Nahal Ashouri, DDS, MS

$8K before insurance. Ouchie pricetag and yet, worth every penny. I would not go to a general DDS just to spend $3K less. This is a once in a lifetime thing, and it's worth paying for the specific orthodontic expertise and follow-through to get it right.

I had always loved my smile and had been complimented on it my whole life. I would never have though of orthodontia as something I would consider, it seemed frivolous. In my 40s, my teeth shifted a bit, and I started having gum problems that concerned me enough to consider it, and I have great insurance now, so I went ahead and did it. And, wow.

The results were far more dramatic than I ever could have expected. (Photo attached.) Creating symmetry and widening the arch made for a dazzling outcome.

I picked the only Board-certified orthodontist in the area, who uses panograph x-rays rather than molds and has the computer-generated trays made to change every week instead of every 2 weeks. A note here when choosing a practitioner -- the computer generated trays are thinner than the ones made from molds. Even with these, my speech was affected, mainly because of the ramps in the back of the teeth.

The incremental trays weekly rather than abruptly every 2 weeks means a huge difference in comfort and in gently moving the teeth. I opted to use Acceledent to enhance bone modeling, because I have bone density issues. I did not elect to reduce the treatment time. My total was almost 9 months. I could have reduced that to 4 or 5 months with the Acceledent but did not.

I went into it thinking my case wasn't particularly complicated and so I was surprised to have so many attachments and ramps. The significant unexpected side effect is that, in realigning my bite, it must have taken the pressure off of my temporomandibular joint (TMJ). As a result, both the frequency and the extremity of the incapacitating migraines that have affected me my entire life were reduced to almost nothing. Huge, huge benefit upon which I could not put a dollar value.

My teeth are unstable for now -- you can even see in the after arch photo that one of my front teeth immediately drifted back. My ortho made adjustments to 'activate' that part of my retainer and is keeping close tabs on it.

Essential recommended purchases, all available on Amazon.
VIOlife dental spa uv/ultrasonic tray cleaner (sometimes can be found half price on eBay) $50
Retainer Brite cleaning tablets (I broke them in half)
VIOlife slim sonic toothbrush to keep with you at work, meals, gym $10
Opalescence whitening gel to use with retainers (Same brand as the $150+ treatment in office.) $20.
LED accelerator light (make sure it has 5 LEDS), about $10

Tip for women who love lipstick: you're going to have to stick with lacquer-type no-smear ones until you finish your plan. They are all somewhat drying, so plan to do lip exfoliation at night.
The only brands that stay on your lips without getting on your Invisalign: Kylie Jenner (I hate to admit it, but it's the best product), Stila Stay All Day, Sephora cream lip stain, Maybelline SuperStay 24, Makeup For Ever Aqua Rouge. Any kind of chapstick or lip balm will take them off. Plain coconut oil is my favorite makeup remover.

I am half way through my predicted invisalign treatment (50 retainers in about 30 weeks). My ortho has invisalign make twice as many retainers, so you change every week. Then I added in acceledent so I change every 4-5 days, sometimes longer if my teeth feel sore.

So far, I am quite happy with the progress. The retainers were terribly painful the first few days but now they range from fine to annoying. In general, it's a lot more crap in my mouth than I had anticipated - I have the buttons, bite ramps, power ridges, rubber bands at night, IPL- the whole nine yards!! So it does impair my speech. However, I love that i can take them out for important meetings or presentations at work. I do have days where the retainers are out longer than they should be. Those weeks I add 1-2 days on to the time I wear that retainer. It slows me down, but I can't have my speech impaired at work.

Still a long way to go and right now my teeth look pretty funny because there is a weird gap between the front two. My ortho is very happy with the tooth movement so far. I am not sure one tooth in moving enough, but it still fits the retainer perfectly. I am also worried that my gums seem to be receding a bit.