Do you have to wear upper and lower refinement trays?

Question

I only have two weeks left on my Invisalign treatment. My uppers look perfect. I have one tooth that needs tweaking on the bottom. Do I have to wear upper and lower refinement trays? Or can I just wear a lower refinement tray and keep a retainer for the top?

Steven Davidowitz, DDS · Answer

There may be times when a refinement needs to treat both the upper and lower teeth in order to achieve the desired result. For example, when treatment is completed you are bothered by two lower front teeth that are slightly crowded while your uppers seem perfect, however, it may be necessary to move the position of the seemingly straight upper teeth slightly in order to move the lower properly. Therefore, it would be necessary to wear both upper and lower trays that are actively moving teeth . In the same case scenario, if there is no need to move the upper tooth and the lower tooth can be moved into the proper position alone then your dentist  can order active aligners - that are actively moving the lower teeth and passive aligners - that are passive and do not move the uppers.  This will negate the need to order upper retainers during the lower refinement period.  Thereby allowing you to start the retention stage at the same time for both the uppers and the lowers.

Sarah Thompson, DMD · Answer

Hello Liz,To answer your question, please wear the upper tray for two more weeks as instructed.  The best advice that I can give you is for you to please continue to follow the recommendations of your doctor.  The biggest problem with Invisalign is patient compliance.  In other words, the doctor tells the patient to do one thing and the patient does something else.  Then, when the Invisalign treatment is expected to end, the results are not exactly what the doctor expected.  This is one of the reasons that orthodontists prefer locking patients into metal braces over Invisalign.  The truth is that Invisalign is extremely effective when worn as instructed, so bare with it a little longer because it's almost over. Good luck with everything.

Janet H. Stoess-Allen, DMD · Answer

One of the great options when using Invisalign is that they offer something called refinements after all of the initial sets of trays have been worn. The reason for this is to “tweak” the final product. If there are any teeth that have not moved fully into the designated positions, and if desired, your orthodontist can request up to 3 refinements at no extra fee. That is, of course, if you have been treated with the comprehensive Invisalign product. Make certain to ask your orthodontist about the different options that Invisalign offers before beginning your treatment. If a refinement is needed or desired, new impressions or a scan can be taken of your teeth, sent to Invisalign with the requested changes to be made, and shortly thereafter new trays will be sent for you to finalize your treatment and address any concerns. Your orthodontist should discuss the desired changes with you so that all of your concerns are addressed.Many times it is imperative to treat both upper and lower teeth in order to accomplish the changes that are requested. For instance, if a lower front tooth is slightly rotated, it may be necessary to change the position of an upper front tooth slightly in order to move the lower properly. Therefore, it would be necessary for you to wear both upper and lower trays that are active. In the same case scenario, if there is no need to move the upper tooth and the lower tooth can be moved into the proper position alone, Invisalign may send trays that are actively moving the lower teeth and trays that are passive (holding trays) for the upper. Every situation is unique and must be addressed properly so that you receive the best possible outcome.

Do you have to wear upper and lower refinement trays?

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