Confessions to my dentist

If you've been following my blog you'll know that I have a history of dental issues that I finally started taking seriously a few months prior to my starting my invisalign treatment. Those dental issues led me to my current regular dentist, Dr. H, a little over a year ago. We have a pretty good relationship which probably due in part to her being quite informative without being paternalistic, about my age and easy for me to relate to. Prior to the summer 2008, I was a quite overdue in terms of seeing a dentist (to say the least!) but quite intent on having things looked at and hopefully having my teeth straightened before the wedding. After a few grueling sessions of deep scaling, xrays, surgical removal of my wisdom teeth (the last was done by her practice partner as my bottom ones were impacted), I finally made my way to a number of different orthos and dentists for consultations.

As it turned out, none of the orthos she had referred me to offered invisalign which I had my heart set on and while I might have considered metal/ceramic braces, the cost for taking them off for the day of the wedding just seemed a bit atrocious to me (upwards of $700 CDN). So in the end, I went with Dr. A, who is a dentist and premier invisalign provider and I haven't seen Dr. H since I began treatment. It wasn't intentional, it just sort of happened given that there were a couple of instances where it was suggested that I have my teeth cleaned at various points in my treatment and it was more convenient to arrange it with Dr. A's office and another instance where my insurance (after having my teeth cleaned about 4 times in the same year) ran out and I decided to pay out of pocket at the local university.

Needless to say, I've been a bit anxious and embarrassed about not keeping Dr. H in the loop and was a bit sheepish when I saw her this morning. She must have gone through her notes because she seemed to remember me quite clearly despite the long absence. I also explained about the invisalign treatment and where I was in treatment and she seemed to be pretty impressed with how my teeth had moved since she last saw me. Also commented on the fact that it was so much easier to clean my teeth now that they're so much straighter and that they seem to be in great shape. It doesn't look like I have any new cavities, however, there do seem a couple of spots I seem to have some trouble cleaning in the back of my teeth and gums have receded a bit. We also talked about retainers a bit and she did suggest that with my history of gum disease, it might be better for me to have removable retainers after I'm finished which makes sense. I might mention that to Dr. A if I get a chance to speak with him at my next appointment.

All in all, it was a pretty good appointment. After seeing Dr. H, I realize how I miss having dental professional who I can spend some time talking to and asking questions of. Dr. A while very efficient just doesn't spend the time. I don't know if this is the difference between going to a dentist for invisalign or just his style but if I had to do all of this over again and had all the time in the world, I'm not sure if I would have gone with an invisalign dentist but then again, I probably didn't do as much research as I should of in terms of understanding that the dental professional can play a very large role in determining the course of treatment.

Anyhow, these are just my musings on a Friday morning off. I'm not unhappy with my treatment, I'm just wondering if it might have been approached different had I decided to go with a different dental professional. Having said that, given that a little over year ago, I was dealing with all sorts of dental issues and today I got out of a dental cleaning and checkup in just over an hour with lots of positive comments from my dentist plus have reasonably straight teeth in my wedding pictures, I'm a pretty happy camper.

Refinement moulds and a split!

Sorry I've been meaning to write this post for a while and am finally getting around to it now. I blame it on the turkey that we had the weekend before I went in my moulds last Tuesday. It was our first time cooking and hosting Thanksgiving dinner and it turned out surprising good is I do say so myself! So as I dragged myself in after the long weekend early in the morning, I figured it would be a pretty straightforward appointment and that I'd be at work within the hour. I sure wish that had been then case!

First the not so great but expected guesstimate. It looks like I'll need another 10+ trays according to Dr. A and a preliminary scan of my teeth. This was a bit disappointing but I had sort of expected it given that my teeth were still pretty wonky looking to me (and also how not-so-straight my teeth were to begin with).

After that they took off my attachments which wasn't too bad since I've been through it once before (when I had them off for wedding) and polished my teeth (which triggered a mental note to myself to book a cleaning). Then Dr. A stepped out and one of his assistants took some molds of my bottom teeth and then she redid them and then she redid them again. I was pretty relieved when she took the third set and checked in with Dr. A to confirm that they were ok.

At this point I figured I'd be into work about 15 minutes late than expected. Little did I know that I would also have to have my top ones done at least 7 times by 4 different people. Yes, that is correct - seven, I was keeping track. Apparently the room was too warm or the moulding material a bit old (not sure what to make of that). I was so glad when the last assistant finally got it right on her first attempt. She literally applied some of the clear moulding material (not the purple goop) directly to my teeth. Not sure if this is proper invisalign technique but I'm just thankful I didn't spend my entire day getting moulds done.

While I did get most of my questions answered during the appointment I was hoping to have more of a conversation with Dr. A regarding the rest of my course of treatment but had to be satisfied with peppering the assistants with questions instead. It sounds like it will take up to another 2 weeks for them (not including past week since I had moulds done) to arrive so in the mean time, I've booked some time with my regular dentist who I haven't seen since I started treatment (I have had my teeth cleaned multiple times though) so I'll be interested in what she has to say. I'm also going to use the last little bit of whitening stuff I have to brighten my teeth a bit!

A couple of pictures:

My teeth after twenty trays and removal of attachments. Never noticed it that much before but I think my smile is a bit lopsided.

It doesn't show up very well here but there is a little crack between the last tooth with an attachment and the next tooth. Surprisingly this tray has lasted me since me in its current state for over 3 weeks now as it cracked part way through week 2 and I had one more lower than upper tray (plus one week since moulds). Good thing because it's my last one and it will be a little while longer before I receive my refinements! Funny how they always told me to move on to the next tray before this and really, you would think that I would have learned not to split my trays by now!

More pictures and thoughts pre refinement

So after 20U/21L, my teeth are a lot straighter but I think that there's probably a bit more tweaking that can be done with my teeth during the refinement process. I can't believe it - but despite going in just humbly wanting straighter teeth, I can't seem to embrace my teeth just as they are at the moment.

I'd really love some feedback on what sorts of things I might want to discuss with my doc when I see him next week. I'd like to come in as prepared as possible so that I can properly articulate the final changes I'd like to see.

Anyhow here's my list so far:

- can the top front right incisor be rotated a little further to the right and right lateral incisor brought out (or both)?

- can something be done with my top right lateral incisor that seems to be at an angle (not perpendicular to the gumline?

- will my top and lower finally meet again?

- will my attachments be coming off? when? what can be done about the staining?

- would it be possible to get both fixed and removable retainers for top and bottom? (he recommends, top removable and bottom fixed I think)

- can my teeth be shaved a bit? it seem like one incisor is longer than the other...

- is there anything that can be done about my uneven gumline?

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End of my first round of 20U/21L

So here I am, at the end of my first round of invisalign... waiting until my appointment next Tuesday to discuss refinements with Dr. A. My teeth really haven't moved very much with the last tray but I thought it'd be interesting to show you every fifth tray since I started, starting from my most recent photo (prob makes more sense if you scroll from the last picture first but I forgot about that when I uploaded the photos).

tray 20 - midline is almost straight and my top and bottom teeth are almost touching, it looks like my own front tooth is longer than the other though

tray 15 - my little crossbite tooth finally sees the light of day!

tray 10 - gappy!

tray 5 - in my gangly stage, it must get worse before it gets better!

pre-invisalign

So, as you can see, there's still a lot of room for improvement but my teeth have changed a lot since I first started. I'd still like to see right front tooth rotate some more and canine come in a bit. I'll update next week after I hear what Dr. A has to say!