4/18/2013 - the future begins today - San Francisco, CA

APRIL 18, 2013 ~ Today is the second, kind of...

APRIL 18, 2013 ~ Today is the second, kind of third, kind of first day of my treatment. But my treatment also kind of hasn't begun yet. Long story...

My teeth have stumped many dentists and many orthodontists. I think that over the course of my life (only 2 weeks shy of 27 years at this point), I've seen 4 dentists, 5 orthodontists, and 2 oral surgeons, and each one, after seeing my x-rays, had the same perplexed look on their face. They've all said, "Well, that's interesting," and called in their colleagues to take a look at something they've "never seen before." Kind of makes you feel special, but also just makes you think, "WTF is wrong with me?"

The good news is that they all think my teeth are perfectly healthy. My teeth, though small and with spaces between them, are straight and clean. They're white, no cavities, and strong. Which is why I've never had braces. And why it really doesn't make sense that I'm putting myself through 16 months of discomfort.

It's cosmetic. It's purely cosmetic. Whatever. I've disliked my teeth for nearly a decade now. And now that I'm (somewhat) settled in a new city, and I make enough money to get this done, I'm getting it done!

So, I found my orthodontist from the Invisalign website almost three months ago (top 1% -- only the best for me), and I went in for a consultation. I came out $4,000 poorer and a date 8 weeks in the future to pick up my trays. Even though I had been thinking about it for years, I hadn't planned on plunging in on that date. It was a bit of a spur-of-the-moment thing.

Within those 8 weeks, I also had a consultation with a dental surgeon, because as you can see from my x-rays, I'm missing bunch of teeth that never came in (ankylosis, apparently), and a couple of my wisdom teeth are coming in sideways. I guess while we're tearing things up in my mouth and moving everything around, we might as well do some preventative work, right? The surgery was set originally for April 11th, but then I had to move to April 22nd due to my work travel schedule

At the end of the 8 weeks, I called up my orthodontist and they said they needed another week or so, since my case was so "special" (there's that confusion over my teeth again!), and we set the date of April 16th for me to come in and get my liners.

April 16th was two days ago, and at 8:10AM, I went into my orthodontist's office to pick up the liners. While I was there, they attached about 8-10 buttons on my teeth. Those buttons are not the best experience in the world, but I guess they're better than regular braces, so I can't really complain. I decided to spend April 16th getting used to the buttons and didn't put the aligners in at all. It was an awkward day. I kept feeling these attachments on my teeth and couldn't help but think I looked like a vampire with them sticking out all over the place. When I left work, I put the aligners in, and then proceeded to have a mental breakdown. They were tight, they were awkward, and they were jamming into my right cheek, so they were PAINFUL. So, Tuesday night there were tears and there was regret. But I took a few Advil and went to bed, thinking I had no idea what I was going to do the next day. I was about 80% ready to say "Eff this," figure out a way to be happy with my teeth, and chalk it up as a $4,000 mistake.

When I woke up, I was still in pain, but the sleep had done me well and I made my way to work. After I got off the bus, I called up my orthodontist right as they opened and they found a slot at 4:10PM that day where I could come in to deal with this immense pain. I took out the aligners for the day. When I got to the orthodontist's office that afternoon, we took a look at my teeth, my x-rays, and my liners, and saw that the liners had spaces for two teeth of mine that I actually wouldn't have until after my dental surgery (which would be working to bring these two teeth--the ankylosed ones--down into my mouth). So, the orthodontist simply cut those two teeth off.

What a world of difference!! It was like night and day. I could actually wear them now and not break down in tears. It still felt like I had peanut butter in my mouth all the time, but at least it wasn't peanut butter filled with razor blades.

Today I wore the aligners all day (except for breakfast, lunch, and dinner), and while I know I sound funny and I still need to work on my pronunciation of words (especially those with "F" and "S"), this is the first time in these two days where I've actually been able to think to myself, and believe that I could do it.

That said, today was not pain-free--but there was a reason behind it. At around 3PM, I realized my tongue was getting a sore on my right side. I did some digging with my tongue and fingers (I looked real attractive, for sure), and the teeth that the orthodontist cut off yesterday left me with a really sharp edge on one of the aligners. I decided rather than bother my orthodontist again (I had asked him about 50 questions yesterday), I would hop to Walgreens, get myself an emery board, and shave down the sharp edge myself. It seemed like it wouldn't compromise the structure of the aligners, so didn't seem to be a problem.

Again: what a world of difference.

I'm ready to do this!!

Oh, and since a picture IS worth a thousand words,...

Oh, and since a picture IS worth a thousand words, and x-rays are weird to interpret. Here's a "before" picture on Day 1.

APRIL 26, 2013 ~ I don't really have any update to...

APRIL 26, 2013 ~ I don't really have any update to provide. The first week of my treatment coincided with when we had planned to yank out my wisdom teeth, so that's really all I've been up to. The procedure was on Monday and boy did it suck. All four of my wisdom teeth were impacted, so they had to expose and extract all four. And, while they were there, they exposed and bonded two (or was it three?) of my molars on my right side, since I had a few teeth that never came in. In order for my Invisalign to work right, we have to bring those teeth down, and I decided to do it all in one fell swoop. Which means one morning of surgery, and five+ days of massive, painful recovery (plus another $4000, ouch). Today is the first day I've really been able to open my mouth, and I'm making the possible mistake of scheduling a week of work travel starting on Monday. I may be the most efficient man alive, or the stupidest. I'm not really sure.

So, week one hasn't started yet in practice, as I haven't been able to wear my liners since Sunday. Hopefully starting next week I'll be able to wear them again and actually get this show on the road!

MAY 2, 2013 ~ Been a rough week. I haven't had my...

MAY 2, 2013 ~ Been a rough week. I haven't had my Invisalign in because of my oral surgery a week ago Monday. The last time I posted I was close to being done healing, and I'd say I was completely done by Monday. Unfortunately, two things happened: 1) the oral surgeon apparently just sutured in the chains that are supposed to be pulling down my second molars (those that got exposed and bonded in the "expose and bond" portion of my apparently really major surgery last week), which meant the shoddily attached chain has been cutting into my cheek every time I move my jaw, and 2) I stupidly decided I was well enough to go on a cross-country business trip and speak in front of a large group of clients.

Today I went to the oral surgeon for a follow-up appointment, and for me to address the "gold chain slicing into my cheek" issue, where he told me there really wasn't anything he could do, short of un-doing the really expensive and really painful surgery I had. And give me pain meds. Not really the solutions I was hoping for. He said my orthodontist would be able to help by taking the sutured chains and actually attaching them how they should be attached to move my molars. Why they couldn't get together and do it all while I was knocked out during my surgery, I have no idea.

So, I went over to my orthodontist. They're so nice over there. But man is this thing more painful than I was promised. They were completely understanding and pleasant and even gave me a hug when I broke down in tears (twice there, four times total today), but they also attached lingual buttons to my teeth to hook the chains onto, and now instead of my cheek getting cut into, it's my tongue.

I don't know if this thing was a mistake or not. I'm turning 27 tomorrow, and while I love what I see when I get to the end of my 15 second Clincheck video, I feel like such a social pariah that I don't know if I can handle 16 months of this. I know people don't actually care that I wear Invisalign and am fixing my smile, but I'm in such pain and discomfort that being around people is difficult. I just moved to a new city in January, I'm finding it hard to make friends, and this is not helping the problem.

I know it'll get better. It's just really hard right now.

MAY 16, 2013 ~ Okay, so I'm two weeks in...

MAY 16, 2013 ~ Okay, so I'm two weeks in, and I think I'm getting used to this. What has happened since I last posted? So much.

I turned 27 on May 3rd, and boy was it a doozy. In reality, it was really low-key and relaxing, but there were a lot of emotions going on. It was the day after I got the chains of the "exposure and bonding" procedure properly hooked to my anchor teeth to pull down my molars, and it was the first day of really being able to wear my Invisalign. In reality, I started wearing the Invisalign on May 4th, but don't tell my orthodontist that. What? I really wanted to eat cake ALL DAY, not just 2 hours of the day.

So, on May 4th, I started wearing the Invisalign full-time, and it wasn't so bad. I think it helps that I had a dry-run back in mid-April before my surgery, so I already got my mental breakdowns out of the way then.

The hardest part is the lifestyle change. I miss being able to savor my morning coffee, and I miss snacking all day. Eating three meals a day in just two hours is a challenge for me. The good part (or at least how I'm looking at it) is that those three meals are HUGE. I can eat whatever I want in those three meals because it has to last me until the next one. That means breakfast is eggs, potatoes, sausage, yogurt, berries, coffee, and pastries. Lunch is multiple proteins, vegetables, cookies, carbohydrates, cheese, bread, and frozen yogurt. And dinner is whatever else I can manage to fit in my stomach. Pizza? Done. Burrito? Check! I may not eat as often, but when I do, it's serious.

Anyway, my first aligner was in for 10 days, then I had an appointment to go back to my orthodontist to get my chains tightened and for a general check-in to see how things were going. Well, did I get some good news there on Tuesday! My orthodontist said my teeth are responding really well, the molars have started to get pulled in, and that I can switch aligners every 10 days instead of every 14. So, what's 4 days? Well, compound that over 32 aligners and you get a treatment time shortened by FOUR MONTHS.

Good news? I think so.

So, on Tuesday I switched over to aligner #2 and will be done with it next Thursday. And so on and so forth. Aligner #2 was tight at first, and it has its own pain points and tender spots that are different from the first, but I'll get used to it. Still counting down to October-ish when my Clinchek shows me actually making progress, and still crossing my fingers for an easy going from here on out. And some beautiful teeth in April 2014.

Now my biggest problem is decorating my new apartment (oh, and finding some friends in this new city).

MAY 23, 2013 ~ All seems good, except...

MAY 23, 2013 ~ All seems good, except for the first day of each aligner. And I'm only saying that because not 15 minutes ago, I just put in aligner #3 and man oh man is that some painful stuff. Immediate pressure, and shortly thereafter the tenderness sets in. I can see why people switch aligners right before bed with an Advil cocktail. The last time I switched, I did it in the morning, and I do recall having a pretty crummy day and going home from work with a massive headache. Hopefully a good night's sleep will cut that off and give me a good and productive Friday tomorrow.

How have things been going otherwise? Pretty good, actually. I went to the orthodontist's this morning to get my aligned #3 (they had originally trimmed the wrong side and had to re-order it. good thing they got it just in time) and had my teeth that were exposed and bonded re-bonded to keep the pressure on the molars to come down. The orthodontist said they're coming in well, so it's nice to know that that pain at least is worth it.

And the pain of the Invisalign itself seems to be worth it, too. At aligner #3, I obviously don't see any change in my teeth when looking in the mirror, but I can feel things are different, and not just the discomfort of this new aligner. When I have the aligners out, I can definitely feel my bite is different. I'm sure it's just millimeters, if that, but I can feel it, and that's worth something, I think.

Lifestyle-wise, I think I'm nearly used to this. Now, that said, I haven't been the most social of people, and I'm still pretty frustrated with my own lack of fortitude and extroversion to make friends (if you remember, I just moved to a new city and I'm pretty lonely, to be honest), but taking all that into account, I think I'm getting used to the lifestyle. I have my routine in the morning during the week for breakfast, then in the afternoon for lunch, and the evening for dinner. And I've even been faced with a few challenging situations I've made work, such as long client lunches, and a baseball game last Tuesday (hint: I drank beer with the aligners in). I also exercised for the first time with the aligners in with a long run last Sunday, and besides needing to drink more money because of a slightly drier mouth, it wasn't bad--I even stopped for a donut at mile 5, and while I didn't have my toothbrush to brush my teeth, I swished enough water around to not feel totally disgusting. I wouldn't go for a long run the first day of an aligner, but it's not like I'm going to become fat and lazy during this treatment.

Anyway, this new aligner is already giving me a bit of a headache, so I'm going to pander off to bed. I'm not sure if I shared my ClinCheck video, so I've embedded it here. I'm probably watching it 1-2 times daily to keep myself in perspective. Looks like aligner #12 will be when I start to see some real change (that'll be around September 2013).

JUNE 10, 2013 ~ Just wanted to...

JUNE 10, 2013 ~ Just wanted to make a quick update. There really isn't that much happening. I'm on aligner 4, going to my orthodontist tomorrow morning, and switch to aligner 5 on Thursday. I'm not seeing any changes, but after (obsessively) watching my ClinCheck video, I won't be actually seeing any changes until aligner 12 or so, which happens in late September/early October.

Which means I'm just chugging along until then!

A quick word on my particular case and discomfort: a lot of what I griped about in my earlier updates really have nothing to do with Invisalign. Thus far, Invisalign has been relatively painless. I miss being able to snack, I miss leisurely drinking coffee and tea throughout the day, I get really sick of having to brush my teeth--but all in all, it's not bad. Just inconvenient. The gripes have to do with the exposure and bonding work that was done/is still being done on my upper and lower right molars to bring those teeth in and actually give me all the teeth I was born to have (they just didn't come in). Exposure and bonding sucks. I have metal glued onto my teeth, I have constant pressure, and I have all sorts of sores and cuts and scrapes on my tongue and cheek. It's not fun, not fun in the slightest. But, for all you people reading this who are considering Invisalign, it's not actually part of the Invisalign process. It's my own special journey I have to take because my mouth is so messed up.

To sum it up: Invisalign = inconvenient, but not all that bad; exposure and bonding = absolutely terrible (but hopefully worth it).

Have uploaded a snapshot so people can see the status of my teeth at the end of aligner 4. Not much change like I said, but I can feel in my mouth my bite is changing, so something's happening! Just gotta stick in there.

JULY 11, 2013 ~

(Picture from July 3, 2013) JULY 11, 2013 ~ Another quick update. Things are going well. I'm on tray 8 now, looking forward to getting through the next three or four aligners and going back to the orthodontist. Looking forward to going to the orthodontist?? Who have I become??

Seriously though, I do look forward to going to the orthodontist. It means things are progressing. And, on a non-Invisalign note, it means my molars that have been exposed and bonded get reactivated and tightened. And the more those get tightened, the sooner I can get the damn things off! This metal crap and bands in my mouth are really putting a cramp in my style--it's just so uncomfortable still. Yes, I'm more used to them than I was, but it's still super inconvenient. That, and I think my Invisalign will work a lot better when it can actually work on my right side. I've realized that for all intents and purposes, my right side isn't moving with the Invisalign, because we're having to chop down each aligner and basically get rid of the right side to make room for the metal buttons and bands.

And that's what makes me nervous really. I'm afraid that because we're chopping down these aligners that my right-side teeth (beyond the canines) are falling seriously behind when it comes to progress. I have to keep looking at the ClinChek to make sure what I see in my mouth reflects what is on the screen. I think everything is going well, and the orthodontist says it is, so I think I just need to trust in that. Sometimes it's hard though.

Still, can't wait for this all to be over!!

JULY 22, 2013 ~

JULY 22, 2013 ~ I wish today's appointment went better than it did. I went back to the orthodontist because my back two feet, the ones that are acting as anchors for my molars that had to be exposed and bonded, were absolutely and unequivocally not fitting in my aligners. And apparently haven't been for quite some time. The doctor and his assistants took a look in my mouth, poked, prodded, and pushed around my aligners (which got painful at moments), and came to the conclusion that I need all new aligners with new molds. The whole kit and kaboodle.

When I had molds originally done, it was before my wisdom teeth surgery, before any exposure and bonding, and before any attachments or buttons or anything was on my teeth. And it was easy. Let me tell you, it's not quite as easy when you have all that junk in your mouth. Pulling the dried molds off my teeth was nothing short of terrifyingly painful. It got caught on my buttons, pulled on the bonding bands, and I basically had to get cut out of the mold.

But, we got the molds. Or so I hope. My new aligners should be here in four weeks, which is basically an eternity right now.

In the meantime, I'm going back to aligned 6 (6!!) on my uppers, with explicit instructions to bite on chewies like crazy to get those back teeth fitted in the aligner. I only have to wear each for however long it takes the teeth to fit into the grooves, and then I can move up, eventually coming back to 9 on my uppers to match my lowers, at which point they're hoping my new set will have come in.

Basically, I feel like I just took four huge leaps back. I feel completely disheartened and hopeless and disappointed and I'm incredibly unhappy, and in a lot of pain to boot. My orthodontist is fantastic and I couldn't ask for a better one, but this is one of the hardest things I've ever done, and I feel basically all alone in it.

I thought things were going so well and I had my eye on April 2014. As far away as that sounded, I was (starting to be) okay with it.
Dr. Yan Kalika

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I just found your story because I was looking up Invisalign cases in my area and I saw your treatment was really cheap.  Anyway, then I read your story!  What a mess.  I hope that things have improved for you in the almost four months since you posted last time.  I 'finished' my Invisalign treatment, though I'm extremely uncomfortable with the way my retainers (Vivera) make me feel and am considering asking for bonded retainers or the more traditional wire retainers.  And I also have to get my wisdom teeth removed by a surgeon, because they're all impacted and the two that bothered to try to come out came out sideways.  I'm hoping they don't mess up my straight teeth.  Blah.  Reading your story makes me very, very nervous.  

Anyway, I hope you'll come back and update soon, though, and I hope it's not all bad news.

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I can definitely understand why you would feel concerned about the right side falling behind. Hopefully your orthodontist took into account all that would be going on with your molar while he/she was treatment planning, but you could certainly ask if the right side of the tray is active or passive. If it was designed passive, no biggie, it has been accounted for. If its active I'm assuming he/she is planning to order you completely new trays once the molar is exposed...but my guess/hope is the right side is passive. If you ask, let us know what you find out.

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That's a great idea, Megan! I'm going to write him right now and ask.
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Cool, post an update so we can hear when you find out - I'm curious! :)

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Just posted a reply. Not the greatest news :( Megan - I'm curious if there's any thread among the orthos/dentists on this site you know of related to Chewies? Long story of my post above short: I have to go back three aligners to get my back two teeth to start tracking correctly while I get new aligners made, and my orthodontist said I should be using Chewies to force the aligner onto my teeth. It's super painful though, so I'm just wondering if pain is normal. My orthodontist said yes and I just need to do the best I can, but I'd love to hear more opinions.
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I'm so sorry to hear you are feeling disheartened. :(

Here is a Q&A that talks about chewies:

If Invisalign Chewies Are Not Used Everyday, Will Alignment Be Dramatically Delayed?

You are also welcome to post your own Q&A since you have a pretty unique situation.

I know adding more time to your treatment probably feels awful, but at least the steps are being taken to make sure things come out right in the end, rather than plugging along until April 2014 and then not have the results you had in mind. But I know, easy for me to say...

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I'm in the same boat with you as far as the reasoning behind starting treatment goes. I was finally in a place in life where I wanted it done (needed it done) and had a job that could support my cosmetic needs. I also went through MAJOR "pre-invisalign" work with wisdom extractions (3 sideways impacted) and arch expansion. It's good to have that base stuff done before starting a treatment like this! You will be so much happier that you didn't just do whatever and start treatment quickly!
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how many sets of invisalign do you have to wear?
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32! I have a long road ahead of me....
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I had 40 on my first set, then 25 on my refinements. I totally have you beat! I'll be in these things forever. And my teeth weren't all that bad to start with, some crowding on top mostly. Good luck!
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Oh jeez. I'm hoping I don't need refinements. I'm counting down all 32 of mine. I have faith in my orthodontist he's doing everything right to have me in these as little as possible, and still have healthy teeth.
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I just started invisalign as well, I begin week 3 tomorrow. My first set hurt for the first few days, but the 2nd set were not so bad. I am praying the new set tomorrow won't hurt too much. I am just glad that I make the switch on Friday so that I have the weekend to get used to each new set. Thanks for posting your experience, it made me laugh, and also made me want to reach out to tell you not to worry. You will make friends, you have a lot of changes (all positive) going on at the moment. Cut yourself some slack, and take time to adjust to all the changes. Good luck with your progress, I think you did the right thing not going with veneers. Time goes by quickly so before you know it your treatment will be done! Enjoy your new city!
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Hey David, Thought I'd throw out an idea for you to consider. Your teeth look kind of like they might be eligible for veneers from a cosmetic dentist. Just wondering if you had considered that route. I'm curious as to what your clincheck shows as your final result.
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Hi Platicized - Thanks for the idea. I had considered them, but I didn't like the idea of covering up otherwise perfectly healthy teeth with a veneers. My teeth are great, they're just not in the right spots. Plus, I really like all the things you're not supposed to eat with veneers, mainly ribs and nuts. And alcohol :) I'll post my full Clincheck when I can figure out how to do it so you can see what the teeth will look like next spring (hopefully - fingers crossed!)
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Wow David, I read your story. You've been through a lot with all of your procedures. Once you get healed up, dealing with the aligners is a piece of cake. Tc and good luck!
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Thanks Dave! So far, they are a piece of cake. Still not used to not snacking, but I'm only on aligner 2, so I have some more lifestyle adjusting to get used to.
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So sorry to hear things are going rough right now. :( If the chain continues to cut into your tissue ask your orthodontist if there is anyway they can put some sort of sleeve over it. They may or may not be able to, but its worth asking. Even if they could get just a little bit of one over it, it might provide enough cushion to keep it away from your tissue.

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Hey davideatslife, how are you doing with your wisdom teeth extractions? Everything healing up ok?

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The wisdom teeth and healing for that is great. The exposure and bonding of my molars however, not so much. I'm hoping they move quickly so I can get these chains and lingual buttons out of my mouth.
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Why don't u just get veneers?? U seem like a really good candidate for that
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I did some research into veneers and they weren't for me. They seemed like slapping lipstick on a pig, and I want to fix the problem from the root and have healthy teeth that are all my own.
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Good luck! Hang in there! Can't wait hear your updates.
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Thank you!
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Congrats on getting started!! Its a bummer you had to go through some uncomfortable periods, but good for you for finding solutions and pushing through!

Keep us posted on what things are feeling like over the next few days as you continue to adjust.

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Thanks Megan! I'm excited to start the process, but it's gonna be a long one...!
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