Falling off the wagon

When I started this blog, I told myself that I wouldn't be one of "those" Invisalign bloggers that stopped blogging.  Alas, it's been nearly a year since my last entry.  Eventually, in treatment, you just hit a groove.  Everything becomes automatic and not much happens.  I got caught up in the somewhat pleasant monotony of weekly tray changes that changed briefly to every-6-days-tray-changes.

Here is the final result:

After 38 trays in my initial treatment plan - or, basically a year's worth of trays with my orthodontist's usual every-10-days-tray-changes - my orthodontist ordered a mid-course correction.  I think the plan was to get me that far and see what else needed done.  After simmering in that 38th tray for about 7 weeks, the new aligners - which included 15 1/2 active trays - came in.  (Bag 16 of the mid-course correction included a passive aligner.)  They popped off all the old attachments and put new ones on as I shifted from 38/38 to 1/16.

My sense is that the early part of treatment was focused on getting the arches established and some basic alignment.   The portion was rotating a few lower teeth (not all cooperated due to anatomical issues) and fine-tuning the bite.  For the last part of treatment, the majority of the attachments/engagers were on my lower arch.  This included some long bar-shaped attachments on my lower right and left laterals.

So, it's been a little while...

My treatment has been flying by and it has been, for the most part, uneventful.

I have had a couple strange experiences with cold sensitivity that came out of nowhere and then disappeared on their own almost as quickly as they started.  A friend who is also an Invisalign patient recommended sensitive teeth toothpaste when I started and now I kind of understand why... I have some in my desk at work, but otherwise, I use regular tooth paste.

There was also a time that just recently ended (I hope, for good) that I did not like how my top teeth looked.  Additional space had to be created in my mouth especially in the upper arch.  Things get worse before they get better with this process and it's important to keep the result/goal in mind.  I've liked how my teeth look when I see them in the mirror as I'm brushing them over the past week or two.  It's a little hard for me to really see how straight they are getting because my brain can't get past the attachments.

Today was my first official appointment since I had IPR done and my attachments attached in July.   JULY!!! It took only a few minutes.  As I've seen - through Instagram, Facebook and the blogosphere - other patients with more frequent appointments, I wondered what in the world my orthodontist thought he was doing seeing me so infrequently.  But, Dr. P. clearly knows what he's doing.  There was even one tooth that was worrying me, to the point that I almost made an appointment, but then it moved into place and the 'extra' plastic that was making me nervous above it was no longer an issue.  I think because all the IPR was done at once that wonky tooth just needed it's time to come to march into it's new spot.

The best news from my appointment is that I can cut my wear back to 6 days per tray because everything is going well so far and I have the Acceledent device.

I have a dentist appointment next week and I'm hoping that they will be able to address some of the staining on/around my attachments.  I am a coffee drinker so staining happened on my natural teeth, too...  I guess I should say that I am a coffee gulper, because I've cut back to two cups a day with meals or snacks rather than enjoying it throughout the morning and early afternoon.

My next orthodontist appointment is February 19, 2015.  I should be on or near my final tray at that point.

Invisalign hygiene essentials

As soon as I made my down payment for treatment, I started searching for "accessories" for the system to ensure I was well prepared for all the brushing, etc. that would come with being an Invisalign patient.  It was pretty easy to order all these through Amazon.

A little over two months into Invisaign treatment, these are what I consider to be my essentials for maintaining good dental hygiene:

Retainer Brite cleansing tablets - One of the first steps in my morning routine is popping my aligners out and into their daily bath, with Retainer Brite cleansing tablets.  I do this in a plastic denture bath because I like the lid on the top to keep my cats out of it.  (The denture bath 'tubs' come as a two pack, so I use the spare when I travel.)  

Dental Appliance Cleansing Towelettes - These handy wipes are perfect for on-the-go!  I bought the 100 pack and still have a ton left at this point because I only use them when I can't get to a sink or, I've brushed my teeth at the sink but don't feel comfortable cleaning the aligners in front of random strangers in a public restroom after the weird looks I've received for brushing my teeth.  They are pretty big but you can fold them and/or use the corners to get into the grooves of the aligners.  

Colgate Wisp - I actually found these itty-bitty disposable tooth brushes at Target earlier this year when I was trying to get my teeth into shape before an overdue dental cleaning and exam.  I really try to rely on standard tooth brushes whenever I can, but these are good in a pinch.  For instance, during a day at Cedar Point when you're trying to travel light, they are perfect in a sandwich bag.  They're also good when the public bathroom seems sketchy or other folks in the public bathroom make you feel self-conscious about pulling out your plastic teeth.

Oral B Advantage (Glide) Floss Picks - My husband actually is the one that introduced me to the beauty of floss picks and, after trying a few brands over the years, these are my favorites!  They are super easy to use and I've mastered flossing without a mirror with them (maybe others have, as well, but this talent impresses my husband).  I floss with one after nearly every meal and, if I didn't floss after dinner and before my trays are in for the night, I make sure I use one before bed.  (I know the link is to a six pack of these - I usually get them at Target but they don't go bad and flossing is super important to dental health all the time, not just during orthodontic treatment. Stock up!)

Gum End-Tuft Toothbrush - The tufts on these toothbrushes are the perfect width for cleaning aligners.  I mean, a regular toothbrush works, too, but you can get these guys in there and really scrub, especially if your treatment includes attachments (and the corresponding bubbles for them on the aligners).  Whenever I'm home and especially before bed, I make sure to use one of these and some plain Crest toothbrush (not whitening or anything else special) to clean the aligners.  

I'm on tray 8! Time is flying! I deliberately stayed in tray 7 a day longer than usual. Days 1 and 2 have been pretty sore for me and I was tired of spending my weekends being uncomfortable. I figure that Mondays are already bad, so... 

Anyway, since I got the attachments on, I've noticed that not every tray feels the same way. Four (especially top) was a real pain in the shark to remove. I thought it was just because the attachments were new... Then tray 5 was easy to get out which led me to believe I had mastered removal. Then tray 6 was even more challenging than 4, so I realized it wasn't just the learning curve of post-attachment life with Invisalign. Tray 7 was more of the same.  The first few days, I almost cried because the frustration of trying to get them out was overwhelming. And now, on tray 8, it feels like tray 5- relatively simple to remove. Even better, there was the usual day one and two "pressure" or uncomfortable feelings. I suspect different ones are having different effects/impacts on my mouth. I do see a different, especially on top. The bottom front teeth ares still pretty crowded but in pictures, I can see how the teeth behind them are getting in line.

When I moved to this tray, I was a little concerned that my teeth weren't tracking correctly.  There were a few that seemed to show a bit more plastic in tray 7. Then, these trays (#8) fit fabulously. I've also noticed that the trays feel lose on the last couple days of wear and the new one almost seems to fit better.

Attachments and IPR

I need to start with a story about a friend who going through Invisalign, too.  The last time she came to visit me, she introduced me to a concept she tried at work during "Shark Week." Basically, you replace every curse word you feel like saying with "shark".  Thus, my appointment on July 18 is when shark got real with my Invisalign treatment.

My first three trays were set up by my orthodontist to have no attachments so I could get used to the aligners themselves before adding the craziness of attachments.

In order to accommodate some scheduling issues on the part of both Dr. P. and me and keep me from spending too long in tray 3,  the tech that met with me during my first appointment recommended I schedule for July 18. So, after wearing tray 3 for only 5 nights (with the AcceleDent), this happened:

Eighteen attachments!  Each blue blob above is a tooth colored "engager" or attachment to help move my teeth to where they need to go. 

The process of getting the attachments was actually fairly simple.  The tech first moved me back in the chair and then inserted a device to hold my mouth open.  Then she had to pull it out and have me remove my trays because they were so invisable, she didn't realize they were there at first.  Anyway, trays out and lip expander thingy back in... Then she used a suction thingy and had me bite down with it to hold it between my front teeth.  Next, she told me she was cleaning my teeth and proceeded to rub something along the outside surface of them. She suctioned a bit more and sprayed some water in, then some air, then did more cleaning type stuff on the outside surface. She advised me to keep my tongue behind my teeth.  As a result, I didn't taste or feel anything with my tongue. I mention this because I remember encountering some pretty nasty tastes when I got my traditional braces on.  Next she pulled the suction doohickey aside and inserted two trays - templates with the attachments - and shoved them really tight into my upper and lower arches.  Then she used a UV device on each tooth with an attachment to cure the adhesive.  She pulled the templates out and did just a little bit of scraping of the excessive adhesive.  Then I noticed something funny behind on of my teeth and she had to pick that out, which went fast, too. She sat me up and had me rinse.

The attachments felt weird when my tongue explored them. Really weird.  Four days later, they still feel strange and one on the lower front really bothers the inside of my lip when I have my trays out to eat. I figure it will keep me compliant. 

But wait, there's more!  Before the attachment procedure started, the tech brought me a one page handout on "slenderizing" or IPR. IPR stands for inter paroxysmal reduction, which is a fancy term for shaving down the sides/edges of teeth to make more room.  This is used as an alternative to extraction and/or surgery when there is crowding and issues with jaw size.  Each red line above represents a spot where part of my tooth was filed using IPR. The orthodontist came in and did all of the IPR called for since I will not see him again until I get to tray 20 or something. The number followed by mm represents the numbers of tenths of a millimeter of tooth removed. A millimeter is about the size of a period at the end of a sentence in 12 point font.  

I'm not gonna lie. The IPR was not fun but it wasn't nearly as terrible as I thought it would be. Dr. P. used manual files and called out for a single, then a double, then a single as he completed the prescribed work. I don't know if this referred to the tools being single and double-sided or single and double width.  In any event, it didn't take long and the most discomfort came from how he had to contort my face to get to some of the areas towards the back of my mouth.  I am usually really weird about filing (nails, etc.) but it wasn't too bad.  I think since I have had a few more unpleasant dental procedures under my belt - like fillings between teeth - this wasn't too bad in the grand scheme of things.

I was provided trays 4-36.  I noticed 37 and 38 don't have attachments. As long as I don't lose an attachment or experience any other complications, I don't go back until early November.

So far I haven't noticed any sensitivity or other issues from the IPR but I do really feel like my teeth moved a LOT with this tray.  It's also a real big pain in the shark to maneuver the upper aligner in particular to remove it to eat. 

Vacation + Invisalign = :-(

The subject says it all... I went on my annual vacation with my husband's family last week. The weather was wonderful and it was relaxing overall, but the Invisalign really out a damper on things. 

I couldn't enjoy beer on the beach and had to turn it down daily.  Daily!! I usually walk to the boardwalk each night for coffee and frozen custard but that was pretty much out of the question.  Two days I only ended up wearing the aligners for about 20 hours. The rest were closer to the optimal time of 22 hours. 

I suppose I could have broken the rules, but I really want to be compliant and hopefully be rewarded with completing my treatment on schedule.  Yes, it was a sacrifice but I told myself that next year, life will be back to normal and I can enjoy all the beer, coffee and frozen custard I want to with straight, beautiful teeth.

I thought I had mastered my temporary speech impediment after a week of tray one but when I moved onto tray two, I had a whole new set of problems! Other "s" words started causing me problems and I suddenly struggled with B's and P's. It has gotten better throughout this week. I am hoping tray three doesn't bring new issues. 

I have noticed a pattern with my first two trays:

- Day 1: tightness and pressure with the trays in

- Day 2: trays feel better, but teeth hurt while eating, especially biting

- Day 3: teeth still hurt a bit while eating, every so often the trays feel tight

- Day 4: trays are barely noticeable, still some tenderness while eating

- Days 5-7: all good

Things are still way better than I remember traditional braces.