Invisalign WWYD (progress PIPs)

[Susie]

Rather than revive the old Invisalign thread I figured I'd start a new one for this question, which ultimately boils down to:  done or not done yet?

This was my "before":  started treatment 3/8/18 for open bite, and to fix overjet while we we're at it.

Initial course was 21 trays with 10 day changes, with class 2 elastics starting about a month into the 7 months.  My bite was closed by the end of that, but not "ideal":
 
My upper canines didn't fully track, and did not come down with the rest of the teeth.  They look high and recessed compared to the incisors.  My molars also needed a little repositioning so they fit together in a more complementary way for a more comfortable bite.  That said, my orthodontist told me that overall we already achieved more than they were confident we could do at the outset.

Refinement #1 was 10 trays @ 10 days each, with triangle elastics.  Things went pretty well until about tray 8/10, when my canines stopped tracking again.  Today is my last day of refinement tray 10/10, and here I am.



I don't feel like it looks much different than when I started the refinement in Nov, so that's frustrating.  My canines look just as high and recessed to me.  Since tray 8 or 9, my canines have still been aching on the last days of a tray before a change, which they shouldn't. My trays also start to pull off my teeth under pressure from the elastics when I open my mouth, which they also shouldn't do.

 

The last time I saw my orthodontist was 12/27, at tray 6/10.  At the time, they said I'd be done after this round, and I have appointments on 3/14 and 3/18 to remove attachments and buttons, install a permanent wire retainer on the bottom, and be scanned for a night-use retainer for the top.  For the month between now and then, I'm supposed to wear my elastics at night only, and trays "lukewarm effort" during the day so I ease my teeth out of this and avoid rebounding.

I can't decide whether this is "good enough" or not.  My Invisalign is fully paid for, it's just a question of how perfect do I want to get for my money (and effort).

On one hand, I'm in for a penny, in for a pound.  If better is attainable, why stop?  In that case, I wouldn't want to waste a month before getting re-scanned, and then another month to start refinement #2 in approx April.  I'm 24 weeks pregnant with baby #2 now, so I'd be starting refinement #2 at about 32 weeks.  I'd probably still be in trays + elastics while juggling a newborn and toddler, getting stuck under a sleeping infant, snacking to keep up with nursing, etc.  It honestly sounds like a compliance nightmare.  If I'm going to go for a 2nd refinement, I want to get on it ASAP, so I can set a time limit on it and be done by early June (due 6/5).  

OTOH, I did refinement #1, and am not really sure what it got me.  It was a lot of effort juggling pregnancy eating (nausea, small frequent meals) with Invisalign, and I need to be motivated to keep going.  Especially because I had gestational diabetes last time, and if I do again it will really complicate eating/Invisalign.  (I take my glucose tolerance test in 2 weeks.)  Lot of questioning whether I have that effort in me for a small margin of improvement that wasn't really the original goal (the original goal was to eat thin crust pizza, burritos, and lettuce on sandwiches again.  Low bar.), and whether it's even attainable for these stubborn teeth.

So WWYD?  I am entertaining...
- Just staying the course until the 3/14 app't and see what they recommend then.
- Calling to try to get in earlier to get their rec earlier (if leaning toward a 2nd refinement).
- Deciding I'm over it, period, and keeping the existing retainer appointments.

[waverly]

I had a different case. No open bite no rubber bands. My teeth were moving a lot/ had shifted a lot. When I was done with the initial Invisalign I was done. I didn’t do any refinements. The ortho kind of wanted to do more to make it perfect, but I was done.

I had him put in permanent retainers due to my issues with compliance. My teeth like to move so much that he also gave me a regular Invisalign retainer on the bottom. Invisalign caused me to grind my teeth more.

Sometime maybe last year I became a clencher and now have TMJ and a slipped disc. This is different but part of my recent teeth/ jaw story. I can’t blame Invisalign that much because who knows why I started clenching- pain from an injury? Stress?

I like my permanent retainers but flossing is an issue and plaque build up. I might try a water flosser.

[jlt19]

I had a second round b/c my dentist wasn't happy with the progress but I was. After that one, there was little movement and I'd have had to do buttons again and it was all so very annoying, so I quit. However, I didn't have to pay anything OOP for mine, so that may have changed my mind if I did. i was just sick of it and felt it was good enough. It's been about a year since then and I'm still satisfied with my choice. Also, I think you have a year or two to change your mind and do another round, don't you?

[Susie]

Feb 14, 2019 13:17:23 GMT -5 jlt19 said:

Also, I think you have a year or two to change your mind and do another round, don't you?

I don't think so.  If I do the retainers next month, I think that's pretty much closing the door.  Retainers at the end are included in the price I paid, but if I wanted to change anything after I've done retainers I'd have to open (and pay for) a new case.  This one was between $5-6k, so there's no way I'm doing that given where I am.

[farfalla2011]

Your teeth look great! Given all the baby stuff you have coming up in the very near future, I think I would be done, especially since you don't feel like there was much change in your first refinement. I would imagine a second refinement would return similar results. These decisions are always so hard because there really isn't a clear right/wrong answer. Sorry not helpful lol.

[jlt19]

Feb 14, 2019 13:54:42 GMT -5 Susie said:

Feb 14, 2019 13:17:23 GMT -5 jlt19 said:

Also, I think you have a year or two to change your mind and do another round, don't you?

I don't think so.  If I do the retainers next month, I think that's pretty much closing the door.  Retainers at the end are included in the price I paid, but if I wanted to change anything after I've done retainers I'd have to open (and pay for) a new case.  This one was between $5-6k, so there's no way I'm doing that given where I am.

Oh yuck! My guy told me there was like a 1 year warranty or something. But that could be something his office provides vs. Invisalign themselves. I'm not really sure.

[boiler717]

Gosh I wish I could give you a firm answer. I feel like my dentist pressured me to be done when I still had lingering questions, and I regret not getting a set of refinements. OTOH, your treatment has been so long that I’d want to be done. I really like either option is okay, just depends on what is more important to you at this stage (which I realize is a hard question).

[VillainV]

I think your smile is beautiful, and I can tell you’ve had a lot of improvement since the start of the treatment.

How do YOU feel when you look at your smile? Are you satisfied with it, or do you think you will always notice and be bothered by the lingering imperfections? Is there any medical benefit to continuing with refinements?

If you’re ready to be done, I think you should stop.

[Susie]

Aw thanks VillainV !

I am really torn. I've accomplished everything I originally intended to... but in the process have become aware of flaws in my teeth and bite that I didn't recognize before I started. Now that I know about them, I do see them every time. OTOH... my teeth are seriously resisting further change, and I'm just not sure if I want this badly enough to do what it will take. And I reallllly miss coffee.  Perfection isn't attainable anyway because of the wear suffered before I started Invisalign, and the change it made to the shape of some of my teeth.  No plans to pursue cosmetic dentistry after I'm done.

[sent]

Feb 14, 2019 23:25:30 GMT -5 Susie said:

Aw thanks VillainV !

I am really torn. I've accomplished everything I originally intended to... but in the process have become aware of flaws in my teeth and bite that I didn't recognize before I started. Now that I know about them, I do see them every time. OTOH... my teeth are seriously resisting further change, and I'm just not sure if I want this badly enough to do what it will take. And I reallllly miss coffee.  Perfection isn't attainable anyway because of the wear suffered before I started Invisalign, and the change it made to the shape of some of my teeth.  No plans to pursue cosmetic dentistry after I'm done.

This is amazing progress. I can see what you mean by the canines not coming down. But given the severity of where you started, wow. You have a lot on your plate coming up. Maybe you'd want to ask their advice on doing another refinement now versus waiting after life settles down a bit with the new baby. 

Sort of unrelated, but becoming hyper acute of the details of your teeth is what makes this job hard despite how easy those mail order aligner companies want to make it look. 

[aprilsails]

I can definitely see some improvement from your first refinement round but I also agree that it is not aesthetically significant.

I would try to move up the appointment and ask the orthodontist if they think further improvements can be made. I wouldn’t want to go through all of that with a baby for nothing, so I would trust their opinion.

I had massive rounds of orthodontia as a kid which was actually paid for by insurance since my overbite was so severe. After two years of head gear, full braces, elastics and bite expanders (the whole nine yards really) my jaw was changed drastically, but there was one tooth on the bottom they couldn’t quite get straight. It’s still crooked (even worse now) and I kind of love my little stubborn tooth.

Your smile does look fantastic now, and worlds apart from your before photos. I’m glad you’re having an easier time eating too!

[Susie]

Thanks sent and aprilsails.  I'm going to keep thinking over the weekend but I am leaning toward calling on Tuesday after the holiday weekend to see if I can get in for a quick consult earlier than 3/14 to see what my orthodontist thinks.  I don't want to go years working on these last little details, but I don't want to leave any reasonably attainable improvements on the table either.  I got pregnant right at the tail end of my original course, and I heard that teeth move faster when you are pregnant. I was hoping that would work to my advantage during my first refinement, but it does not seem to have, ha. Don't know if that's an old wives tale.

It's funny, even now, looking at photos taken of me pre-Invisalign, my old smile doesn't bother me.  I have no motivation, e.g., to get my professional headshot redone.  But my teeth work so much better now!  I stopped eating burritos, onion rings, deli sandwiches, etc. for years, and that was sad.  

[claudiakishi]

Your teeth look great and the improvement to your bite is amazing.

I have an “in for a penny, in for a pound” mindset about it. It took me years to decide on Invisalign and an orthodontist I felt comfortable with. Now that I’m in it, I want the best result I can possibly get and I’ll do whatever it takes to do it. But, I also don’t have near as many attachments as you did/do, no rubber bands (yet - they are coming), don’t drink coffee and have curbed snacking (thanks to Invisalign I guess).

I don’t have kids but I can sense your frustration with having your baby and messing with all of this. If you trust your Ortho I would try to get the appointment moved up and get their honest opinion on how much more change you would see with more refinements and if that’s worth it.

[Susie]

I went in to see my orthodontist today because I just was not feeling confident about deciding this by myself.  Ultimately I am glad I went in, although the plan didn't change.  She said that my top canines are not actually in a bad position, they're just not angled quite properly -- which fortunately can often be fixed without attachments.  The bottom is good to go.  We are going to proceed with the retainer plans in 3 weeks, but the top retainer is going to put some torque on my upper canines to try to get them to angle forward a bit more.  Kind of like doing one more tray, but without attachments.  About 8 weeks after I have the retainer (by which time I'll probably have delivered), I'll go back and we'll reevaluate.  She said if at that point we didn't get the movement we're looking for, I can opt to do additional trays.  I feel better that I am not totally closing the book now, and very much looking forward to getting my 4 buttons and 9 attachments off.  I don't have as many now as I did in the first round, but I have two on the same front tooth, and I find them kind of annoying!

I'm also secretly kind of glad that I won't have buttons and attachments all over my teeth in any pictures taken shortly before or after this baby is born.  Even though I know they are not objectively super obvious, they make me feel kind of self conscious.  I didn't do any pro pics when I had my first, and was thinking I'd like to this time.

[raangoli]

Susie I was thinking of you today as I had a hectic day with work and BB being sick yet again after I got my attachments yesterday. Eating has become such an ordeal since I have to brush and floss every time after not to mention scrub the trays. I really was having a moment of regret bc I skipped lunch bc there just wasn’t time for the whole nine yards. And then when I did sit down to eat, BB woke up and I got a work call. I gave up on trying to eat since the trays had been out too long.

All that to say I’m sure that it would be a nightmare to deal with more attachments and trays etc with a newborn and a toddler and life in general. I’m glad you see to have a workable plan. Fingers crossed for you.

[froggy76]

I can't really give good advice because my bite is not quite right after finishing Invisalign and I just don't have it in me to correct it. I was also pregnant during the process, which slowed things down because I took a break, so at this point additional aligners would cost me. As it is, I've been paying $65/visit for the orthodontist to check every 6 months to see if my bite is closing in the back.

If you can handle it, keep going I guess. My bite is a daily annoyance to me and it's been over a year...