MADE TO MOVE – INVISALIGN
If you’re interested in having your teeth straightened, you’ve probably heard people talking about, or seen advertising for, Invisalign aligners. These aligners look like a clear, fine mouthguard that’s been trimmed to fit snuggly around the teeth. You’ve also probably wondered if they actually work, right? Seriously, how can a thin piece of plastic move teeth?
Usually when people think of straightening teeth they think of metal brackets glued to each tooth and a wire that connects all the brackets together. In case you are wondering, we do still use these braces although they are much smaller, lower profile and more comfortable nowadays.
For adults and young adults though, these traditional braces can be the stuff of nightmares and one of the main reasons many people never set foot in the orthodontist’s office. Invisalign offers the opportunity for orthodontic treatment that is virtually invisible. Yes, most people won’t even know that you have anything on your teeth! If this sounds like something you’ve been waiting for then wait no longer.
At Toowong Orthodontics we offer many options when it comes to straightening teeth. Treatment can be carried out by using metal braces or clear ceramic braces placed on the outside of your teeth, braces placed on the inside of your teeth (lingual braces) or Invisalign aligners. Whatever option you choose you can rest assured that by the end of treatment you will have a beautiful smile.
During a consultation with Dr Goodyear she will spend time finding out what bothers you most about your smile, carry out an exam and show you what your options are in order to give you the smile you want.
Invisalign aligners can be used to treat a wide range of malocclusions (fancy word for the different types of crooked teeth) it’s not just for people with a little bit of crowding. In order to start treatment we take a series of photos and a digital scan of your teeth; no more runny impressions.
Dr Goodyear then submits the records and a treatment plan and when she is happy with the Clincheck (3D treatment planning software) the aligners are manufactured by Align Technology just for you. When you come in for the initial placement of your aligners we can show you an approximation of how your teeth will look at the end of treatment. Almost 4 million people worldwide have been treated using Invisalign.
So how does it work?
The plastic aligners are made from a non-toxic medical-grade plastic and are worn 20-22 hours a day. Basically you take them out to eat and drink (if you are drinking anything other than water) or brushing your teeth. However, they need to be in your mouth at all other times.
The aligners are made with movement built into them so that each aligner puts pressure on certain teeth to move them in a direction that the orthodontist has requested during the treatment planning phase. You change aligners every two weeks or as often as Dr Goodyear advises, we give you 3 to 4 aligners and you change them at home – we see you for visits every 6-8 weeks.
Attachments are sometimes required when a tooth needs to be moved in a certain way. An attachment is a tooth coloured piece of composite (filing material) that is bonded to a tooth that helps the aligner grip and move that tooth. The attachments vary in size and shape.
Each time you change aligners you may find that there is some minor discomfort – I hear you thinking “discomfort is usually the polite word used instead of saying it will hurt for a little bit”. Actually, most people describe an aligner change as an increase in the pressure felt on the teeth that usually goes away after a couple of days.
The number of aligners used and the cost of your Invisalign treatment depends on the complexity of your case. Toowong Orthodontics believes that specialist orthodontic treatment should be available to as many people as possible and so we offer interest free payment plans.
If you would like to find out more about Invisalign or any other orthodontic treatment options, please head to our Contact Us tab or call us directly on 073870 0922.
MYOFUNCTIONAL APPLIANCES – WHAT’S THE EVIDENCE?
Myofunctional therapy is treatment aimed at changing muscle (Myo = muscle) function and possibly influencing jaw growth and the position of the teeth. Myofunctional appliances have been around in various forms for many years. These can include lip shields and screens, eruption guidance appliances and the T4K™. Although claims are made that they alter muscle function resulting in improved facial growth, better alignment, and more stable results, what evidence is there to support these claims? Please have a look at the references below.
There are a number of studies examining the clinical effects of the eruption guidance appliance and the T4K™ and they provide clinical evidence as to the compliance and effect of these appliances. (References 1-5). These appliances are available in a small range of sizes where one is selected to suit an individual rather than being custom made from an impression/scan. Possibly due to this generic fit, one study found 31% of patients did not wear the appliance.(1) A randomised trial of the T4K™ vs. a custom made Activator appliance found the Activator caused less discomfort than the T4K™ and was more acceptable (6). All five studies showed that treatment at age 5-9 was quite long (13-36 months) and protrusion of the top teeth was reduced by only a small amount (1.5-2.5mm).(1-5) A study of the T4K™ appliance showed it had no growth effect (3). Another study on the eruption guidance appliance followed patients over time and found the small 2mm improvement in crowding relapsed to the initial state which shows it is not stable (4). A 2mm improvement in bite depth was also unstable and relapsed leaving only 0.5mm of change.
A 2mm change is considered a minor improvement and could be treated once all adult teeth have erupted (~age 12-13) in one phase of treatment. This results in a reduced overall treatment time as well as potentially less cost than doing two or more phases of treatment. Clinical trials in the both the USA and the United Kingdom where patients were randomly assigned to early or late treatment have shown that when patients were treated early for much more severe protrusions (7mm rather than 2mm) they could be treated equally as well by delaying treatment until all the baby teeth had been lost (7,8 ). The result of treating later (~ age 12-13 years of age) was a shorter overall treatment and less cost. However a case can be made for early treatment to reduce protrusive teeth when the appearance or function is concerning the patient or for a small reduction in the risk of trauma to the front teeth.
So if you are unsure about whether treatment with a Myofunctional appliance is required for your child, consult your orthodontist. Some problems such as crossbites and impacted teeth can be detected and treated more effectively if found early. Your orthodontist is an expert in growth and development and can best determine if early treatment or simply monitoring your child is indicated to achieve the most efficient and cost-effective treatment at the most appropriate time.
1. Keski-Nisula. American Journal of Orthodontics & Dentofacial Orthopedics 2008;133:254-60
2. Methenitou. Journal of Pedodontics 1990;14:219-30
3. Usumez. Angle Orthodontist 2004;74:605-60
4. Janson. American Journal of Orthodontics & Dentofacial Orthopedics 2007;131:717-28
5. Myrland et al. European Journal of Orthodontics 2015;37:128-134
6. Idris. European Journal of Paediatric Dentistry 2012;13:219-24
7. Tulloch. American Journal of Orthodontics & Dentofacial Orthopedics 2004;125:657-67
8. O’Brien. American Journal of Orthodontics & Dentofacial Orthopedics 2009;135:573-9
This material courtesy of Dr Peter Miles, Orthodontist.