Crooked Teeth - Not the Ortho's Responsibility?

8-month into Invisalign treatment, I realized that the back teeth, impacted, crooked and misaligned, had not been corrected. When asked why it was not addressed, the ortho responded that because it was not specifically brought up in the initial consultation therefore it's not his problem and cannot be fixed with Invisalign anyway unless I pay extra for additional appliance. Is this true - that I as the patient have to know all the things that's wrong with my teeth before entering any treatment?

Doctor Answers 5

Patient responsability...

At the initial consultation you are supposed to address the complains regarding the position of all your teeth in your mouth. This way your dentist will specifically request that into the treatment plan form.
There is a specific spot into this form asking what is the patient main complain?
If you miss something to address to your dentist at the initial consultation you still have the opportunity to bring it up and modify once the clean check is ready.
Thank you,
Dr. Barba

Santa Ana Dentist
5.0 out of 5 stars 1 review

Invisalign or braces treatment require good communication.

I was sorry to see your question.  As so many times is the case, good communication is king.  These things should of course be discussed before treatment is undertaken so that a clear understanding is present.  The orthodontist should have done a thorough evaluation and discussed his findings including any limitations seen.  It also is important for the patient to bring up any concerns they might have before the treatment is started.  This is just common sense and can avoid the type of problem you are having. Our office has a policy of satisfying both the patient and myself with the result, so sometimes we have to keep adding Aligners or even a short time in braces(no additional cost) until we get it right.  The patient's happiness with the result and my personal pride are more important than any profit motive.

Kent Lauson, DDS, MS
Denver Orthodontist

Correcting Back Teeth with Inivsalign

You and the Doctor are both correct.  A prudent dentist would perform a thorough examination and explain the need for treatment that you did not bring up.  If you said your concern was the front teeth and that is what has been addressed, then your problem has been solved. Sometimes, Invisalign, with advanced training, can correct tipping of teeth in the back and other times it will take other orthodontic techniques. 

Mickey Bernstein, DDS
Memphis Dentist
5.0 out of 5 stars 1 review

Invisalign has some limitations

Invisalign is an excellent product, but it does have its drawbacks.  I agree with Dr. Timmerman in that every office is different and each has its own philosophy, especially when it comes to informed consent.  In my office, we review the virtual movement of the patient's teeth and obtain written confirmation from the patient stating that he/she is pleased with the virtual result and that it is "OK" to proceed with having the Invisalign aligners fabricated. 

It is the responsibility of each and every dental provider to inform patients of their preexisting condition, including teeth that are in malposition which may not move with Invisalign alone.  If you were adamant about not having "traditional ortho" (i.e., brackets), then perhaps your provider did not consider that as an option for you. 

Fortunately, it sounds as if you are in the midst of Invisalign treatment.  Perhaps now would be a good time to speak to your dentist about alternative options that will provide you with an optimal result. 

Good Luck!

Molars rarely change much with Invisalign®

Every office is different, but in our office we ask what your chief complaint is at the beginning.  Before Invisalign is started, the computerized plan of treatment is shown to the patient and if accepted the aligners are ordered.  If some teeth on the screen do not move, the patient can ask why and perhaps look into alternatives.

Invisalign has many limitations, among them is molar movement.  If molars are rotated, they won't be going far.  Most orthodontic cases, especially adults, are seeking a result that can be seen (front teeth), so unless specifically asked, many dentists will focus on the smile.

Changing molars usually requires wires and brackets, not Invisalign.

Lance Timmerman, DMD, MAGD
Seattle Dentist
4.3 out of 5 stars 6 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.