Exclusive Q&A with DR. Kassabian

This is a Q&A with Dr. Mark Nalbandian of Wired Orthodontics that answers some frequently asked questions about Invisalign and braces. Thank you Dr. Mark for such an informative session. I often work together with Dr. Mark to give patients the most comprehensive treatment including orthodontics, should they need it. Enjoy this read:

Q1. Will Invisalign (invisible braces work for me-What is it exactly?

Invisalign is a set of fully customized clear plastic aligners designed to give you a perfect smile. Think of Invisalign as a tool. That tool is used and manipulated by your doctor to achieve a desired outcome. Just as Invisalign can be viewed as a tool, so can braces. It is your doctor’s training and responsibility that helps him/her determine whether Invisalign or braces are best suited for you based on the desired tooth movement.

Q2. What are some other alternatives to Invisalign?

Alternatives to Invisalign include:
Traditional metal braces (although they have become a lot smaller than they used to be)
Clear ceramic braces
Lingual braces (braces on the inside of the teeth)

Q3. Will I need the brackets and rubber bands at some point in my treatment even with invisalign and for how long?

Rubber bands during treatment with invisalign are not uncommon and are not worn for the full duration of treatment. They usually accomplish movement that cannot be attained with aligners alone. The better you are at wearing them, the sooner you can be done with them. With regards to brackets with Invisalign- it is extremely uncommon to require full brackets after Invisalign, however, there may be cases where select teeth may require brackets to work out stubborn tooth movements. Fortunately, this also is uncommon.

Q4. Will I have to have teeth pulled to make room for the shifting of teeth? Is that necessary for every case?

Extraction of teeth is definitely not necessary for every case. This is usually only reserved for cases of severe crowding in order to make space. For mild or moderate crowding cases, there are more conservative ways to make space. At the initial consultation with the orthodontist, you will be notified of the severity (or lack thereof) of your crowding.

Q5. How long will the treatment typically take?

Treatment times vary greatly depending on the level of complexity of each case. Milder cases usually can be treated in 6-12 months with severe cases taking 2.5-3 years. Moderate cases will fall somewhere in between.

Q6. How often do I have to come in for check ups and adjustments during treatments?

Checkups are usually scheduled from 4-8 weeks apart depending on the stage of treatment you are in.

Q7.Are there ways to pay for this slowly while in treatment such as a payment plan? Does insurance cover any of this for adults?

Payment plans are definitely available. Typically, they involve an initial fee for diagnostic records (x-rays, photos and impressions/scans of your mouth). Next, there will be a down payment to start treatment. The balance of the treatment fee can be divided over the months of predicted treatment at 0% financing. Private insurance companies do offer orthodontic insurance. It is possible for adults to have orthodontic coverage under these plans, however, it is best to consult with your insurance company to confirm coverage.

Q8. Will I need a retainer once my braces are removed? For how long?

Everyone needs some form of retention after braces/Invisalign. There are fixed (permanent) retainers, which are usually a metal wire/ribbon that is bonded to the inside of the front teeth, as well as, removable retainers which are usually worn at night. Patients will require either one or a combination of both. The permanent retainers are ideally left in for life (this can change) while the removable retainers are progressively worn less as time passes.

Q9. Should my oral hygiene routine be any different when I have braces and how?

While wearing braces, we ask that patients brush after every meal and use a waterpik or floss every night. Patients should still be seeing their family dentist at least twice a year for professional cleanings. If hygiene becomes a problem during treatment, it is advisable to have 3-4 professional cleanings a year.

Q10. Will braces/invisalign affect my lifestyle and how?

Both will cause lifestyle changes, but hopefully, you will adapt soon and the results will be worth it! With braces, because they are fixed to the teeth, hygiene is the greatest affected. The brackets and wires will trap more food and plaque and hence need to be cleaned more frequently (which is why we recommend brushing after every meal). As for Invisalign, the aligners should be in your mouth for 21hrs/day. They need to be removed for eating, brushing and for drinking anything besides water. Hence, keeping your teeth clean with Invisalign should be easier than with braces. However, eating habits may change, because they are in your mouth for so long. For example, if you are normally a “sipper” when drinking your coffee, you may have to resort to drinking it quickly so that your aligners are not out of your mouth for too long.

Q11. Is there any pain/discomfort involved?

Whether braces or Invisalign, they move your teeth by applying gentle pressure to the teeth. Initially, because your body is not accustomed to these forces, there will be a slight discomfort (usually for 1 week after starting treatment). At each adjustment appointment for your braces or for each new aligner with invisalign, that period of discomfort is shortened to approximately 3 days, because by now your body is used to the pressure on the teeth.

Q12. I want to whiten my teeth as well. When should I do this, before, after or during orthodontics?

To ensure that your teeth are evenly whitened, it is advisable to do this once orthodontic treatment has been completed.