding
4. Alignment

I haven't had any big problems with pain so far. I started to see more noticeable results around tray 4-5. Trays 6-8 will really straighten my front two teeth and then after that the adjustments will seem less noticeable I think. If I remember correctly it is then the back teeth that will be moving.

My only complaint now is that my right rubber band attachment at the bottom has been hitting my lower cheek (by gum line) and giving me a sore for the last 4 days. It has not done this in the prior 2 months. I don't know what I would do to fix that though. I think it's just one of those things that will eventually stop as my mouth adjusts. And it's not a constant pain (depends on how my mouth moves).

Tray 6 has been a pain!

I'm not sure why, but my pain hasn't settled with this tray yet and it has been a week. It's usually first thing in the morning when it is most painful. Is that a sign I'm clenching my teeth at night?

Week 12

Just finished up with tray 6 and I'm loving the progress! I'm still waiting for my front teeth to be more center...but everything is starting to look nice and straight and there has been major improvement in my bottom teeth these last 2 trays.

I'm not sure if I see/feel anything different from having bands on.

With each week I've noticed my trays come off a lot easier even with all of the attachments. I think it's because the more your teeth straighten the easier it is. Though, it almost seems a little too easy...especially when I think back to those first few days with them where is was nearly impossible to get them off! Lately I've been checking to make sure my attachments haven't fallen off haha.

Speaking of attachments falling off, I haven't really had a problem with that. This surprises me - as much as I yank on these trays to get them out and how many times a day my trays are in and out. I did have a button fall off about 2 weeks after I got them (what hold my bands). But since having another put on I haven't had a problem.

I haven't had too much soreness either. I switched my trays this morning instead of last night and went to work all day. There was no need for pain meds and for the most part I don't even notice they're new trays. A drastic difference from tray 5! For whatever reason that one hurt quite a bit at first.

Adding a new start vs. current photo!

End tray 13 (~wk 26) of Invisalign

I haven't updated in a while but that's because not too many changes have happened. Well, my teeth are noticeably straighter! So that is a major change and I have updated individual pictures to post as well as a picture showing my monthly progress. Unfortunately I've missed 4 trays worth of pictures. But there have been fairly minor changes with those ones. However, comparing what has happened since two months ago, those minor changes really add up! Right now the trays seem to mostly be working on the front teeth (finally!! Yes!!). And instead of an offset crooked smile, I finally have a centered arch!! Woot!

I just put in tray 14. Technically I should be around tray 16, but my work schedule got crazy and I missed a few appointments. So I had to keep in trays for up to 4 weeks sometimes until I was able to get back to my dentist office. All seems to be going great though. My dentist is very happy with the progress and I have not had any problems.

Surprisingly I have not had cavities either. Knock on wood!! I'll admit, sometimes I'm really bad about eating/drinking certain things and then putting my trays back in after only a rinse with water. That kind of comes with my job though and there is not always opportunity for access to restrooms or breakrooms. Because of some horror stories I've read on here about lost enamel and cavity bills I was a little worried going into this.

Though I do not condone what I sometimes do, it seems like it really all depends on the person and overall hygiene. For example, if there's a day that I happened to be really bad about putting trays back in without properly cleaning, as soon as I'm home they get a 20 minute soak in disinfectant/cleaner while I eat dinner and I make sure to do a thorough floss, brush, floss, mouthwash routine. I guess that would be my advice. Because as much as we can try to be perfect about hygeine with trays, sometimes it's not possible and you have to choose between not wearing them for 15+ hours (in my job) or wearing them immediately after a meal. Again, not that I recommend that..

I'll try to keep more up to date on here and get back into the habit of posting at every tray change.

Additional progress pictures for trays 6, 8, 9, and 13

I just posted my tray 13 update and then realized that I hadn't put my other progress pictures up. So here they are! My last post has a great picture of tray-by-tray progress looking just from a front view.

These pictures are of how the side views/bite alignments have changed over the last 8 trays. I haven't notice too much of a difference but it does seem like my front teeth jut out a little less and when I close my mouth my top teeth no longer rest partially on my lower lip. Sorry for the poor quality photos...

Trays 14 and 15

Today I had a check-up and boring story short - I'm still on target with all of my trays. I am starting tray 16 today, so the pictures posted are for trays 14 and 15. I had some IPR done as well. Well, a LOT, not some. While IPR doesn't hurt, the sound drives me nuts and the thought of a grinding tool between my teeth makes me cringe. Now, I get to go through that lovely process where I learn where all the IPR happened based on where food gets stuck. Disgusting. I know. But it's true. Considering they only take off a very little bit of tooth, it's amazing how much of a difference it makes. You can't see the gaps - at least for me - but you can feel the difference with your tongue. I'll stop now with that subject ;-)

I haven't noticed many major changes in a while. Initially, when my front teeth got a lot more straight that was the HUGE change that everyone noticed. There are still obvious improvements if you stare at the pictures. But there's nothing too dramatic happening. While I will continue to take pictures after every set of trays, I'm not expecting to see major changes at each switch. Perhaps comparing a few months at a time instead to see progress that way.

All in all, I still have no complaints! My teeth are SOOO much better than when starting out that I could stop treatment now and be happy. And this is only after 30ish out of 50ish weeks! I can't wait to see when the final real life picture looks like. The 3D scans at the office look awesome but it's different when it's actually your body. I can't wait to be done!

As I said I have no real complaints. My biggest "complaint" is just the hygiene...as I state every time I post an update haha. This becomes more of a problem as the holidays approach just because of all the festivities and what not. I'm sure I'll have a couple of days where the trays are out most of the day - and I'll have to tack those days and then some back on later.
Eby Dental Care

5 out of 5 stars Overall rating
5 out of 5 stars Doctor's bedside manner
5 out of 5 stars Answered my questions
5 out of 5 stars After care follow-up
5 out of 5 stars Time spent with me
5 out of 5 stars Phone or email responsiveness
5 out of 5 stars Staff professionalism & courtesy
5 out of 5 stars Payment process
5 out of 5 stars Wait tmes
Was this review helpful? 12 others found this helpful

Comments (12)

Sort by

Your orthodontist sounds awesome, wish I could have had yours. Thank you for such a well written review.
  • Reply
Love reading about your progress. It's really great to see visible results!
  • Reply
Your progress is great!! How many trays do you have for your initial treatment?
  • Reply
27 and Im changing every 2 weeks. Hopefully by march ill be done!
  • Reply
Great info! Thanks for taking the time to be so thorough! I am about to go onto tray 3 of an every two week change-out and so far so good! Thanks for all your good info--it will help a lot of people! Good Luck! Your teeth look great so far!
  • Reply
Hello. Sorry I just saw this comment. Thank you! I hope everything continues to go well for you.
  • Reply
I was quoted a price of 6980 for upper lowers. Is this reasonable? My impression was I'm typical meaning no sign. issues. I'm 50 yrs old.....thanks. Love Your info.....
  • Reply
Hi I just now saw this comment. I think that might be a little higher than the averages ($5000-5500) that I have seen. However, I've also seen many people in the $8000 range. It really all depends on what they have planned for you. If you don't have any major issues I wouldn't expect it to be that high...but if you have a few teeth that need major rotating, that is what takes the longest and that could be the reason for the price.
  • Reply
I am glad you feel your case is going well. In the begining of your post, you said you felt it was important to go to an orthodontic specialist for treatment. I would just like to point out that your Dr is not a specialist, he is a general dentist. How many aligners are you scheduled to wear? You never mentioned the total in your story. I look forward to hearing about the rest of your treatment.
  • Reply
You're right, I probably should have clarified about the dentist. I had a second opinion follow-up by an orthodontist to make sure the procedure was right for me. Which I highly recommend. Not that I don't trust general dentists, but I think it's important to know certain things. I have 27 trays total so far. I'm not sure if I will have refinements at the end.
  • Reply
Wow! Such a thorough and great review!! Your progress looks great! I'm anxious to see the final results! Hopefully time goes by fast for you.
  • Reply

Man, I wish Invisalign existed when I had crooked teeth!  Your results look amazing, please continue to update your review as you move through the trays so we can see your transformation.  Thanks so much for sharing on RealSelf.

  • Reply