I've Had Two Very Contradicting Consultations About Invisalign... (photo)

I have mild crowding on the top and bottom and three of my teeth protrude slightly. He recommended 15 months of trays and to create a bit of space he would file the sides of the protruding teeth. Today I went to another specialist. She said she never recommends invisalign because it is a less permanent solution. She wanted to extract four teeth to create room and use traditional braces for 18 months. I see this as way to intrusive..but which dentist is right?

Doctor Answers 4

Invisalign vs Braces

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Great question!  From your description and the photo you've provided it is not possible to give a definitive answer to  your question.  If I were examining you I would ask myself what my goals were as an orthodontist, and then I'd ask what yours are as the patient.  In general, when I examine a patient I ask myself how I would achieve an ideal bite and smile.  If you have a significant overbite and crowding I might conclude that the best result would be obtained with braces.  On the other hand, if you told me that you were strongly opposed to wearing braces (and many people are!), and asked what Invisalign could do, I'd evaluate what results could obtained with it and explain them to you.  This way you are in control of your treatment and you fully understand the alternatives.  If I limited myself to using only braces or Invisalign I might not be able to explain the differing treatments to you.  Bottom line: I would suggest getting an opinion from an orthodontist who is highly experienced with both types of appliances.

Seattle Orthodontist

Invisalign for Protruding teeth

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I am not an orthodontist, however I have had a good deal of success using Invisalign in cases like yours.  You may require a small amount of slenderizing to make space -- but it would be a very small amount and we could accomplish it creating spaces smaller than 0.4mm...If you were my patient, I would do Invisalign first and finish your case with some gingival contouring to help minimize the gumminess of the smile.  I would NOT have your teeth extracted to make space.

Invisalign or Traditional Braces Extract or Don't

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You have a complex situation.  Your answer partially lise in the expectations of the results you hope to achieve.  Invisalign would work and provide a satisfactory result for some people.  We as clinicians know that in cases like yours we get a much better result from traditional braces.  You have moderate crowding, a class 2 dental relationship and a little bit of a gummy smile.  Most docs can get your teeth straighter wit invisalign and traditional braces.  A really top-notch doc can get you a much better result with traditional braces.  I would try to do it without extracting teeth.  MAny people get a sunken in look when they have teeth extracted.  You must be very careful.  It is much harder and more laborious and expensive to do it without extractions but you can get a better result.  Also look at PAOO (periodontally accelerated osteogenic orthodontics).  Also tads would be use flu in your case. Keep getting consultations and see before and afters of similar cases from the clinicians.  Your best choice will become more evident.

Lawrence Singer, DMD
Washington Dentist
5.0 out of 5 stars 4 reviews

Which orthodontist is correct?

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I assume both doctors are Orthodontists.  As far as the one doctor saying that Invisalign is not as permanent a correction, this is both true and false perhaps in your case.  A well treated Invisalign case is just as stable and permanent as a case treated with braces.  What she may be referring to is the fact that there is a limit to how much expansion and filing (slenderizing) you can do to create room before the final result is unstable.  As it usually is necessary to extract one tooth in each quadrant.... if you do extract teeth the decision becomes do I extract 4 teeth or no teeth.... a black and white choice for a borderline problem.  As Invisalign has a much harder time dealing with extraction problems I can see why someone who wants to extract teeth would not recommend it.

I would certainly get more opinions, but realize that there probably is not an ideal correction to your problem as nonextraction treatment may just be less stable (meaning you really really will need to wear retainers at night forever!)

Robert Waxler, DMD, MS
Saint Louis Orthodontist

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.