At the end of the 1st Refinement Trays

OK, truth be told, even though this entry has a date of 8/25/07, I'm actually finishing the typing of this in October. The summer months have flown by, and with my brother's wedding, life has kept me extremely busy.

In short, my teeth hurt like heck for the first several days with these refinement trays, but here are the pictorial results:

Full center smile:


Center, mouth agape:


Upper:


Lower:


Right side (with my ugly Flintstone-rock-like crossbite tooth):


Closeup of right side button:


Left side:


Closeup of left side button:


What my teeth look like from the bottom looking up. Notice my center line being off, and how my right lateral incisor really just has its lower tip over the bottom teeth, while the incisor on my left side is firmly and completely over the bottom teeth:

More on the 1st Refinement Trays

OK, so the pain has subsided somewhat.

My front teeth are no longer incredibly sore, but my rear molars last night were really sensitive! It was odd, because by Day 3 of these trays, I felt like a million dollars. All of a sudden, on Day 4, my molars were sore to the point where it was ruining my appetite again.

Last night, I finally filed down that rear part of the tray that was bothering my tongue. Unfortunately, it looks like the mold for my back teeth didn't completely get my entire left rear molar, so the trays cover only half my molar. This is resulting in a not-so-smooth feeling against my tongue, no matter how much I filed down the area. I've tried wax in the past, but it only lasts for a few minutes, and then gets dislodged, so I don't think I'm going to bother. I'm hoping my tongue will just eventually get used to this new annoyance. I looked ahead at my next 3 trays, and confirmed that they all only cover half my rear left molar. Oh well.

I'm now on Day 5, and my molars are still slightly sore, but not as bad as the day before. It's much easier to pop my trays on and off now, but will never be as easy as it had been pre-buttons. I'm very self-conscious about them, and told everyone about them so that I didn't have to deal with wondering whether or not they were staring at the weird thing on my teeth ("Hey, you got some rice stuck on your teeth there -- yes, of course I'd say it's rice because you're asian - why else would I think you'd be eating anything else?" <-- sorry, I always have to stick in asian humor in here somehow) or not. Now, I know they know.

It's much more of a pain to pop my trays out for a quick snack during the day at work, so I'm once again starving. Aaaaa!!! The sacrifices I make! Oh, the agony!! :)

Refinement - 1st Trays - just the beginning

5 weeks after my last ortho visit, my Refinement Trays came in. I called to make an appointment, slightly nervous because I had a few business trips that required meeting new accounts and public speaking with training coming up. I had an inkling that I'd be getting buttons attached to my teeth, and wanted to see if I could hold off on getting the trays until after my trips.

I asked the girl on the phone if my teeth would be getting any modifications (buttons, IPR, etc.). She said, yes, 2 buttons. I literally groaned a big "Noooooooooooooooooooooooooooooo!!!!!!!!!!!!!!!!!!!!!!!!!!!" into the phone, to her dismay. Plus, I was at the office, and behaviour like that could really attract some negative attention. Luckily for me, I already have the reputation for being very vocal about my feelings, so my whine was pretty much ignored by the rest of the nearby cubicle inhabitants within earshot.

Next question for her: how many trays did I have? 7. That meant 14 weeks. I quickly counted to see how close that would be to my brother's wedding, and saw that would put me just a few weeks right beforehand, so knew I couldn't hold off on getting them later since I planned on whitening them and possibly getting the one tooth bonded, too. Darnnit!!

I came in Friday, 6/8/07 to get my buttons put on and my 4 sets of refinement trays. Looking at my chart, the buttons were going on my 2 canines. At least they weren't going on my bicuspids, so they were a little less obvious on the canine teeth. Good! However, the buttons for refinement trays are square, not round or oval, so they're more obvious than other buttons I would have had during my initial phase. I should really stop complaining because I didn't have any buttons during my initial phase.

They put a "cheek spreader" into my mouth for self-titled reasons, which kept my teeth as dry as possible for the application. There was a separate tray just to put on the buttons. It was pretty cool. It was the same mold as my 1st set of refinement trays, but was super thin. The goop for the buttons was spread onto my teeth, the special tray was put in, and the goop was cured with a special blue light to have it shaped and hardened by the trays. The curing time was 30 seconds. Then, the trays came out, and I was allowed to rinse out my mouth with water and Listerine, b/c the goop tastes really terrible (almost like battery acid). Next, the ortho came over and filed away all the excess button goop.

Next, I tried on my 1st set of refinement trays. Holy COW they were hard to get in (because of the buttons)!! It took the ortho a while to get them in, too! My bottom ones didn't have any buttons, but they were really snug as well. I guess I was really used to not having snug trays for too long, b/c I forgot how tight these can be. The bottom trays almost felt like they were the tightest trays I had had to date, which is weird.

The top trays? OUCH! I was given instructions on how to take them out with the buttons, and went over to the mirror to practice taking them out and putting them back in before I was allowed to go home. I felt like a complete idiot. Getting them off was easier than I thought it would be, but it still felt like I was pulling out my teeth a bit. Putting them back in felt nearly impossible! It was like they weren't fitting or something, which I knew was not the case.

In the end, I wound up lining them up in the center first, and then pushing them on from the right rear and working my way around, all the while keeping slight pressure on the center so that it wouldn't move while I pushed around my mouth. I think I was initially afraid of pushing so hard to get the trays on my teeth b/c I thought they weren't going to fit, but I needed to realize that I just needed to use this amount of force for these trays now in order to get them on. Once I realized that, it wasn't a big problem.

I was forewarned that the buttons may come off, and if that was the case, to call the ortho to have them put back on.

Can I tell you? I'm in so much pain. So much more so than any of the other trays I've ever had. These buttons make these trays SO tight, and my teeth are incredibly sore and tender. With some other trays, I had this for the 1st day or so. It's now nearing the end of Day 2 with these trays and my teeth are still sore. It ruined my appetite, and even disturbed my night of sleep. I don't even have to be doing anything, and my teeth hurt. I know!!

Granted, most of my other trays have been introduced to my teeth at night, so that I was able to take 2 Advil and have them get used to the tightness for 7-8 hours while I slept away any pain. I think the fact that I started out with these trays in the morning and couldn't sleep away any pain (I did take 2 Advil) definitely exacerbated the problem. By the time I went to bed last night, the pain was very much on the forefront of my mind, and I wasn't able to sleep away and forget any pain I was feeling.

Like the other trays, the edges were mostly smooth, but the molding by my left rear molar doesn't cover my molar completely, and the edges there are a bit rough and have been making that part of my tongue a bit sensitive. I thought it was a different part of the tray, and filed away at that part, and didn't realize it was the most rear part until pretty much right now. I'll be taking care of that shortly.

These trays definitely fit MUCH better than my 16th trays did, though. I guess it makes alot of sense that they do, since the 16th trays were made based on a estimate of where my teeth would be, and not really where they currently are. This Refinement Tray 1 was made more on where my teeth currently are. So remember that gap on the trays above my crossbite tooth? Gone. The trays fit all my teeth like a glove now. Unfortunately, it still currently feels like the same glove OJ Simpson tried on in court ;)

I've been dreading taking them out to eat. It hurts so friggin badly!! However, now that it's after midnight on Saturday, and I've taken out my trays to eat dinner and have put them back in, I can say that the pain is starting to lessen now. Finally!

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: