Questions about Invisalign

[nug]

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Does it take longer to move teeth with invisalign than with normal braces? Can Invisalign be used with if one of your teeth has a porcelain veneer? How much more expensive is invisalign?
Thanks

 

[texas_dds]

hope this helps:

yes, invisalign can move teeth around as fast as braces, but its best for only simple alignment cases - so basically it depends on what you are trying to do with your teeth

yes invisalign is safe w/porcelain

a lot of cautious orthodontists will charge $6K per case b/c align technologies bills the doc $2k, and 1/2 the time the patient has to be finished w/brackets and wires. that is if you care about them having good occlusion.

 

[nug]

thanks, I was thinking about getting invisalign, but not for 6K

 

[ItsGavinC]

Are you a dental student? If so, you can get them for a much cheaper rate through the school.

 

[Gutta Percha]

Invisalign is great for cases of mild crowding, spacing and those with class I occlusion. It also works for other malocclusions but it is a little more difficult. It typically costs 4k to 5k depending on who does your tx. They have finished over 100k cases since inception. It is b/c the lab bill is between 1200 to 1800 depending on if you are doing both arches, A/P or just anterior.

From someone who has gone thru the invisalign training.

 

[45540]

I"m going to see about having invisalign done sometime this year since it'll be my first year in ... I figure it'll be the more convenient route ...

 

[tooth_sleuth]

I just started Invisalign, so far it seems good! 👍
I have mild-mod crowding in the mand. and they're trying to flare out my incisors. I have to say the 1st day I had them in my teeth were killing me!

The good thing about Invisalign is definitely the cosmetic aspect. Other dental students will of course notice but the averge joe you pass on the street can't tell at all!!

 

[predentchick]

My mother-in-law and aunt both had them. They had beautiful results! If you don't go the school route, go to the dentist who is the cheapest because you will get the same aligners from Dentist A and Dentist B. Just shop around and ask for quotes. I believe my aunt paid about 3,500 for both arches.

 

[Gutta Percha]

Go to the dentist that is the cheapest because they have the same aligners??? That is the most absurd thing I have ever heard. Different dentists have different tx plans and experience. With invisalign the doctor is ultimately the person who approves how the teeth move. So if one doctor doesn't have a good understanding, they might approve what the technician in costa rica shows them the first time. A well disciplined doctor will carefully review the movements and determine if the teeth are properly aligned and will request further movements.

 

[texas_dds]

thank you gutta percha - i was trying to think of a nice way to say just that

 

[RaiderNation]

Man, I don't know what orthos you guys are going to, but I talked to one about invisalign in Cali. He said that if I wanted invisalign it would cost me $2800 and the treatment would last 10-12 months.

 

[predentchick]

Go to the dentist that is the cheapest because they have the same aligners??? That is the most absurd thing I have ever heard. Different dentists have different tx plans and experience. With invisalign the doctor is ultimately the person who approves how the teeth move. So if one doctor doesn't have a good understanding, they might approve what the technician in costa rica shows them the first time. A well disciplined doctor will carefully review the movements and determine if the teeth are properly aligned and will request further movements.

Duh! I know that. I have been an assistant for years with a Dr who does it. What I was saying is that the aligners are the same: Meaning clear plastic trays. I didn't mean the techicalities of them. If a dentist is certified and has gone through the invisalign training they are qualified to get your tx to your desired result. That is what I meant. Sorry you were confused.

 

[3rdMolarRoller]

I will tell you all how it works out after I get certified this year 🙂

 

[DDSSlave]

Remember that invisalign has it's limitations and is really only effective for minor tooth movement. I would consult your orthodontist before proceeding. Some dentists may have you believe that your case is ideal for invisalign when in fact it is not. Keep in mind that braces may be needed after the invisalign tx for final adjustments.

 

[3rdMolarRoller]

You can get certified before you graduate? How much and how long does the course take just out of curiosity?

NYUCD put it part of the 2nd year curriculum last year. Right now we are the only school doing this, but I'm sure others will follow soon. The cost is part of the tution so I have no idea

 

[texas_dds]

invisalign cert 1 is an elective at UT san antonio starting this year
but you have to also be enrolled in the advanced preclinic electives to take it (basically our dept doesnt want to teach invisalign to anyone who couldn't finish out with a fixed appliance if needed)

and all the aligners are not the same
most orthodontists i know have to send back the "clin check" proposed modifications upwards of 3 times before they get a tx that will work well. if you get lazy or dont know much, you could just approve whatever they send the first time.
maybe im an occlusionist and that is why invisalign scares me -if there is no plan for occlusion, you will end up requiring either being finished out in fixed, or doing a lot of equilibration (AKA grinding on enamel) or else a person can have a problem finding a good CO/MI after tx. (my friend and classmate will vouch for this, she has some damn straight teeth but got invisalign through a general dds who had only done 3 cases before her - her occlusion is all messed up now)

 

[texas_dds]

oh yea the cert 1 course is 2 days for us, and would cost about 2K i think (but then i think they give you one free case so it pays for itself)

 

[predentchick]

and all the aligners are not the same

I still don't think you understood what I meant... oh well! It is said all over this board that if a dentist is qualified in a procedure they are going to get your desired results (MOST of the time, of course). I was telling the OP that more than likely both dentists will get you the results you want if you research their treatment and find it suitable. They both give you "the same plastic aligners" that IS invisalign. Anyway... just had to clarify.

 

[Gutta Percha]

I guess I find it funny that 1st and 2nd year dental students (and possibly pre-dental) are explaining procedures they really don't understand.

To the person who said they would be charged 2800 for invisalign, either the dentist was doing you a favor or it is not true. With the average lab bill for invisalign being 1600 and the average ortho overhead being 55%, the lab bill would completely take up the overhead. So the 1200 left would be designated for fixed expenses. The dentist wouldn't being making any money off of that.

 

[toothcaries]

🙂

 

[predentchick]

People on this board can be so arrogant and unreasonable. It is very unfortnate. Specifically the two above. 🙄

 

[texas_dds]

i hope i have not stepped on any toes, if so i apologize

yes all the aligners are invisalign's so they are the "same"

what is NOT the same is the level of scrutiny that the proposed treatment is given by the dentist/orthodontist. invisalign sends a digital proposal of treatment (clin check) that most often needs adjustment. so in the end, aligners for the same patient could be different depending on how carefully their treatment was planned.

 

[predentchick]

True. I know all of this. I have assisted on many clin checks. I have seen the progress on the computer, etc. I have faith that most dentists who certify understand the importance of occlusion, making my statement valid. It is also important to get a good feeling from a consult on the dr (like this OP would with their invisalign one). Anyway... no hard feelings. I just don't want to be taken for someone who doesn't know their **** cause I do, ya know? 😉

 

[texas_dds]

peace to predentchick

sorry for being abrasive

 

[Gutta Percha]

I came off harsh, but thats life. I found this forum b/c I was bored, and am a dentist--not a student. I wanted to help the mis-informed which I was before I went to school and going thru school. You may think you know a lot about dentistry because you've been a dental asst. or have been thru a couple of years of school. You just don't have the facts. Your relegating yourself to a "tooth technician" or a "molar mechanic" if you think just because you're in school or an asst. you know dentistry, and I do not want my chosen profession to go the route of car mechanic .I'm not trying to rag on anyone, but the real learning starts after school. I go to 50 hours of CE a year and still have a ton to learn. Just remember this is a profession not a job.

 

[busupshot83]

does invaslign correct cross-bites?

 

[trypmo]

[....]
(my friend and classmate will vouch for this, she has some damn straight teeth but got invisalign through a general dds who had only done 3 cases before her - her occlusion is all messed up now)

Anyone else have some invisalign-gone-wrong stories to share? I'm the type of person who really tries to consider, "what's the worst that can happen?" and in the case of occlusion (generally speaking) I'm of the impression that a small screwup can lead to a major pain.

Perhaps DT would also be a good resource for info on this.

 

[texas_dds]

are you talking anterior or posterior crossbite
it all really depends
oh and no skeletal posterior crossbites for sure

your invisalign patients are supposed to be done growing (NO kids!)and in class 1, among many other things. does anyone else get weirded out by the infomercials that make it sound like any orthodontic problem can be fixed with this?

 

[JattMed]

 

[texas_dds]

interesting question about "scoring"
Ive heard it being called 'circumferential fibrotomy,' and it does exactly what you said. basically by severing the coronal pdl fibers in a tooth that has been rotated in treatment, and allowing that part of the pdl to regenerate in the new position, you lessen the chance of relapse afterwards. i would prefer a periodontist do this on me, that is where my orthodontist sends his patients for the procedure. If a general doc is familiar w/the procedure and is experienced with making sure the gingival esthetic outcome is preserved, that would be fine too.

 

[JattMed]

Texas-DDS:
Thanks, I appreciate your reply.

 

[jeanne]

Can anyone (i.e non-dental student) get treated w/ braces/invisalign by going to a dental school?? I've been looking into invisalign and shopping around for the best price. Just curious...

 

[texas_dds]

jeanne
absolutely yes!
ut san antonio charges around $3K for a resident to do a comprehensive case

 

[jeanne]

jeanne
absolutely yes!
ut san antonio charges around $3K for a resident to do a comprehensive case

Really? What do I do, just call up my local dental school and find out how to get a consult appt??

 

[marmoreus]

#1: Invisalign certification doesn't mean squat.
#2: Just because two orthos use the same brackets doesn't mean you can expect the treatment to be equal.

 

[jeanne]

#1: Invisalign certification doesn't mean squat.
#2: Just because two orthos use the same brackets doesn't mean you can expect the treatment to be equal.

So are you saying I should stay away from going to a resident for treatment in order to save some $$? How many patients should an ortho have treated w/ invisalign in order to be considered seasoned/low risk??

 

[marmoreus]

I think you will do just fine to be treated by an Ortho resident. In that instance you are getting a resident and an attending faculty for less than the price of one doctor at a regular office. Both the ortho resident and the attending will have experience in orthodonics in general and at least some with Invisalign. I think it is the general ortho experience that is most essential. Of course going to an orthodontist who is very experienced in Invisalign would be a plus.

I guess I am saying I would never go to a GP for any siginificant ortho tx. I think it makes no sense. It is extremely difficult to really learn ortho through weekend courses. It just doesn't lend itself to that kind of teaching situation. It isn't about learning a specific procedure that takes less than an hour to complete and can be practiced over and over to achieve proficiency.

 

[Gutta Percha]

I guess I don't understand why one wouldn't go to a GP for ortho tx. By saying that then you are saying GP's shouldn't be doing full mouth rehab, changing VDO, doing any sort of TMD tx because they are all in the same realm which is occlusion. You probably don't understand occlusion because few people truly do and are making statements about something you don't have a grasp on yet. I would say it is much more traumatic for a GP to do a full mouth rehab chaning the VDO after they attend one of the weekend rehab courses than it is to do ortho. You are destroying vital tissue by prepping all teeth for crowns or onlays to create a new "bite". With ortho you are just moving teeth with a recreatable systematic approach (provided you go to a few decent ortho course). Should a GP treat every malocclusion? NO. But they can pick and choose cases to tx and do just as well as orthodontists.

If you are a GP and are limiting yourself in your practice, then go attend some good CE and learn new procedures and techniques. You can do some procedures just as well as specialists and patients don't like being shipped out of your office for every procedure.

 

[drben]

As an orthodontist, I must agree with the vast majority of Gutta Percha's post. There are very competent general dentists that provide "specialty" dental care that meets/exceeds the standard of care (inlcuding orthodontics). I would also agree that there are many dentists (including orthodontists) that do not understand occlusion, and the importance of developing an occlusion which is in harmony with the COMPLETE masticatory
apparatus (joint position in maximum intercuspation)

However, there are many GP's that THINK they are meeting the orthodontic standard of care, but fall woefully short; it's more than just getting the teeth straight guys. I recently agreed to see a GP's orthodontic patients for him while he was recovering from a major illness and was very disappointed with the treatment he was providing; type of mechanics for desired tooth movement was counter-intuitive, to say the least.

I support general dentists doing orthodontics, provided that a COMPLETE set of orthodontic records is obtained, a comprehensive treatment plan is developed, and treatment objectives clearly established PRIOR to strapping the case up. Orthodontics is no different than Endo, Pros, Perio, OS, etc...it's about case selection.

Best wishes to all of you still in the dental school trenches; life is better on the outside!! 🙂

B. White, DDS, MSD

 

[marmoreus]

Gutta: "With ortho you are just moving teeth...." : That's exactly why I wouldn't go to a GP who doesn't "truly" understand ortho. Any honest person will admit you can't learn ortho doing weekend courses. Doing ortho is very different from doing a denture set up with vital teeth. One may be an occlusionist virtuoso and do great full mouth pros cases, but that doesn't mean he/she will also do great ortho. Experience has shown me that your average orthodontist does far superior orthodontics (comprehensive ortho) than your average GP/Pedo. There will always be a few who can't be characterized this way, but in general this has been my experience.

As much as I enjoy ortho, if I were a GP I don't think I would do any. I just don't see how it would be efficient to do ortho in the context of a general dentistry office. Maybe if you could have someone screen some easy Invisalign cases for you that would make some sense. Otherwise you are asking for trouble without really getting that much in return.

 

[dort-ort]

Gutta: "With ortho you are just moving teeth...." : That's exactly why I wouldn't go to a GP who doesn't "truly" understand ortho. Any honest person will admit you can't learn ortho doing weekend courses. Doing ortho is very different from doing a denture set up with vital teeth. One may be an occlusionist virtuoso and do great full mouth pros cases, but that doesn't mean he/she will also do great ortho. Experience has shown me that your average orthodontist does far superior orthodontics (comprehensive ortho) than your average GP/Pedo. There will always be a few who can't be characterized this way, but in general this has been my experience.

As much as I enjoy ortho, if I were a GP I don't think I would do any. I just don't see how it would be efficient to do ortho in the context of a general dentistry office. Maybe if you could have someone screen some easy Invisalign cases for you that would make some sense. Otherwise you are asking for trouble without really getting that much in return.

I totally agree. Way too many GP's are under the false assumption that a couple of sessions at a stupid weekend ortho course will enable them to tackle ortho cases. Most of these courses are taught by GP's and Pedo blokes anyways. I am not one to put them down, however, GP's should just stick with class I malocclusions, period. If you want to do more than this fricken go to ortho residency otherwise REFER!!!!. I know way too many GP's who happen to treat class I mal. very nicely -- and thats all fine and dandy. However, then they start to get a big head and feel they can now tackle any ortho case. Sorry baby -- not so and thats when cases get screwed up. And I've seen way too many of these scenarios occur and feel sorry for the parent and his/her child. These GP's should not forget the motto -- a little knowledge can be dangerous. Stick with what you know the most.

 

[Gutta Percha]

I totally agree with all of you which is that GP's should not treat every case which is what I said in the first place.

However, by your logic then GP's should just be drilling and filling and leaving everything else to specialists. I've talked to endodontist that say if a microscope isn't used, then it isn't to the SOC. If you don't find 4+ canals on 1st molar then you violated the SOC. Implants shouldn't be done by GP's either b/c they can't provide the SOC for everyone.

GP's have to "pick and choose" what cases to treat in regards to everything in dentistry. If you become a "referodontist", then good luck on having a highly successful practice because half your income is out the door to the guy down the street.

I've seen too many patients where the braces just came off from an orthodontist I didn't refer them to where the bite is horrible. If GP's can provide in house ortho tx and do class I malocclusions with no TMD with no major skeletal issues and do a good job, then I think you are providing a good service to your patients.

Some GP's are stupid and think they can go to one weekend course and do impacted 3rd's and ortho, but that is not what I'm saying. It's called continuing education for a reason. GP's can provide great care for patients but they have to be smart enough to know when to punt.

 

[dort-ort]

I totally agree with all of you which is that GP's should not treat every case which is what I said in the first place.

However, by your logic then GP's should just be drilling and filling and leaving everything else to specialists. I've talked to endodontist that say if a microscope isn't used, then it isn't to the SOC. If you don't find 4+ canals on 1st molar then you violated the SOC. Implants shouldn't be done by GP's either b/c they can't provide the SOC for everyone.

GP's have to "pick and choose" what cases to treat in regards to everything in dentistry. If you become a "referodontist", then good luck on having a highly successful practice because half your income is out the door to the guy down the street.

I've seen too many patients where the braces just came off from an orthodontist I didn't refer them to where the bite is horrible. If GP's can provide in house ortho tx and do class I malocclusions with no TMD with no major skeletal issues and do a good job, then I think you are providing a good service to your patients.

Some GP's are stupid and think they can go to one weekend course and do impacted 3rd's and ortho, but that is not what I'm saying. It's called continuing education for a reason. GP's can provide great care for patients but they have to be smart enough to know when to punt.

Ditto my brother, you've crystallized my thoughts so eloquently. I second that motion!!