16th Trays and a Refinement Conversation

OK, truth be told, I haven't posted to my blog in over a month. It's currently Saturday, 6/9/07, and I had gone to the ortho on 4/30/07 for my last "initial phase" visit.

To be honest with you, I don't really recall anything particular about my last set of trays, other than the fact that my teeth didn't really move much more from my 15th trays. The difference with these trays, however, is that I got to see my ortho after I was done with them.

Armed with printouts of my blog with all the pictures of my teeth, with problematic areas highlighted and circled, I discussed what I wanted to see fixed in my refinement period. I got some more pictures taken (which I'll post below), some new molds created, and notes were taken on everything both I and my ortho wanted to see happen with my next set of trays.

When I told my ortho my concerns about my crossbite tooth sitting at an angle and jutting out with the root still way back, he said Invisalign wasn't strong enough to move roots. He basically explained that my tooth will never look the same as the opposing tooth because of the fact that it's developed its whole life behind the other teeth and not in front, so it doesn't have the same shape/size as the opposing tooth. Only cosmetic dental procedures can fix that. He said he can have Invisalign move my tooth out more, but that it wouldn't give me the effect I was looking for.

So, I decided that, after my refinement in done and I'm completely satisfied, I'm going to get my teeth whitened, and then maybe get that tooth bonded. I have to talk it over with my dentist, but I think bonding doesn't file away your tooth like veneers would -- it was just add to the existent tooth -- which is what I need. I need to build it up more towards the top. I understand that bonding doesn't last as long as veneers would, but that's OK. I think this is what would make me really really happy in the end.

I was told the turnaround time for this would be about 4 weeks. It wound up taking 5, and I'll go over my next experience with all that in my next post.

Onto the pictures! These will all be in Before and After style, from before I started my treatment, to after my 16th and last trays in my initial phase.

Center smile:



Upper:



Lower:



Right Side:



Left Side:



Full face smile:

15th Trays & some concerns

OK, again, not too much movement with these trays. I'm actually REALLY happy now that I'm getting refinement trays. I know initially I had wanted to be completely done with this by April 30th, but if that had been the case and we stuck to it, I would have wound up with not completely straight teeth.

One detail that concerns me is that my crossbite tooth isn't snug by the front of the trays. I'm not sure if Invisalign purposely did it this way for some strange reason, but it appears that the back of the tooth isn't getting moved much further, but there's quite a gap between my crossbite tooth and the front of the tray in that area. I'd think that, either the tray should have formed itself more closely to the tooth, or Invisalign should have been pushing the back of the tooth more towards the front so that it would be more snug towards the front.

In addition, when the trays are taken out for me to eat, etc., my bite is still very off. It feels like my bottom center teeth are too close to my upper front teeth, and as a result, my molars aren't able to line up with each other. My jaw aches a bit when my trays are out because it feels like I've developed a slight overbite.

On my right side, my bottom molars have some distinguishable spaces between them. All the rest of my teeth are pretty tight, but there are 3 molars where the floss is able to super easily glide in between them with hardly any tightness.

A sneak peek at my 16th trays shows that there's really not much more movement to be expected by my crossbite tooth nor my bottom center teeth. Upon careful examination, it looks like my crossbite tooth may need to get twisted a bit AND pushed out further, and my right center tooth may need some twisting as well. Thank goodness I'm keeping this blog so I can really come with a laundry list of concerns and requests for my ortho when I see him next.

I can't believe that tomorrow night, I'll be putting on my last set of active trays. My last set!! I clearly remember the start of this whole process, and 16 trays seemed like such a long time away. The time has now arrived.

Oh, on another note...my gumline by my crossbite tooth has started to detach from the tooth. I hope this will clear the way for it to recede as well, because my smile is still visibly more lopsided because of this. You can't actually see that it's detaching, but when I use a dental pick to get at any tartar, I'm able to easily stick it underneath my gums and almost even lift a corner of it up a bit. Sorry for the gross visual. Hey, it's a blog about TEETH, so it's not like you were expecting prettiness, were you? :)

Anyway, here are pictures of what my teeth look like right now.

Center smiling:


Mouth agape:


Lower (still not as straight as I thought they would be by the end of my second to last set of trays):


Upper:


Crossbite side (I hate how my tooth looks like an ugly jagged little rock AND is angled out so severely!):


Opposite of crossbite side (look how much prettier this bicuspid is compare to the problematic one!):


Crossbite side looking up from below (see how it's mostly just the tip that's over the bottom teeth?):


Opposite of crossbite side looking up from below (notice how much this bicuspid is over the bottom teeth - check out that gap compared to the picture before!):


Looking up from below so you can see how the 2 biscuspids differ in position. Also, check out my center line. Yikes! It used to be perfect. Now, where my 2 front teeth meet does NOT line up with where my 2 center bottom teeth meet. In fact, both upper and lower center lines appear to be slightly angled in opposite directions as well. NOT good....


You can really see a difference between the way the 2 bicuspids are positioned in this picture:


Wanted to show you what my teeth look like with my trays in now that they're straighter. Do you see, however, that my crossbite tooth isn't touching the bottom of the mold like the rest of my teeth are?


With trays in, mouth agape:


Looking down from above. You can really see here how there's a significant gap in front of my crossbite tooth compared to the rest of my teeth.


And a normal smile with the trays in:

14th Trays & a whitening conversation

My teeth haven't really felt like they've moved much more with these trays. No bleeding at all, either.

The crossbite tooth has moved more definitively across the bottom teeth, but I'm still not liking the angle it's taking. I know I have 2 more trays to go, but I'm apprehensive that I'm going to require a button after all during my refinement trays. That would stink!! The buttons are much more easily noticed when you have your trays off, and sometimes, I'd take out my trays if I had to do a presentation or meet someone new and important. Wouldn't be able to do that then, would I?

OK, I have to take a deep breath and slow down. I'm way ahead of myself and don't even know what's going to happen here, so I'll just relax until then and make notes of what exactly I want to accomplish with my teeth and just go over them with the ortho when I see him again.

I did take a sneak peek at tray 16, though, when I went to put in tray 15. I wanted to see how much of the upper part of my crossbite tooth (by the root) would be moved in the final tray. As it turns out - not much. Looks like Invisalign calculated teeth movement more on my bite than on the rest of my tooth, so I'll have to make sure the roots are moved more forward as well.

Speaking of bite, my bite is still off. I've noticed, however, that as the 2 weeks progress, the bite gets better. So the major movement happens within the first couple days of a new trays, but the tiny movements that affect bite more so happen gradually throughout the course of the tray.

I also saw my regular dentist, Dr. Bocian, halfway through my 14th trays. He was surprised to see how much they had moved, but wanted to make sure that I'm just as diligent about my trays usage during the retainment period, and reminded me that this period will, in actuality, last for the rest of my life. He was also concerned a bit about gingivitis, and saw a bit of it along my gumline. It's a very tough thing to avoid since that is exactly where the trays rest by my crossbite area, which explains the gum bleeding. I just need to take extra care in brushing, flossing, rinsing with mouthwash, etc., to prevent this from getting any worse.

I also talked to him about whitening my teeth afterwards, using Zoom! I always wanted to do it, and it would be perfect timing before my brother's wedding. However, he actually suggested that I try in-home whitening, which uses the same stuff they use in the office. He said that most people opt for in-office because it's fast, and they tire of the whitening at night with trays in for 3 weeks straight. Being that I'll be wearing form-fitting trays anyway, it wouldn't be something I'd have to get used to. In addition, in-home is half the cost of in-office, and insurance doesn't pay for any of it. When I asked him how much in-home was compared to in-office, I was shocked at the answer!! I had no idea that in-office was about $600!!!!! He said in-home would be a little over $300.

He told me to check with Invisalign (not the ortho) to make sure this hydrogen peroxide mixture would be OK to use on the trays without any damage to them. I believe they are. His only other concern was that the trays cover a tiny bit of my gums in some areas. This could get irritated from the whitening solution. He was, however, willing to let me test out the solution for a few days before we commit to the whole thing. He also told me that the in-home would last just as long and would get my teeth just as white as the in-office. I love Dr. Bocian!

Here are the pics!

Center smile showing top and bottom:


Center, agape:


Lower:


Upper:


Crossbite tooth (looking up from bottom):


Opposite side of crossbite tooth (looking up from bottom) - you can see it's seated in front more than the crossbite tooth still:


Side view of crossbite tooth - yes, my bite is still not flush on this side, but it's getting better:

13th Trays

The first night after I put in my 13th trays, I woke up to a crossbite tooth that had definitely crossed over to the other side -- no doubt about it. I was so excited! I shared the news with my mom, who was just as excited for me.

However, as the days wore on, I noticed that the tooth would VERY easily slip back each time I took out my trays to eat. To the point where, at the end of my lunch hour or dinner, I'd notice a discernable difference in my bite. That's fast! So I made a point to wear them as much as possible, and just kept my fingers crossed that the next tray will make the new position more permanent and less likely to slip back.

The very last night I wore these trays, I woke up to a bloody smile. It was odd because they didn't bleed once - not even a little bit - until this point. I must have been grinding my teeth really badly from a bad dream or something - not sure - but there they were. Bloody. I rinsed them out and just proceeded with the rest of my day. They didn't bleed any more. Like I said - it was kind of odd.

I took some closeups this time of the crossbite tooth so you guys can see how it's hopping over to the front. I've noticed that the trays are getting the bottom part of the tooth out in front before the top, or the rest, of the tooth. Because of this, the tooth is angling out more than usual right now. I hope this gets corrected in the refinement process.

Speaking of which, I've come to accept that I won't technically be done by April 30th. And I'm OK with that now - really. I'd much rather have perfectly perfectly straight teeth than anything else after all is said and done, so now I'm on the lookout for minor details that I want fixed before I'm ready to say to my ortho, "Yay! I'm 100% happy with the results!"

For one thing, I want to make sure my bite on my right side is flush in the end, because it's far from that right now. Like I mentioned in a previous post, I think it's because the crossbite tooth's position is temporarily interfering with it, but I still need to be sure.

Another thing is the angle of my crossbite tooth. As mentioned above, it's jutting out from the bottom right now, and I want to be sure it's nice and straight in the end. I also noticed that the right rear side of the tooth itself isn't moving forward as much as I'd like. Again, I'm jumping the gun because I still have 3 more trays left, but it's a detail I just noticed in looking at my 14th trays last night. It seems like Invisalign is moving my tooth towards the front by angling it both from the bottom and from the right side. Sort of like twisting a large object through a doorway. In the end, I want to be sure that large object (my tooth!) is straightened out in every way possible and mimics the angle and placement of its corresponding bicuspid on the other side, and doesn't remain slightly twisted.

I also hope this doesn't mean I'm going to need a button, or attachment, to help with straightening out this twist. Ugggg. I'm getting myself all worked up, though, and I have 3 more trays to go still.

And speaking of trays, I'm going to be getting new molds of my teeth taken after the end of my 16th trays. I wonder what the turnaround time for those trays will be, and how long I'll have my 16th trays in before I move onto the next set? I hope not too too long. That would stink. OK, enough ruminating, and onto the pictures!

Center smile showing top and bottom:


Center, mouth agape:

Lower:


Upper:


Closeup of crossbite area:


Crossbite area, looking from the bottom up so you can see the tip of the tooth completely crossed over to the front:


Crossbite area - side view. Here you can really tell that it's just the bottom portion of the tooth that has moved and angled out. The top part, closer to the root, still needs to move more:

Random FYI's

I thought it would be a good time do a posting on some random FYI's, especially since some time has passed now since I first started this treatment.

Cleaning
I still use Efferdent daily to keep the trays clean. They're usually film-free, but after a week or so, I touch them up with a toothbrush (I use the Efferdent solution to dip the toothbrush in) and they're sparkling clean again. It takes just a few seconds with the brush to get them this way.

Smelly Trays
I don't make a point of smelling my trays anymore. I guess that lost its luster with me really quickly (go figure?), so I really don't know if they still stink sometimes.

Smelly Breath
To make sure I have fresh breath, I've taken to always having Listerine strips with me around. Obviously, I can't chew gum with the trays in, but the strips ensure that my breath is acceptable. I've also, on occasion, sucked on a starlight mint as a last resort, but I don't like doing that too much because they do tend to get sticky and stick to the trays a bit, and all the sugar in them makes the trays get yucky and filmy quickly. Imagine without the trays, all that sugary, yucky film would simply be on my teeth, eating away at my enamel! Wow -- I never thought about it like that. Of course, this is never going to stop me from snacking on sugar after my trays are out ;)

Eating
Speaking of food, I've never tried eating a piece of chocolate with the trays in again. It's just not worth it. I pop the trays out and pop them back in when I'm done with the chocolate. I used to make it more of a pain for me, since I'd go to the bathroom to pop out the trays, and then go back in to put them back in. But now, I just go to take them out. When I want to put them back in, I grab a cup by the water cooler, fill it with water, and head back to my desk. I grab my trays, dunk them in the water filled cup, and pop them back in surreptitiously. At least I hope it is. Hee hee!

Spit
Because the trays are fitting better with my teeth getting straighter (AND me clenching down on them once in a while), I also haven't noticed the spit collecting in them too much, either. Of course, I could just be getting used to it and not bothering with it, too.

Clenching
I've noticed that I sometimes clench my teeth at night. Not sure if I'm grinding them, but sometimes, I'll wake up from a particularly intensive dream (I'm a very intensive dreamer) and find that my teeth are clenched tight. I'm really glad that I'm wearing my trays at that point, and wonder if my alignment problems had been exacerbated by my nightly clenching before. I know one of the issues people with alignment problems have is with teeth naturally trying to occlude, or "fit together", regardless of whether or not it's the proper way to fit. I'm actually looking forward to wearing my Invisalign retainers (same trays - just heavier duty, I think) at night after my treatment is complete to prevent my teeth from moving again. I'm such a geek to have said that. For those of you who know me, I know you didn't expect any less, of course.

Lisping
I hardly lisp with my trays in now. It will happen immediately after I put new ones in, but after the first night, my teeth have already moved, with the trays fitting better, so the lisping disappears. What was kind of odd is the fact that, with the earlier trays, I'd lisp AFTER my teeth had already moved. Whenever I'd put in a new set of trays, I wouldn't lisp because the trays felt really tight around my teeth even though they actually didn't fit as well because my teeth hadn't moved to their new positions yet. Now, it's the opposite. Weird, huh? I'm glad it's this way, though. I wind up lisping only for a few minutes with each tray -- right before I go to bed. For the remainder of the 14 days that I have them on, I don't lisp!

12th Trays

I was really hoping these trays wouldn't hurt as badly as my previous ones had been hurting. Wouldn't you know it? I hardly felt a difference between these and my 11th trays!

(BIG sigh of relief................)

As with my 11th trays, I can feel my crossbite tooth moving the slightest bit more in front of the lower tooth. Again, if I move my lower jaw back in an extreme way, I can have the sensation of what that one tooth would feel like if it were in front of the tooth beneath it. I know it may sound really stupid to get so excited about how your teeth would feel in a certain position, but for someone who's pretty much always had crooked teeth, the sensation is really exhilirating! I really can't wait for the next set of trays, where I'll REALLY be able to feel my crossbite tooth set firmly in front of the tooth beneath it.

Fortunately, I have yet to experience my crossbite tooth and the one below it hitting each other accidentally while eating. I had been forewarned about this from both the ortho and one of his assistants, Trish, who did Invisalign for the same problem. Luckily, I'll keep my fingers crossed (but NOT my teeth! sorry -- corny dental humor had to rear its ugly head at some point in this blog of mine) that this doesn't really happen to me.

I encountered the slightest bleeding towards the end of these trays. Once, Hubby and I were at a pizza parlor, waiting for our order to be ready, and he notioned that my teeth were slightly pink. Since he knows about all my bloody gums with the previous trays, he knew I must have bled the tiniest bit, but that the blood had gotten really diluted within the trays. I sucked on them, like I was trying to get the excess spit out, and it was gone.

However, once I got home that night, they started bleeding a bit more. They stopped again after about a 1/2 hour or so. Weird, I know. It's just such a little amount, though, and happens only along my gumline where it's lower from the crossbite tooth, that it doesn't concern me in any way. My teeth aren't loose in any way, so all the more reason for me not to get too worried about it.

What's kind of weird is that, although I hardly felt any pressure or movement with this set of trays, something about the movement that was made really makes the changes in my teeth more obvious than I had originally thought. It wasn't until I actually posted all these pictures that I noticed the major differences in them. This prompted me to edit my posting, and to add some comparison pictures between post-Tray 12 and post-Tray 1. The pictures below will have Tray 12 on the top, and Tray 1 pictures on the bottom.

Center smile. You'll notice an indentation on my gums right in between my 2 upper front teeth - this is because I had just removed the trays from my teeth. Do you also notice that, even in this picture, my crossbite tooth is right on the cusp of jumping over to the front side? In general, it's just more visible, so my smile is more symmetrical:

Center, mouth agape. Even in this picture you can see that my bottom teeth are lining up nicely:


Lower. Getting closer to that perfect "U" shape, and away from the "W" shape they were starting to get into:

Upper. Do you see how my crossbite tooth has been inching forward to meet up with the rest of the front teeth?

Crossbite side. Again, my gums are a little puffy because I had just taken out the trays. You have to realize that the top of the trays are right above my gum line where my crossbite is, so it's going to swell right around there the tiniest bit:


Closeup of the crossbite. You can really see here how the bottom of that tooth is just about to officially jump over to the front side in this picture. You might also notice that my molars aren't really meshing well on this side. I'm thinking that this might have something to do with that crossbite tooth temporarily interfering.


Either way, I'll bring it to my ortho's attention when I go back to see him in 8 weeks. I'll be finished with my trays, but he just told me tonight that he'll be taking new molds for a "refinement" process, which I'm delighted about. I had been told he was a perfectionist, as am I, so I wouldn't want anything less than absolutely perfect teeth at the end. My basic movies didn't make me 100% happy, since, as I've mentioned in previous posts, my gumline didn't show recession above the crossbite tooth to match the corresponding tooth on the other side. I know the movies are meant to show tooth movement and not fleshy tissue movement, but I'm just glad to hear that any slight tweaks in getting my teeth totally straight are going to be done.

Speaking of done, can you believe I'm 75% done now?????

11th Trays

The 11th trays hurt a bit. My teeth were sore in the beginning, but I'm starting to realize that I'm just feeling it more now because most of the movement is now happening in the front, whereas all my other trays had my back teeth moving, which weren't as exposed to tearing action as much during eating as my front teeth are. Now that my back teeth have shifted to make room for my front teeth to do their moves, I'm experiencing all the joys of moving teeth on my incisors and canines instead of my bicuspids and molars. Yayyyyyyy.................

Interestingly enough, these were also the first trays where I developed a slight sore in the back of my mouth. One of the edges of the upper trays by the rear left side of my mouth was a bit sharp and rough around the edges. I didn't really notice it until the end of the 1st full day of wearing them, and simply filed down that trouble spot with the nail file part of a pair of nail clippers. 2 seconds later, they were totally fine. I'm so glad these trays are so low maintenance, and don't need anything fancy to keep them clean, or to fix them if they need some adjusting.

What was especially exciting was the fact that, with both trays in, I could actually feel that my crossbite tooth was crossing over to the front side! With my jaw closed, I ran my finger from top to bottom of that crossbite area. It was SO exciting to feel the crossbite tooth as the slightest protrusion instead of being flush with my bottom tooth. YEAH!!! Without the trays in, the tooth wasn't exactly in front of the bottom tooth, but I knew it was inching its way over there. If I moved my lower jaw back drastically, I was actually able to get my crossbite tooth to go in front of the lower tooth, even for the tiniest bit. I don't think I've felt that ever since I was a kid and still had my baby teeth!

What was also kinda cool was something my mom said to me. We had gone over to her house for the Lunar New Year on Sunday, 2/18/07, for dinner, and when I smiled, she commented that she could hardly tell I was wearing them. What I noticed was that, the straighter my teeth got, the more invisible the Invisalign trays became! I guess it was just easier to fit, without weird gaps of plastic, since they were straighter now. For instance, by my crossbite area, the plastic had to suddenly go inward to conform to the position of my teeth, making that area more visible than other areas of my teeth, where the fit was as tight as a glove. She was so glad that things were working out so well with this treatment!

I only had these trays in for 12 days instead of the standard 14. It's not too bad. I know my ortho would hate to hear about that, but most of the movement has already occurred, and the latter part of the trays time is more to allow the bone to grow back after the teeth have moved. 2 days isn't going to make a huge difference, especially since I won't be cutting any more tray wearing times for future trays after Tray 12!

Anyway, here's what my teeth looked like after Tray 11:

Center smile:


Center, mouth agape:


Lower:


Upper:


Crossbite side: