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Thomas P. Connelly, D.D.S.

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Crooked Teeth? Exploring New Options For Adults

Posted: 08/26/11 12:31 PM ET

Today I want to talk about a very common issue that in the last few years has gotten rather complicated. That issue is crooked teeth and braces.

We all know what braces are and we know what they look like. Basically, braces are metal bands affixed to the teeth, and their purpose is to straighten them over time. They are very effective at doing just that. However, braces do present a problem -- they don't really look all that nice. Usually, this isn't a huge issue, because the largest group that uses braces is young children. Not that we don't want our kids looking good, mind you, but children -- especially young children -- are definitely less self-conscious in terms of "looks". Plus, when they are young is the best time to tackle crooked teeth.

That said, many adults now opt for teeth straightening. And because adults are far more apt to be interested in their everyday appearance, technology has answered with a few options beyond the "silver railroad tracks" that are a part of many children's smiles. Available today are ceramic braces that are much like their metal cousins, the big exception being they are more in line with tooth color. But also available is a new technology of "clear" braces that goes by the name of Invisalign. Which is what we are going to talk about today: Invisalign braces vs. traditional metal braces.

I'll state here in the beginning that it is very difficult to find any real, objective studies regarding Invisalign. The reason for this is that almost any information available now is paid for by or slanted towards one or the other. Even sites that have a name that appears to be objective are generally just touting one side. Therefore, much of this post is my own opinion (however, as a NYC Cosmetic Dentist I am in a pretty good position to have one about this.)

Let's start by stating something somewhat obvious: The big advantage to Invisalign is looks. Because they are clear, plastic-like "slip on" devices, they detract very little (if at all) to one's physical appearance. I can state firsthand that they do look good (well, good as in "not being able to tell they are there.") So they are very popular with the adult crowd for this reason alone.

There are a few other advantages as well, such as being able to take them out when eating. This is not only great from a comfort standpoint, but also because you can eat just about anything. Also, food doesn't get stuck in odd places, so cleaning teeth is easier and the risk of plaque is lessened.

But here's the big question that everyone asks me: Does Invisalign really work?

From what I can tell, yes, Invisalign does seem to be a viable alternative to "regular" braces -- for the most part.

I say this because I have heard (and read) enough to state that for some situations, Invisalign may not work as well as regular metal braces, and may even need "regular" braces to finish the job.(1) This becomes especially true if you have severely crooked teeth. Also, it would appear that premolars have presented a bit of a problem for the Invisalign braces.(2) Again, there is a lot of information out there, but most of it is written by dentists who offer the Invisalign product, so you have to take what you read with a grain of salt.

Ultimately, I do think the product has merit, but I would advise any patient really to have a real discussion about this issue with his or her orthodontist before making any decisions.
] go to the professional who makes his or her living straightening teeth, meaning an orthodontist instead of a dentist. This won't make many of my dental colleagues happy, but I feel very strongly that we dentists should really stick to what we know and let the orthodontists do their thing. There's also an ongoing class action suit regarding the Invisalign company dropping professionals who did not meet a quota.(3)

Lastly, like I mentioned earlier, in many cases, it would appear that Invisalign doesn't do the entire job. A patient may need regular braces at the very end of his or her treatment anyway. I don't know about you, but I would be more comfortable with the professional who could do the entire job -- which most dentists cannot. And again, I say all of this as a dentist.

So there you have it. I do think Invisalign has merit and should definitely be explored if you want to look into straightening your teeth. But I would advise you to see an orthodontist in doing such. Tell them Dr. Connelly, D.D.S. sent you :)

Until next time, keep smiling.

References:
(1) http://www.archwired.com/ceramic_vs_metal_braces.htm#INV
(2) http://www.dentalcaresource.com/orthodontics/invisalign/
(3) http://www.ada.org/news/4228.aspx

 

Follow Thomas P. Connelly, D.D.S. on Twitter: www.twitter.com/dr_connelly

Today I want to talk about a very common issue that in the last few years has gotten rather complicated. That issue is crooked teeth and braces. We all know what braces are and we know what they lo...
Today I want to talk about a very common issue that in the last few years has gotten rather complicated. That issue is crooked teeth and braces. We all know what braces are and we know what they lo...
 
 
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12:23 PM on 08/27/2011
I got the regular wire braces and the age of 46 and wore them for two years; one of my front tooth was becoming more crooked and would become more problematic over time. The crooked tooth was a result of overcrowding so I had to have four teeth removed (two on top and two on the bottom). The process was painful but well worth it. The cost is $$$; I just wished insurance would cover some of it. I can understand why someone would opt for the invisalign and I was given that option and was told it would cost even more. If there is anything that I learned from my experience is that my teeth are very important and how my eating impacts my teeth. I am now very careful of what I bite or eat. I also appreciate the investment in time on my teeth.
12:21 PM on 08/27/2011
I personally know at least 10 adults who have used invisalign, 2 out of the 10 ended up in metal braces, Then my issue is with removing vital teeth PREMOLARs to make room due to over crowding,which happened to my Daughter. (this was her choice I disagree Wtih the removal of healthy theeth) I also disagree with the removal of some wisdom teeth, if they are not bothersome, and create no health problems. We Get 32 teeth as adults 28 if you have your wisdom teeth removed as a teen. Every tooth in your mouth may someday be an anchor for inplants for hybrd dental work in the future. Once a tooth is removed we start to loose bone vital BONE.
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Nonpartay
♫Nonpartisan, liberal, ex-conservative♫
02:39 AM on 08/27/2011
I used Invisalign for six months by which time my teeth were straight, but my orthodontist didn't like my bite after about five months, and I use a retainer for the bottom but I do use Invisalign on top, but I just wear them now to sleep with. I'm glad I did this. I'm 65 and always had perfect teeth most of my life and never had braces, but about 10 years ago I started noticing they were crowding on the bottom and pushing the top teeth somewhat crooked. It drove me up the wall with this one tooth poking out, so I decided to go for it a couple of years ago. I think it's great to have a good smile and teeth that are straight and healthy. It's important to avoid heart attacks, too, to make sure you get them cleaned and checked every 6 months. I also use a SonicCare. I would recommend Invisalign with an orthodontist. He didn't charge me any extra to have the retainer made, and it did improve my bite so the top teeth closed in front of the bottom ones. The whole thing was around $3500.
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Mark128
04:33 PM on 08/26/2011
Invisilign was the best invention ever! I used it back in 2003 and avoided braces! AWESOME!
03:44 PM on 08/26/2011
Ive had both metal braces and invisalign. The first time around I had them for nearly 4 years in high school and they cut up my gums and lips and I hated them. This time I was 27 when I got the invisalign and had them for 2 years and I loved them. I found myself actually smiling more, and seeing the improvements every two weeks when I changed my aligners. I had tops and bottoms done and I couldnt be happier. Insurance paid for a bit of it and I paid the rest on a payment plan. They ended up costing about $4600 (metal was about $3000) but now I can smile because I love what my smile looks like. Its brought me so much confidence. I know its just cosmetic but for me it seems life changing and as a bonus they were completed just in time for my wedding.
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HereinDC
02:26 PM on 08/26/2011
I had Invisalign in 2001 when I was 44 years old. Well worth the price and time.
Actually enjoyed wearing them. Had them on for about 18 months.
Never needed the hard wire to "fine tune" as this article states.
Been told many times....I have a great smile.
02:12 PM on 08/26/2011
This is a very timely article for me. I just happened to have gotten my braces put on yesterday. This something that I have wanted since childhood. Now as an adult in my 40s I went for it. I opted for the clear brackets on top and traditional metal on the bottom. So far here at work no one has noticed or ever inquired. One thing that I notice is that eating is little more challenging. I tend to now take very petite bites so as to not get anything lodged in the braces. Guess I've got to fine the right foods to eat.
01:04 PM on 08/26/2011
I’ve had both traditional braces and an invisalign (actually orthoclear) “tune-up”. I can say orthoclear is markedly better in every way. Orthoclear doesn’t cut up your lips and your mouth doesn’t constantly taste like stainless steel. Much better! Take the invisalign if you can.
11:05 AM on 08/26/2011
... I am a 30 year old adult and I had "traditional" braces for 2 1/2 years. I completed my treatment in January and now wear an "Invisalign-like" retainer 12-16 hours a day. I can see where Invisalign is a definite bonus for appearance. However, I would say having to take the Invisalign out before eating anything would be a pain. I have found this particularly annoying wearing the retainer. If I had to do the braces things all over again, I would still choose the traditional metal braces...
11:00 AM on 08/26/2011
I am disappointed that this article didnt touch on cost. Invisaline is far more expensive then metal braces. In today's America lots of people can't afford there homes never mind dental care. I am one of those Americans and I also have severely crooked teeth. A person like me would hope that their dentist would offer some help. This article really reinforced the opinion I've had for years, that dentist are only interested in your money. It confirmed that they are there to sell you a product without really caring about what the patient actually needs. Invisaline was offered as an option and couldnt afford the cost. I'm now glad I didn't sacrifice something for this procedure because it wouldn't have worked completely for me. Its insurance, cash, or that expensive dental loan program. It's disguising!! This article also doesn't touch on other options like braces in the back of the teeth.
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NrthrnLord
Prince of a very small part of the universe.
10:42 AM on 08/26/2011
Hey...it'd just be nice to afford a visit to the dentist for cleaning...much less actually get the dental maladies addressed. Crooked teeth? I'll take 'em, as long as most of them are there and it doesn't hurt to chew.
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Nonpartay
♫Nonpartisan, liberal, ex-conservative♫
02:47 AM on 08/27/2011
You really can't afford not to go to the dentist. Do you realize how close your mouth is to your heart? If your teeth are in bad shape, it can lead to heart attacks. I have a friend that happened to. He had terrible teeth with lots of problems and ended up with quadruple bypass surgery. Go for it, please. It's not that much, and you'll feel a lot better.
10:15 AM on 08/26/2011
i got my braces when i was 35 years old. best choice i made in my adult life!!! plus chicks dig braces!! you'd be amazed, lol
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Nonpartay
♫Nonpartisan, liberal, ex-conservative♫
02:47 AM on 08/27/2011
I am amazed. :)
09:55 AM on 08/26/2011
Great article. Thanks for the info!
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AcademicFreedom
Often banned; always factual
08:49 AM on 08/26/2011
I'm in my 50's and would like to get some of my teeth aligned. Right now, I"m a bit tight on cash and my insurance company does not cover orthodontics. I'll be getting Invisilne in a few years when the new Obama health care program is in place.
09:54 AM on 08/26/2011
It probably won't include dental care and if it does it probably won't include braces as they are usuallly deemed cosmetic. You might just want to save up your own cash and pay for it.
12:02 AM on 08/27/2011
I'm unhappy with my metal braces. I'm 56, and now my front teeth are all cracked. The dentist says I will need five veneers to correct the damage. I had four teeth pulled and a bridge broken in half to accommodate the anchor. Now I have gaps and my teeth still aren't straight. It will cost me over 10k to repair the damage caused by the metal braces.

My word of caution is, your molars wear as you age. If you have a lot of caps and an overbite, your front teeth may hit the lower brace. This could cause your teeth to chip.
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Nonpartay
♫Nonpartisan, liberal, ex-conservative♫
02:42 AM on 08/27/2011
I made monthly payments for my Invisaligns through my orthodontist. It was only about $153 a month for two years. You might check it out. The sooner you do it, the more chance you can get a shorter time and thus a cheaper treatment.