Alexa Alborzi, DDS, MDS

I had a moderate crossbite and some crookedness that was getting worse over the years. I'm 37 years old, but I never thought there wasanything worth fixing with my teeth until my late 20s. Slowly, one of my front upper incisors became crooked enough that it was affecting my smile from the side in pictures. My husband went through the ordeal of Damon braces (the best thing he's ever done for himself besides being treated for hypothyroidism). If you have terrible teeth and the orthodontists have recommended pulling teeth or jaw surgery, definitely look into Damon. If you only need a moderate or small fix, in my experience, Invisalign is a great way to go, because it allows you to more efficiently floss and brush your teeth. You just have to have the discipline to wear your aligners 20-22 hours/day.

My total treatment will be 15 initial aligners plus 6 refinement aligners, or about 42 weeks--less than a year in all. My teeth are straight and I love the way they look now! I have a couple of triangular gaps I didn't have before, which I knew would happen, but that was worth it to me. The ortho sanded me down three times in all, to make room for teeth.

The main cons are gum recession, which for me has been minimal, and the staining from the adhesive used to attach the anchors. So far, polishing with pumice has been able to remove the staining (it retirns within a few weeks, though). My only real concern at this point is whether they are able to remove the anchors without any negative side effects.

The insurance, btw, covered $2000 of the total cost.

Will post pics soon!



Updated on 18 Oct 2012:
Today was my last day with Invisalign, and I had the anchors removed without incident. There is no trace of them left, including the glue and the staining. I am waiting for Dr. Alborzi to send me my pictures, at which point I will attempt to get them scanned and posted in a timely manner. I feel that I've gotten excellent results, though my teeth weren't that bad to start with. Overall, I'm happy with my investment, since I smile showing teeth (and I smile a lot) so my teeth are seen a lot. I always get comments on my smile, even with the aligners in and the anchors still attached! If cost is an option, this is not the best way to get a great smile--it's expensive for what it does and is limited in its efficacy. For me, it was the only option because I did not have time to floss half an hour after each meal. Because I could remove the aligners, flossing was a 5-minute affair a couple of times a day. My husband, while he had his Damon braces, spent literally 90 minutes a day flossing (3x30 minutes). It was prohibitively time-consuming. He got phenomenal results, but paid in both time and money.

Anyway, I'm very happy and would not hesitate to recommend Invisalign to those who are good candidates (ie. not with severe problems).

Updated on 27 Oct 2012:
Still haven't gotten pictures from the doctor, but I will say that I got at least two, possibly more, cavities while I was doing this. Despite the fact that I floss two or more times/day. I think it's something about having the trays in all the time. I'll find out exactly how many cavities I got when I go to the dentist on Thursday, but I'm not hopeful :(

It increases the price of the treatment somewhat, obviously, and ancillary damage is always something to consider. Still, I am very happy with the way my teeth look, and more fillings will not affect that. It's more inconvenient than anything else, since I'm not scared of the dentist :)

Updated on 1 Nov 2012:
Finally got to go to the dentist today, and it turns out that the spots I saw were not, in fact, cavities. They were just more staining. It turns out that flossing 2-3 times per day is a pretty surefire way to avoid getting cavities between the teeth, says my dentist. Go figure ;). SO, after a thorough polishing, my teeth are looking even MORE fabulous, although she could not get all of the staining off in the crevasses of my molars. Or between my teeth where I thought the cavities were. But yeah, very pleased.

Updated on 1 Nov 2012:
I've added some before pictures. The after pictures have not been added to my dentist's account yet.
Updated on 21 Oct 2013:
So, I've been out of my aligners for...has it been a year? Yes! Thank you RealSelf...I could look back and see that it has indeed been a year since I finished my aligners. I've been in retainers since then, and I've been using them religiously. It is, of course, much easier than the aligners. You only wear them at night. BUT, I was having problems with the retainers hurting terribly. So then I'd wear them more. But then I couldn't close my mouth and eat properly during the day. So my dentist told me I was wearing them too much, and that I should only be wearing them at night. Eating is no longer a problem.

But here's the rub: With Invisalign, you get four sets of retainers. And each of them is identical. You need to break in each of them. My dentist had me on a 3-month schedule, so I was supposed to wear a set for 3 months, then switch to the next set, and then have them all four broken in after a year. I didn't do that. I wore the first one for five months, the next for 3, the next for 4. Anyway, I've broken them all in now, and I'm still on the fourth set of retainers. But man do they hurt when you're breaking them in! They're sturdier than the aligners, and for four days, my mouth was just a wreck. Still, even though I've been wearing these for two weeks, they are uncomfortable when I put them in my mouth and for the whole night. It's bearable, I can sleep, but it's not put them in and forget about them like it was for the aligners.

I think that when I go for my next appointment, I'm going to discuss getting wires or something. I feel like my teeth are just moving too much during the day, and I'm not sure why that'd be. I suppose it could be because I get up at 4:30 and go to bed at 9:30, which makes it a long day without the retainers. But even when I leave the retainers in until 11 a.m., I feel like there's a lot of movement by bedtime. I only eat dinner, so it's easy enough for me to keep the retainers in all day, but they're not comfortable, and I still lisp with them in. I'm not sure what to do. But asking my orthodontist will be first on the list. If I can remember.

Otherwise, still very pleased with the Invisalign. They certainly worked. I just want to make sure that my teeth stay the way they are now.


Updated on 3 Nov 2013:
Okay, at least I'm no longer in pain from the retainers. They're always a little uncomfortable when I put them in, but it goes away by the time I get to sleep. Also, I've been wearing them later most days, and they're broken in now. I recently had to take a video of myself speaking, and I can see that I'm still having trouble getting the English words out. I don't seem to have this problem in my other language. But I speak the other language more (even though I'm native in English and more comfortable with English) so I may just have had more practice speaking it with my new teeth. It may also be because the T's and S's are less strong in that language than in English. Anyway, I don't know, but it's a little uncomfortable talking when the retainers haven't been out for very long. It takes a few hours for my jaw to settle back into something I can talk well with.

Still happy with the way my teeth look. These are just small issues for me to remember to discuss with my orthodontist.


Updated on 7 Nov 2013:
Bummed. Just went to the dentist yesterday (regular, not ortho,) and what is normally a relaxing time to meet with my buds who work there and get a nice tooth massage turned into terror. I got the word: I need a crown. And also, I need my wisdom teeth extracted. And it needs to be surgical, since they're all impacted and the upper ones (which are the only ones to even start coming out) are too close to sinuses. They're all too difficult. Waaaaaaaah! I don't want to get my wisdom teeth out! I'm doing the crown next week, though. *sigh*.


Updated on 13 Dec 2013:
I'm so busy talking to everyone else, I forget to update my own darn review!  

Anyway, I got my crown but I posted about that on my crown review, so I won't say more about that.

The big deal for my Invisalign lately has been that I've decided that my increasingly common headaches and migraines, and difficulty chewing my food, as well as the return of my TMJ (with a vengeance) is as a result of these darned retainers.  So I moved my next appointment with the orthodontist up to yesterday, and here's what they had to say:

First, it is the retainers that's causing the problem, but more specifically, it's the fact that I'm clenching my teeth with the retainers in.  When I do that, I am pressing my molars up into my jaw and hurting myself.  When I take the retainers out, it takes a while for the molars to descend back into their regular positions.  Since I started wearing the retainers more and more, as an attempt to keep my teeth from moving too far, I've had more opportunity to clench and move those molars.  So, in order to alleviate one problem, I've exacerbated another :(.  

So, right now, I've been told to go back to only wearing the retainers 8 hours a day, max.  After six weeks, my teeth should be settled again.  At that point, we'll do some selective filing to make sure everything is the right height, and we'll consider doing a Hawley retainer for my top teeth instead of the Vivera retainer.  If I can't stop clenching with the Viveras, though, I'm going to request a full Hawley or a bonded retainer for the lower teeth.  We'll see.  Next appointment is in January.  I have to admit, though--my jaw is already less painful now, after just 30 hours of sticking to 8 hours/day.  So I'm hopeful that we can get this stuff squared away.

So yeah, if you're not feeling right about how your results are in any respect, you should talk to your doctor!  And don't be timid about it (like I usually am).  Talk like you know what you're talking about, and if you read enough on here, you will ;).

Peace.


Updated on 23 Jan 2014:
I had my follow-up appointment with my orthodontist's office today.  I haven't actually seen my orthodontist since I started my retainers, actually, but I saw the same orthodontist that I saw last time.  They did something I think they called 'equilibration'.  I will start off by saying I was actually pretty upset that they did not explain what it was first.  Nor did they ask me whether I wanted it done.  They just said they were going to do it, then started.  They made me bite down on this weird marking paper stuff, then they filed off parts of my teeth so they wouldn't hit each other anymore, and hopefully allow my molars to touch again.  It feels better now, and I can't see a difference, nor do my teeth feel more sensitive.  It did not allow my molars to touch again, though.  She was all ready to file more off, too, before I said I didn't want to just file off teeth until they fit together.  I wanted to stop clenching my teeth and making the problem worse!

I told them about how my jaw was constantly exhausted and that I'm still having headaches.  Then she suggested she fit me with a Hawley retainer on my upper arch.  So we did that, and it'll be done tomorrow afternoon.  I can't pick it up then, though, so my appointment is for Monday morning instead.  I'm excited and nervous at the same time.  I'll update with a picture when I get them.


Updated on 30 Jan 2014:
So I went and picked up my Hawley on Monday, and I have been wearing it…a lot.  I only got an upper Hawley and they didn't charge me for it, so I'm kind of assuming that they used my 'one free replacement retainer' for it.  I continue to use the Vivera lower.

The first night was misery.  The Hawley seemed so loose when I first put it in, but it started moving a couple of teeth that don't usually move in my Vivera.  So uncomfortable.  And it concerns me because then I wonder whether the Hawley will leave me with a different smile.  But two nights and an extra day in the retainer and the pain went away.  So hopefully it wasn't a big change.  I'd like to still be able to use my upper Vivera for whitening.

The best news is, however, that my open bite has diminished significantly.  It no longer bothers me at all, and I know it is resolving itself.  I no longer clench my teeth because the Hawley makes that supremely uncomfortable.  I'd still prefer to have two Hawleys, but I'm not sure I'm willing to pay $500 for the lower jaw when the open bite is resolving itself.  So…yeah.

If you are not well-served by the Viveras, at least a Hawley is a possibility to consider :).


Updated on 19 Feb 2014:
It seems like I might have started clenching again, since it is no longer uncomfortable to do so in the Hawley.  Because it's only one layer of plastic, the length of time it takes for my teeth to settle after wearing my retainers is much shorter now, but now I also have an issue with that one of my upper central incisors (on my right) is thicker than the other, so after wearing my retainers, the back of that tooth touches the lower incisors and it's very uncomfortable.  After a while, the teeth shift and they no longer touch.  

I'm so tired of my teeth going through this constant shifting day after day.  I just want them to be in the 'right place' for my mouth, and then settle there.  Is that so much to ask?!  Maybe I have a completely unreasonable expectation of what teeth are supposed to be like in my mouth.  Opinions are hereby solicited from you guys….



Updated on 3 Mar 2014:
I went to the orthodontist last Wednesday and kept forgetting to update.  It was my actual orthodontist this time--I think it'd been close to a year since I've seen her.  But I discussed with her all of my concerns and stuff.  The short of it is, if I want to move to a Hawley lower, it's only $250, which I think is worth it if I continue to have problems.  But for now, I sacrificed one of my bottom Vivera aligners and they cut them off just behind the premolars.  So now I have a tiny tray that only covers the front of my lower arch and I can't clench my molars anymore.  I still sometimes chew on the front of the tray, but not nearly as much as I did the backs before.  They also ground some more off of my front teeth so my lower incisors didn't get caught on that thick upper incisor anymore.I've included a picture of that cut-off tray :).
Updated on 2 Apr 2014:
My two front teeth started getting tight again.  So tight that food was getting stuck like in the old days, and it was harder to floss.  Soooo I went back to the upper Vivera (Align Tech).  I am immediately back to clenching, though it's less of an issue now because the equilibration and the half-aligner on the bottom.  However, the teeth had shifted so much in the Hawley that I have trouble chewing after taking them out in the morning, just like when I was in aligners.  I'd just have them cut off the upper retainer as well, but my teeth are moving all the way back to the first molars!  

So here is what I'm wondering.  Are my new wisdom teeth possibly the culprits?  They are coming in in my top jaw.  If I go to a bonded retainer, will the same thing just happen?  Gah.  Do I have to go to full-time retainer-wear in order to get this sorted?  I am not pleased.  I don't think I can bear full-time Vivera retainers, with the chewing problems.

But that's where I'm at, currently.


Updated on 18 Apr 2014:
I'm still using the Viveras and my teeth are back to where they're supposed to be.  There's no longer a great deal of movement during the day, I think, so I'm feeling happy about how things are.  I'm still using my cut-off bottom retainer and a full-length top retainer.  


Updated on 23 Sep 2014:
Okay--this has absolutely nothing to do with my Invisalign, except that we're using the same orthodontist, but my eldest daughter, who is seven, just got Damon Braces yesterday!  I had no idea they could start that young.  This is what they call "Phase 1", which is to make space for her adult teeth to come in and, hopefully, push out her baby teeth.  So far, her mouth is so crowded that that's not even been possible on the bottom.  In her upper jaw it's been working fine, but in her lower jaw, she lost one tooth naturally and had another pulled, and nothing else yet.

We're paying $2090 after a $2000 dental insurance payment for this first phase, which is estimated at 15 months but may end up being interrupted.  So excited for her, so I had to share :).  We also got a family discount, since I did Invisalign through the same doctor, and my husband got his Damon Braces through her.