Week 10 Invisalign - I have bone loss on the lower teeth and the teeth are now very loose. What is the best course of action?

Question

My orthodontist had suggested a wire on the back of the teeth after completion of treatment. and seeing a periodontist at that point. I'm concerned that without a guard the teeth would fall out when eating anything hard - ie apple. 1. I'm concerned about proceeding further with Invisalign. 2, Would teeth have a better chance of stabilizing with gradually moving back to old position (using old trays)? 3. see a periodontist at this point -bone grafts?

Neal Nealis, DDS (retired) · Answer

You ask a good question. Dentists frequently move teeth and expect the bone to follow. The bone does not follow. It stays in place and teeth move through it. You can even move teeth right out of the bone, and this happens quite often. You need to get a CBCT type x-ray to see the roots and bone in 3-D. Most oral surgeons and most specialists have this type of x-ray system available. Once a tooth is moved out of bone, it cannot be moved back again. It just doesn't work that way. It can be done, but a bone graft will be necessary and I'm now certain of the effectiveness. You would have to ask a periodontist or oral surgeon. Dr. Donald Enlow wrote an excellent textbook regarding facial bones and teeth. It's called Facial Growth. I read it after encountering a problem with one of my patients similar to yours. Difficult book to read. Ask your dentist if he has read it. He should. I have attached a link to Amazon.

Week 10 Invisalign - I have bone loss on the lower teeth and the teeth are now very loose. What is the best course of action?

Answers (1)