Most of my 'nightmare' involves the orthodontist, but the aligners weren't right for me either. So begins my brief experience with them:
About myself -- 40ish year old male with TMJ, minor crowding of lower teeth, which started to push the upper teeth slightly out of whack. I have a deep bite, i.e., with the lower teeth hitting the gums above when my mouth is closed. My teeth rest comfortably against each other when my mouth is closed as well (I mention this for reasons you’ll read below).
Because I have TMJ, I originally inquired about what could be done to remedy the headaches and muscle spasms I’ve had all my life, starting a few years ago. I saw two dentists/specialists, and they both let me know there wasn't much that could be done about it. However, possibly changing my 'deep bite' with braces might help.
Well, the first dentist said my face was not perfect, and if I got the braces, what I ought to do is get the facial surgery, and what would happen is they'd cut and shift my jaw forward and then 'fix' my pointy chin. This was all very interesting to me, because I never really thought there was anything wrong with my face (nor my pointy chinny-chin-chin) to begin with?
I asked about Invisalign, and he said no, my teeth were just a little too crooked, and upon further inquiry, he said he didn't care for Invisalign, and rarely recommended them. In other words, I don't think he did them at all. Not that it mattered, I certainly wasn't interested in facial surgery, and a little insulted at the suggestion, so I decided to get a second opinion.
So I spoke to a second dentist/specialist, and he also (more kindly) made the suggestion about the facial surgery for perfect teeth and jawline, but was more clear that there's really nothing to be done about the TMJ. He suggested traditional braces to straighten out the teeth, and also did not recommend Invisalign.
I also saw another fellow, who seemed rather old and slow-moving, and his office equipment even older (medieval, really, like out of the 50’s or before). He recommended a home-made ‘appliance’ that would clip to the inside of my teeth (like a retainer, perhaps?) and ‘push’ my teeth forward prior to getting braces. He wanted $50 cash for that assessment — and only dealt with cash (no credit cards or insurance accepted!). I wasn’t interested in that at all, but looked him up out of curiosity, and he was 92 years old when I saw him! I wasn’t sure if he’d make it through the 3 years he felt I would need braces, but I was impressed he was still working at that age. I notice his office is closed down now, but I hope he’s doing okay…
Anyway, I let a few years go by, and then I recently saw an ad for a coupon to another local orthodontist who specialized in Invisalign -- and at a cheap price! $3000 and you get a free iPad. My frugal nature overcame my sensibilities...
So I visited with this orthodontist, and something within me just said there's something wrong with this guy. I thought maybe his quick-tempered demeanor was throwing me off. I decided to not let any prejudices stand in the way. His assistant (and they always have an assistant to act as a marketer or go-between) said his personality was due to the fact that he's a perfectionist. Okay, whatever.
So he also prefers the facial surgery for most all adults (really, what's up with that?), but we can do the Invisalign if that’s what I really want — he just won't be happy with it, because I won't have 'perfect' teeth in his view. In fact, he said he’d be losing sleep over it. Well, I said I wasn't asking for perfection, but at this point, and TMJ aside, I wouldn't mind just straightening out the teeth. I figure they're only going to get more crooked as I get older, and I’m not getting any younger!
So unlike the other dentists that would go ahead and do an impression gratis, this orthodontist wants a $2500 down payment and we’ll get started. Another $2500 would be paid over time. Hey wait a second -- what about the $3000 coupon? Oh yeah, he says, and scribbles some numbers down on a pad, this time $4000 total. Umm, why is it still $1000 over the coupon? He explains the coupon doesn't apply for folks with my 'significant' teeth problems and it'll just have to cost more, but I was already getting a deal at $4000. Oh, and no iPad. So I tell him I'll think about it. Considering my earlier offers were $6500 and $5700, and those were for traditional braces, I was still listening…
I think about it, and I liked his little assistant who I'd probably have to see more than him anyway, so I agree and plunk down $2500 cash for the down payment. They wanted that immediately, and then they took some impressions to send off to Invisalign.
Well, the little assistant does her best (she's perhaps 22 years old? And right out of school) to do the impressions, but she can't get the large tray in my mouth. I'm gagging! So the ortho comes over and says, No, this is the way you have to do it! He takes his hands and crams the tray hard up into my mouth, knocking my head back! He tells me to use my hands to hold it in for 5 minutes to get good impressions for each tray, or we'll have to do it all over again. Ugh... I'm starting to panic on the inside, like an anxiety attack. I decide to just use one hand to hold it in while they were helping someone else, so I can play with my iPhone to help calm me down. They have 4 chair/beds there, all next to each other (no sense of privacy), so I was a little uncomfortable having to look at the other patients while assistants were doing whatever they were doing to their teeth…and they watching me.
Finally, after about an hour, they get all kinds of impressions that required sticking cotton in my mouth and trying to keep my teeth as dry as possible, with my mouth as wide open as it can be (and with my TMJ, it doesn’t open wide, and hurts to do so). More irritatingly, was a piece of plastic film they used with the impressions, that forced my tongue back into my mouth. Why couldn’t they remove this excess piece of plastic? It’s just like the plastic (ceran wrap?) you use to wrap up your food for lunch, so that was making me angry. But let’s just be strong and get through this, I think to myself!
Great, the impressions are done, and I’m told that’s the worst of it. Whew! Everyone tells me that when the aligners arrive from Invisalign, we’re just going to pop those suckers in, and I can go about my way, with a nice thin piece of plastic polymer aligner, perfectly molded to my teeth - practically invisible to anyone looking. Sweet!
But it doesn’t turn out that way.
I get the call to come in to get my aligners, and that we’ll need about an hour to put the attachments on. Attachments?? What?? Okay, okay, I did read online that ‘buttons’ may be necessary, but I really didn’t like this idea, and the ortho never mentioned it. So I get there and sit in the chair/bed and ask the orthodontist about it, and he’s like, Oh yeah, it’s no big deal. The assistant will glue them to my teeth, both aligners (upper and lower) will go in, and I can enjoy the rest of your Saturday! Umm, okay. I’m getting nervous, and one of the main reasons why I was more attracted to Invisalign was that I didn’t want anything stuck to my teeth. But they assure me that the attachments are small, no one will notice, and it won’t take long.
Despite everyone’s assurances, this experience, for me, was even worse than the impressions by a long shot. The little assistant starts by stuffing cotton in my mouth (ugh, not again!!) and then explains that she’s going to remove something from my teeth to dry them out. I didn’t quite catch that, but I ask if this is going to be removing the enamel from my teeth, or otherwise compromising them in a way that would cause cavities later in life? She assures me that nothing of the sort is possible. From what I read online, this appears to be true, as long as the doctor knows what he’s doing. But she’s doing this, and does SHE know what she’s doing??
So she rubs on them with something or another, starting with 5 lower teeth that’ll need 7 attachments. Interestingly, 2 attachments would go on each of my lower K9 teeth. I’m doing my best to stay calm, and it’s taking FOREVER for her to fiddle with the template-tray she’s using to get the glue prepared. In fact, it took her over 40 minutes!! The entire time, I’m sitting there with my teeth and gums exposed to the air and the cotton and having them to be blown dry multiple times while she continues to struggle with the glue! I’m about to have a full on panic attack, so I say I need to get up and walk around. I finally let my pride down a bit, and ask if there’s anything they can give me to call my nerves (laughing gas anyone??) but they say they don’t do that. Why not, I think? Are orthodontists not certified/qualified to do gas? I’m thinking it’s probably just because this guy’s cheap, and he doesn’t want to spend the money on it. Whatever the case, I couldn’t calm down, and my nerves are escalating!!
Once she finally gets the gluey bits prepared, it goes on my teeth with the aforementioned template-tray, and it feels like she uses something hot to activate the glue to force it to stick to my teeth. Thankfully that part doesn’t take long, but once the template-tray is removed (and they had a tough time of that), I get a quick sense of what these attachments feel like. I immediately think, Wait a second — I can’t close my mouth properly! The attachments are hitting the upper teeth like Frankenstein, and worse, making me bite my lip, and it’s making my bite go in a crooked direction, which can’t be good for the TMJ, right?? This is horrible, I think to myself. I tell them I’m uncomfortable with these attachments, and the little assistant assures me that I’ll get ‘used to it’ and that it’ll ‘all be worth it in the end’. (I mention this in quotes, because I can’t tell you how many times I would hear this by various people, and at this point I’m thinking, yeah, I could cut off my arms and ‘get used to it’, but why the heck would I?? And at this point, it’s not looking worth it in the end, if this won’t allow me to chew or bite correctly!!)
I walked around a bit more, and thought about it while the assistant struggled getting the upper tray prepared. I kept touching the attachments, looking at it in the mirror, and trying to get used to it, but I can’t. I walk over to the Ortho’s private office, and ask if I can talk to him about this. I tell him that I don’t think Invisalign is right for me after all, and maybe we should come up with some other plan? He gets defensive, and said the only other option would be traditional braces, and if I don’t like the attachments now, then I’m certainly not going to like braces! I concur.
But he says he can probably help by polishing the attachments down. So, we go back to the chair, and he starts polishing away at them. He motions at me to tell him if I’m okay with it now, and I feel around and close my mouth, but it’s no good — although the attachments are no longer sharp and cutting the inside of my mouth (literally!) they’re still preventing me from closing my mouth or biting properly.
He gets defensive again, and points to the 12-14 year old girls in the other chairs, and says that THEY aren’t being babies! He barks that I’ll be wearing the aligners all the time, so why do I need to close my mouth all the way? I reminded him that I NEED TO EAT. So he sighs in desperation, and says Okay, let’s remove the attachments and just wear the top tray first. That way, it’ll move the upper teeth first, and make more room for those lower attachments later. This sound reasonable to me, and I’m wondering why this wasn’t the initial plan? I read a lot online that it’s typical to start with any kind of braces with the upper teeth, to make room for the bottom ones. But he’s the expert, right?
So he angrily drills off the attachments, one by one, then asks me if it’s all good now? I feel around, and I still have gluey sharp bits, so he polishes or drills some more. I don’t know what this guy is doing, but my teeth hurt like *$(#$* now, and it’s 2 hours later, and I’m tired, and he’s tired, and we’re starting to attract attention from his other patients (the teenaged girls who are looking concerned at all of this drama), and I’m starting to make him look bad (perhaps).
At this point, I’m pretty afraid of him doing anything more in my mouth, so even though I still have some gluey bits, at least they’re not hurting me, and I can close my mouth normally again. I say it’s good, and so he pops in the upper tray. For the sake defusing the situation, I make some conversation about how I found these plastic hooky things on Amazon that help you remove the aligners (sorry, I forget what the product is called now, but it WAS helpful). He gets defensive about this as well, and asks why in the world did I get those?? He says just to use both fingers from the back teeth, and they’ll pop right out. Okay, whatever. I try, but I can’t pop the upper tray out by myself, so he does it for me, and then I pop it back in. I’d be using the hooky things later…
The first thing I notice with the upper tray, is that the quality of the aligner is not at all what I was expecting. The commercials show a very precisely thin cut piece of plastic that goes over the teeth, matching the gum line, but this just looks like something close to what a boxer would wear (okay, not that bad — but it’s not pretty). It feels too thick, easily gets water/saliva in it, and shows bubbles on the front teeth! It’s not invisible at all! At least, not for me.
I sigh at this, and say it’s good enough, I just want to go home (at this point, it’s almost 3 hours later…).
I wear it for a few days while I evaluated it, but my final decision to discontinue Invisalign was due to the fact that the aligners were too thick for me. Apparently my deep bite isn’t compatible with these aligners Invisalign sent me, and it always felt like I was having to keep my mouth slightly open all the time — and that was just with the upper aligner! Had I put both in there, there’s no way. I’d be gagging all the time! And no, I didn’t want to ‘get used to it’. (Just FYI, they mold them all the way to the very back molars.)
Between that, and the not-so-invisible look of it, the poorly designed plastic that I could feel with my tongue (and it’ll cut your tongue if you don’t watch out!…or not have your Ortho file it down…), I just decided it wasn’t right for me. This seemed like a huge hassle with something way too expensive. In the end, it was just a big, expensive mistake. :-(
Maybe I just wasn’t motivated enough, or perhaps the experience with the Orthodontist from you-know-where just put me off of it, but I finally got my nerve to call him back and tell him I thought he was an incompetent jerk, the aligners weren’t right for me, and asked if he was going to hold me to the contract to pay out the rest of the money. I haven’t heard back on that score yet, but he said he’d mail me a letter back with the final disposition. I hung up on him, and that was that.
1) First and foremost, don’t be cheap; find a Orthodontist you trust, has a good history with ALL his patients (not just a few good google reviews) and has many years experience. I looked this guy up on Peoplesmart and discovered he’s only 35 year old. Yes, that should be enough experience to do what he’s doing…but I think I would have preferred someone with a bit more experience (and wisdom in dealing with patients). He looked older, though.
2) If your gut feeling is telling you something about the ortho, then don’t go any further. Remember, it’s your money and your teeth. If something isn’t going wrong during the procedure, make them stop and make sure the EXPLAIN everything they’re going to do to you, through and through. This will help with any anxieties as well.
3) If there’s going to be a little assistant doing all the work, make sure he/she is also well experienced, and know what they’re doing.
4) Ask about the attachments. Will it affect your bite during treatment, and how? Unfortunately, much isn’t known until Invisalign sends you the trays, and you’ve already bought them at that point…
5) The other Orthos I visited were willing to talk a lot about treatment, and offered a lot of information without me having to ask much. This is a good sign. And the other (probably more reputable) Orthodontists were probably right; Invisalign wasn’t right for me. Traditional braces probably would have been better, but I just wasn’t interested in that.
There’s some other lessons in there, but after typing all this up, I’m a little beat, but I only hope that this will help someone else before they make a big expensive mistake as I did. It’s quite possible that wire braces will be better for you. Are you happy with your face? Then don’t consider the facial surgery. I shutter to think if they’re always recommending this with younger females, who would be much more sensitive to such ‘advice.’ And from what I’ve read, it’s terribly expensive (like, buying-another-car expensive), and just offers an ‘easy’ option for the Orthodontist to make things perfect.
I notice Orthos tend to prefer their method of doing things, and each one of them offered different solutions for me (ie., one said I’d need rubber bands, another said I was too old for that).
Invisalign is still relatively new (at least to many aging Orthos), and they don’t like to recommend it (or perhaps aren’t licensed for it?). Whatever the case, many of them feel they have better control with wires, and I’m sure that’s true.
Also keep in mind, that if you’re just wanting to straighten your teeth out for vain reasons like I was, keep in mind that most people are probably not even looking at your teeth, and if they do notice the crookedness, they could probably care less.
In the end, I came to that conclusion; who’s really looking at my teeth anyway? I’m okay with them the way they are, even if they’re not perfect.
So far, $2500 down the drain. We’ll see what happens next…