Not in Love with Invisalign (Yet??) - Raleigh, NC

I've been thinking about Invisalign for many years...

I've been thinking about Invisalign for many years but as it was quite expensive and mostly cosmetic for me, I never followed through. But suddenly at 35 I found myself able to afford it and I figured, why not? It sounded so easy (Invisible! Mostly painless! Few office visits! Amazing results!) so I talked to my dentist (yes dentist, not orthodontist, oops!) and decided to give it a try.

I know now after doing hours of research (that I should have done beforehand instead of just relying on family experience) that it is not uncommon for dentists and orthodontists to omit some pertinent details when describing the procedure. I was shown a model of top teeth with a very thin, truly invisible, plastic tray on them attached by two buttons on the back teeth. I asked about these buttons specifically and was told there may be a "few" more for me but that it would be unusual for them to be on the front teeth (my concern). I know now that this is not true. IPR was never mentioned at all and as both my dentist and hygienist were hovering over me while I read the Invisalign disclaimer, I missed those few lines and didn't get to ask about them.

My molds were taken and sent away and I was given the impression that I'd get the opportunity to preview the final projected outcome before proceeding. The next call I got, however, was that the trays were in and I should come get them.

I thought this visit would be easy. I expected a preview of my results, as promised, but they immediately leaned me back and stuffed my mouth full of cotton to get started with the buttons. The hygienist started counting, counted up to 14 and I asked her what she was counting, "Oh, your buttons!" she said. I was more than a little surprised at this. She proceeded to tell me that not only would I have 10 more buttons than I was expecting, but many of them would be on my front-most teeth including two on my top right front tooth. I told her I was not ok with that and she called the dentist over to reprimand me and explain that without those buttons the procedure will not work. I allowed them to continue, I wasn't sure what else to do. They swore that the buttons would not be noticeable once the aligners were on and barely noticeable with them off. This was not quite accurate.

They popped the trays on and handed me a mirror, I was so disappointed, it could not have been further from my expectations. They gave me some wax, two cases, some cleaner crystals, and two more sets of trays and sent me on my way. I was fairly certain at that time that I would simply return the next day to have the buttons removed and forget about the whole thing. I am two and a half weeks in now, I put my second set of trays in last week. I am still not sold on this procedure but I promised I'd give it one month.

My most immediate issue revolved around a serious amount of tooth and jaw pain for the entire first week. I ate mostly yogurt, soup, and Ensure drinks, I couldn't handle anything else and some meals I skipped because taking the trays in and out was just too painful. Obviously I was lisping like crazy, partly because the hygienist accidentally swiped the inside of my cheek and lip with the etchant used to help adhere the buttons causing my mouth to swell and peel, ick!

My ongoing issues are the sharp edges that cut my tongue and cheeks to ribbons, this second tray set is even worse than the first. My doctor "smoothed" my first set at my request but while the edges were no longer sharp, they were then rough, and caused just as much irritation so I've used and am currently just using a lot of wax. My trays even seem to have a "shelf" on the outside edge (my top tray on one front tooth has an indentation at the top, the reverse of the button bubbles, that created even more of a shelf) which catch my lips when I talk, like regular braces would. And although I've seen no mention of it in anyone else's reviews, I am unable to completely close my lips over the bulge of the aligners without straining my cheeks and chin. This leaves me with an aching face on a daily basis, not to mention I look ridiculous walking around either trying to force my mouth closed or just leaving it hanging open, lovely ; )

I would like to say I am getting used to this and I am on board now, but I am not. I was initially told I had 10 trays on top and 10 on bottom, but then oops, it's actually 15 for both! And honestly, my final projection shows my top front teeth moving forward which makes me fear that I may NEVER be able to close my lips again! And I see "black triangles" on my lower teeth thinking that IPR may be in my future although I've been told not. I’m hoping I will adjust and be able to stick this out but all of it is such a hassle and so much discomfort that I am thinking my vanity is simply not worth it!

Still going...

I am now on my third set of trays and I have my first check-in appointment on Oct 22nd. I have not had much improvement in the sharpness of the trays, I have to do a LOT of filing and then still use wax, but at least I can get them comfortable after a few days. I am currently having to use a bit of wax on the front of my top tooth, though, because there is a significant shelf/gap there and it catches and cuts my lip when I talk. I am not sure how noticeable the wax is, I think the trays themselves are so distracting that it's just all part of the weirdness and no one can tell!

My biggest problem now is that when my trays are out, my front top and bottom teeth hit when I try to chew and I am unable to comfortably eat. I can't chew properly because my back teeth don't touch at all and I'm very anxious about eating because it hurts like crazy when they do hit. I am thinking now that this may be related to my jaw being pushed forward or just irritated by the trays 22 hours a day (it feels the same as when my jaw is swollen from a bad night of clenching) and I am concerned that this could be causing some permanent issue. Guess I'll just have to see what my dentist says.

I'm also wondering if I'm the only one whose teeth never stop hurting? They are sore for the entire two weeks making it hard to eat at all, and then they just get MORE sore for the first three or four days of the new trays. Ugh.

I'm not lisping anymore but I am having periodic issues with air flowing through my top tray when I talk and like, bubbling and whatnot and I feel like I'm spitting on people! I am STILL not sold on this, but maybe I've gone too far already?

First six week appointment

I had my first six week check-in on October 22nd. Not that much to report, my dentist seems to think that everything is going well, the trays are fitting "perfectly" and so on. She seemed to think that my teeth hitting in front had more to do with my teeth moving and less to do with my jaw being pushed forward. I tried to explain that at the end of an hour with the trays out I was able to touch some of my back teeth together, but this did not sway her opinion. I am not sure how confident I am in her opinion anymore, oh well.

She filed my tries for me a bit, but I wish she hadn't. She tends to nick the front of the trays leaving rough patches that I then have to wax over. She did finally explain that the irritating shelf on the tray in the front is a "power ridge" and that it's not going anywhere for the duration so I just need to keep packing the gap with wax. Awesome.

Today I actually had to go in because I realized I was missing a button on my upper canine. I looked back at photos I took from my first day and I think perhaps this button was never even placed! My dentist didn't think it was going to affect much because there is another button on the same tooth, but I guess we'll have to wait and see if I'm on track at the next check-in.

Still wishing I'd never done this but I think at this point everyone I associate with already knows I'm doing Invisalign and has seen me so I get less weird looks now ; )

Some Pictures

Not sure exactly how to add pictures so I'll put some here : )

One more picture!

12 weeks done

I am now on my 7th set of trays and I had another appointment with my dentist. She seems to think I may need IPR on my lower teeth, which I expected but she had said not. I am concerned that one of my bottom teeth seem to be tilting, as though the top is moving but not the root, my dentist said she thought it was just the way it was turning to fit in. I'm afraid my teeth are looking worse now than they did originally! I had my dentist send me some photos of my upper and lower teeth on the first day so I could compare, I will add those here. I will also add a current picture of my teeth from the front, I think they are also yellowing considerably! Ugh.

I will see my dentist again right after Christmas to assess whether I will complete my original 15 trays or we will do a mid-course correction and send in impressions to get new trays. I have no idea how she's going to make that decision as she is not an ortho, but we shall see.

Tray Pictures

I am noticing my bottom teeth FEEL different from the inside so I decided to compare my trays and see what exactly is going on. I was actually quite stunned to see how much progress I've apparently made. As of now my trays are fitting pretty well, although I'm concerned that my current bottom tray never settled in all the way (my dentist didn't seem concerned when she put it in, though, so who knows). I switch trays tomorrow, to set 8 and I'm just crossing my fingers that they go in smoothly! I am terrified of the day when they just won't go on and the mid-course correction is then inevitable. Anyway, I'll post some pictures comparing my 2nd set of trays to my 9th set.

Bottom Tray not fitting?

Just a picture of the bottom tray that doesn't seem to be quite fitting. As far as I can tell there are just a few teeth that aren't all they way seated, although all the buttons seem to be popped in where they are supposed to be. This picture is from the last day of tray 7, I put in tray 8 tonight and it is the same.

Mid-Course Correction

I just received the first of my new trays after a slight mid-course correction. Just after Christmas as I was finishing up tray 8, I had a meeting with my dentist. There was one tooth that was clearly not filling the trays anymore and she decided to do new impressions (I did NOT have to have my buttons removed for this as I had expected) and send them back to Invisalign to see whether to continue to Tray 9 or to get new trays.

Today (January 13th) I went in and was told they sent back new trays, 9-18, which only adds 3 trays to my original 15 unless they are withholding some like they did before. I had several buttons removed which was painless and very fast, not what I expected at all and pleasantly surprising! And then several more put on. I am so pleased that the two buttons on my right front tooth are gone! These new trays hurt as badly as the very first trays I had, maybe because I spent an extra 2 weeks in Tray 8? OUCH!! But apparently nothing drastic needs to be changed and hopefully all will progress well from here. Of course there is always the chance that the are again planning to reassess at the end of these trays and actually have 20 more trays waiting, ugh. I think I don't even want to know ; )

Almost Done (maybe??)

I am currently on Trays number 16 (of 17 on the top and 18 on the bottom). As far as I can tell the top seems to be in line and complete, there wasn't much to do there though. The bottom however does not all appear to be fixable with only two more sets of trays to go (5 weeks left including one week for the trays I'm on). The teeth are not quite straight and this gives the appearance of them being arched, or maybe they are arched now?? The dentist says it's an illusion.

My other big concern is that currently only my front teeth are touching and I am unable to chew properly because my back teeth do not touch at all. So I find myself constantly "clacking" my front teeth together when I DO chew too hard and it hurts. I am not sure how this can be amended in only 5 weeks, but I've been through a lot of bite changes so I'm trying to have faith!

Only recently did my dentist begin to do some IPR with the strips on spots where my teeth seem to be tight on the bottom. IPR was not, however, part of the recommendation by the Invisalign orthodontists so I think she's just winging it. Obviously this means that things are not going exactly as expected, so I am now trying to come to terms with the fact that I will be continuing with refinements, although this has yet to come up. As of now I am just heading back in to the dentist whenever the teeth get tight, so I've been in 3 times now for more filing. She says she doesn't want to do too much at any one time, but they never seem to stay "unstuck" for more than a day so I don't know how much it is helping.

I guess we will see how it goes. I am not that happy about it all right now, I'd hoped to be in retainers and done with this by now but I knew it was a long shot!

Peek at Final Tray

Just took a look at my final tray to make sure that my teeth WOULD be perfectly straight at completion (as promised and as indicated by ClinCheck) and I was shocked to discover that they are NOT!! I was having a hard time figuring out how they'd get this one tooth pushed to the front in just two more trays and the answer is, they won't!!

My dentist just scheduled my retainer impressions appointment (before I realized this). I have a call in to her to see whether this is actually supposed to be impressions for refinements, at least on the bottom, because I did not pay $3500 for crooked teeth (I had those for free!). If Invisialign did not expect me to be successful, would that not have been indicated at the outset? Would they really stop treatment when the projected outcome has not been reached, without even mentioning that they were "giving up"? Or is this confusion on my dentist's end? I'm very frustrated right now!!

ANOTHER mid-course correction!

Today I went back to the dentist to get the trays from my new impressions. She informed me that rather than being my refinement trays, these were actually still considered mid-course correction trays, so I can still do a set of refinements if necessary. It better not be necessary!!

Much to my horror, they decided my top teeth were not finished after all and I actually have ELEVEN more trays to go on top!!!! And 12 more trays to go on bottom (making my end totals 30 and 31 trays, twice the original number). To make matters worse I got the two buttons on my top front tooth put BACK on after having them off for months and thinking I was done with them. I was also looking forward to getting rid of the power ridge on the upper front tooth as well, it is the bane of my Invisalign existence, but that was not to be.

The only good news was that in quickly peeking at my final tray this time around, the teeth seemed to be nice and straight. I forgot that I wouldn't get to take it home to examine more closely so I'll have to take a better look next time I'm in to be sure.

I am incredibly disappointed to be essentially back at square one when it seems like there is so little that really still needs to be done, but what can you do? For now I'll just stick it out and see how things go. If at the end of this round my teeth are a mess, I will certainly be seeking the services of an orthodontist. I can say at this point I am really regretting my choice to have my teeth fixed, they really weren't that bad!!! Oh well.
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Comments (48)

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Could you give us another picture? :)  It's been two months since the last one and I thought your teeth looked pretty good in that one already, except that one tooth on the bottom row.
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Hi! I don't think there has been any change since the last picture, I was waiting on trays for a LONG time so I've just now had my first new tray in for two weeks. I will take some pictures soon and see if there is anything worth posting : )
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Ohhhh!  That explains it :).
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I will never understand why docs choose to push people through treatments rather than actually do their job. It's not like it's taking much more time or effort from them to make these corrections and actually pay attention to the patient. I hope you get any refinements that you want and that in the end you are happy with it all!
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Thank you! My appointment is on the 27th so I'll post about how it goes. I sure hope my dentist just sees things my way and that we move forward with refinements. I also hope the invisalign folks can actually finish the job and straighten my teeth! But I'm not holding my breath about any of it at this point!!
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Very odd!  You are not crazy--I definitely see that that tray has crooked teeth.  I agree with ocdave.  I had to push (only gently, but I did have to push) for my refinements as well.
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Your experience is sounding very similar to mine. Loose fitting trays, open bite, Dentist quick to make retainers, clincheck results with no basis in reality. I went to a "Dentist" for my treatment as well. How I regret making that decision now. I felt he was in over his head and trying to rush me out of treatment from the start. After my first 22 trays (1st year) he said my teeth looked great and wanted to take impressions for my retainers. I told him I need a refinement not retainers. After some resistance he finally agreed after seeing things I pointed out to him that were very obvious. Early in my treatment with him I started questioning my decision to have him do my treatment. I never felt confident with him and kinda felt he was just winging it. So the moral of my story is I got my refinement, something I paid for by the way, but not much progress was made in that extra year. I'm going to see an orthodontist on Thursday to see if he can help me achieve a better result. I'm done wasting my time with the other guy and cutting my losses. Expensive and time consuming mistake on my part. If you're confident in your Dentist's ability I would push for another refinement. If not you may want to look into other options. Good luck to you.
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I'm frustrated because my dentist has assured me throughout that my teeth WILL be straight at the end, that it's an easy case and that the results were definitive. I am very interested to see whether she will be surprised about my final tray, or will try to get me to just accept it. This has been a very frustrating experience! I can't believe they weren't able to help you with an additional year of treatment! Did you have your consult with the ortho? Will you be doing regular braces? I feel like while I do NOT have confidence in my dentist, my teeth have improved considerably. I do plan to push for refinements but I am coming to terms with the idea of needing to see an ortho after all of this is done. I should have done more research!! I thought this was all going to be easy! Oh well. I hope things improve for you! Good luck!
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Hey Wednesday, I saw my new Ortho a few weeks ago for a consult. He told me Invisalign could not rotate my lateral incisors and that braces were the only way to straighten them. So in a nutshell he told me I wasted the last year on a refinement that would've never worked in the first place. I had X rays and impressions done today and I go back in 2 weeks to go over the treatment plan. He said I'm looking at 9 months in braces max, and could be a shorter duration. I'll keep everyone posted. My teeth also had big improvement along the way but Invisalign as i know now does have limitations. My first consult with my Ortho was free. It never hurts to get a second opinion, and could possibly save you a lot of time and headaches down the road. I'm glad I did it. Definitely feels like I'm on the right track now, and as I should've done from the start. Keep us posted. Gl, tc.
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I was curious about you situation, mine seems similar. I went to a dentist and not an orthodontist. My teeth look great, but the whole reason I got invisalign was to give space between my upper and lower front teeth and now they hit each other more, not have space. My teeth are sore and my bite feels so off, yet I am on my last refinement alligner and he plans to fit me for retainers and finish treatment despite not fulfilling the whole reason I paid him for invisalign. I am feeling like I may have to do the same route as you and cut my losses with the dentist and go with an orthodontist to continue my treatment. I feel my dentist is out of his knowledge base and just rushing me to be done. Did you drop your dentist and seek out an orthodontist yet.
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I now have braces on my top teeth, 8 brackets. My ortho is just going to straighten those front teeth. As for my bite, to get that the way it should be, would require lower jaw surgery and at least 2 years in full braces. Just like starting over. I've already wasted 2 years and 3 months on Invisalign with a general dentist so I decided to have him just do the front. I couldn't bare the thought of 2 more years of treatment. So when it's all said and done, total treatment time will be 3 years. Costs, Invisalign: $5900.00, braces: $2,100.00 for the grand total of $8,000.00 and my teeth still won't be the way they should be. I would venture to say most general Dentists are in way over their heads trying to prescribe tooth movement. My ortho told me Invisalign could not have fixed my teeth correctly and full braces would've have been his recommendation from the start. Now I know I got taken for a ride. Second opinions never hurt, and most Ortho consults are free. Good luck to you, tc.
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Oh no that's crazy! Did the orthodontist say that if you'd had braces to start then your teeth and jaw would have been fine? Was the Invisalign the cause of the jaw problem? I completely agree, regular dentists are NOT the way to go for Invisalign. I did, however, see my dentist again and she agreed to take impressions for refinements instead of retainers. She seemed confused about the last tray, insisting that my teeth must just not have moved correctly, that they got stuck, and not understanding that they HAD moved exactly to the form of the tray but that the tray itself did not have straight teeth! I still can't comprehend why they would stop me at 18 trays without any explanation if the teeth were not going to be straight? Did they tell my dentist that my teeth were unable to be further straightenend and she just didn't relay this to me? Was there a new ClinCheck?? On Tuesday it will be 3 weeks since my impressions appointment, not sure what's taking so long but I'll be giving my dentist a call then. Good luck with the braces! I'm so sorry things have worked out so poorly for you. Hopefully your experience will benefit others, though, I wish I'd read it before I started all this!!
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Hey Wednesday, sorry it took so long to get back to you. My lower jaw would've needed surgery from the start to correct my bite. Something my Dentist never mentioned. He suggested upper jaw surgery after my first 22 trays to correct my overbite, and I said a big no. When I told my Ortho that, he said my upper is fine and only the bottom would've required surgery. Any way I read your review and you have more trays in your future. Good luck on this go round, I hope it works for you and you get your desired results!
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A couple of thoughts for you:  first, the easy one.  It is, I'm beginning to realize, very common for people to get a posterior open bite from the invisalign treatment.  This is the problem you were talking about with only your front teeth touching.  It happened to me, and many here on RealSelf complain about it.  For me, it was simply a matter of cutting off the back bit of one of the trays and having some equilibration done.  Here are some words from the doctors here on RS about it:

After Developing a Posterior Open Bite from Invisalign Treatment...

As for the IPR, that I have no idea.  You may wish to ask a question of the doctors here on RealSelf about it.  You may also want to get an in-person second opinion from an orthodontist.
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Thank you! I will definitely talk to my dentist about the posterior open bite. I didn't realize it was common, I hoped it was just temporary as my teeth finished moving. I AM a severe clencher, though, and would not be surprised at all if my teeth had been affected by that. Did you actually cut the aligners yourself?? My concern is that if I don't have the aligners in place in the back, those teeth will shift out of alignment again, how do you prevent that?
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Sorry, I was not at all clear.  Not only did I not cut the tray myself, it was also done to my retainer.  I finished the treatment the normal way, then, once I was no longer in full-time retainers, the teeth started coming back out during the day.  The problem is that when we clench (I'm a clencher too, though only with aligners/retainers in) we compress the layer of tissue between the teeth and jaws.  It takes hours for that compression to go away sometimes, but it generally does.  So I just went through treatment like that.  I'm about two years post-treatment now and the tray was cut off a few months ago I think.  I have it in my review but I'm too lazy to look it up right now.

So glad you asked for clarification.  I was thinking you'd just read the doctors' advice and they definitely say you should not cut the trays yourself!
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I am on my last refinement tray and my front teeth are hitting. I am a clencher also, especially with alligners in. It also makes my jaw sore. I don't see a posterior open bite and my back teeth mildly touch or do so but the front teeth hit hard. Did the back teeth re erupt with you before cutting the trays and after you stopped wearing the alligners full time, or did they only re erupt after your retainers were cut? The whole reason I got invisalign was to give space between my bottom front and top teeth and now they hammer each other so I am kinda freakin out that my dentist plans to finish me up in a week when my teeth hit like they are.
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So for me, they did have time to fully erupt when I kept my wear to 8 hours/day, though it took a few hours before I could eat anything.  But another thing that contributed to fixing all of this was the equilibration, and that is something your doctor may be planning, so definitely ask your doctor about that.  For me, they had to shave a bit from my front teeth, because they hit too soon (the backs of my upper front teeth) as well as some other places on my premolars and molars.

Even though it's late in the game, I hope you start a review so that others can see how this issue is treated for you.  I started my review about the same point in treatment as you're at now, and though I regret not having posted pictures throughout the treatment, I still feel like it was valuable to me :)
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Thanks for the response. I read your invisalign experience and I can relate on many factors. My dentist is planning a full mouth equalibration but I'm nervous about it and don't know if I should let him or demand refinments. I don't see a posterior open bite, but my back teeth don't seem to feel like they touch much, when I take out my alligners, only my front bottom and top left incisors do. I guess my biggest concern is that my front teeth are so thin already from grinding in the past and that my invisalign plan was to give me plenty of space between my front teeth so I would not have them touch. I definitely clench heavily on the alligners like you mentioned. I never had jaw or tmj issues until invisalign and my muscles in face face get tired now after talking too much. My teeth are all always sore since I started invisalign. Thanks for talking story. I promise I will post a review . Any more experience and advice relating from your experience would be great. Did your posterior teeth erupt on there own and relieve your front teeth from hitting after you stopped wearing your aligners full time?
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No, my front teeth still hit, even after the teeth fully erupted. :(  It was the equilibration that relieved the front teeth hitting.  I didn't want the equilibration done, because they didn't even tell me what it was, but I honestly can't feel a difference in my teeth except that they fit better.  And then I found out from my husband that he'd gotten it done as well after his Damon braces but I'd just not understood what he meant when he'd said it.  Apparently it's extremely common after orthodontic treatment.
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I am almost to the end of my first refinement tray, and I had the same issue with pain. I wore my last tray before refinements came in for about 5 weeks, so my teeth were nice and set! I hope you won't have any reoccurring issues with the fit or your aligners and all will be smooth sailing from here on out!
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Yeah, when you hang out in a tray for a while, the teeth start settling, and have to loosen up again.  Terrible.  That happened to me between the last aligner and the retainer, and then again every time I had to get a new retainer (Vivera gives you 4 you need to break in.  Ugh.)  Anyway, not unusual, but definitely unfortunate and unpleasant.  

It seems unlikely they'd be withholding some aligners but give you nine at once.  But there's nothing that says you won't need/want refinements at the end of the 18.  I started with 15 and got 6 in a refinement.  But I felt like the refinement was somehow easier--I don't know if it was less tooth movement or just psychological. :)

It's good to see your tray fitting again, though.  Hopefully it'll be smooth sailing from here!
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I definitely do not think your teeth look worse than before! You could try chewies to help seat your aligners the first few days of wear. That should help them fit properly so that by the time your 2 weeks is up and you are switching to a new tray they fit perfectly. Usually when you first put in a tray it won't fit great as the teeth need to move into those new positions. After a few days though the trays should fit fairly well if there are no problems. I look forward to hearing what the dentist has to say after your post Christmas appt!
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Thank you! You know, the aligners feel seated, they fit all the buttons it seems, but they don't look seated. I will post a picture of the bottom teeth that concern me, I just don't know. I did put in trays #8 this evening and they went in just fine, so that at least was a relief, though the bottom tray looks the same as the previous one. I also look forward to hearing what the dentist has to say after Christmas, crossing my fingers that she feels I'm on track!!
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I love those pics side-by-side.  Excellent illustration.  Good luck with your post-Yule appointment!

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