I like Invisalign for tooth movement. It is physiological, meaning it moves the teeth with just the right amount of force. It doesn’t hurt, always a plus. When done properly and the aligners are worn for the prescribed amount of time, Invisalign gets excellent results. The Invisalign aligners are virtually invisible. The aligners are comfortable. Many of our patients (myself included) have found that during active treatment, they were more comfortable with the aligner in the mouth than out.
My having gone through the alignment of my own teeth with Invisalign has given me a greater understanding of the process. A different perspective, if you will. My enthusiasm is based on how easy it is to adapt to the aligners. Dr. Shukovsky’s Law of Invisalign: Minimal changes yield maximum results. In geology you can see the mountain ranges that developed over millions of years to get to the topography that exists today. But in less than a year (in most cases), we can move teeth to an improved functional and aesthetic position.
In cosmetic dentistry we can very often, by design, combine restorative techniques and Invisalign to achieve an optimal result. Invisalign, like many of the techniques in dentistry, is a tool to help us get a result. So there are times when, for example, the teeth are misaligned and we would have to remove more tooth structure than we would like to achieve an excellent result. Invisalign can align the teeth properly so that less tooth structure would need to be removed for porcelain veneers or crowns.
When I was at the American Academy of Cosmetic Dentistry, AACD, this past April, I had the opportunity to listen to Dr. John Kois for an entire day. An amazing educator. One of the things he stated during his six hours of lecturing is this maxim: Our teeth should out live us, we should not out live our teeth. A 65 year old recently said to me that the only thing that has made him feel ‘old’ was his recent loss of two teeth. As we live longer, it becomes more important to take care of our teeth so that we can have them for our entire lifetime.
So what is the cost of replacing a lost tooth? The dollar cost of losing a single tooth is fundamentally large. The progression from a lost tooth (cost of extraction), placement of an implant, and then the required abutment that fits into the implant and then the crown that goes over the abutment can cost four to five thousand dollars. For one tooth! So modern dentistry, 21st Century dentistry, needs to be more proactive in preventing tooth loss so that our patients do not lose teeth. Remember: We want our teeth to out live us! This means, for example, that if we have large silver fillings that have been there for twenty five years, they should be removed because they are probably in some state of failure and it is a matter of time when they will break down. Do we want to be proactive or reactive? By being proactive, we are not waiting for failure but preventing a potentially bigger problem.
Two weeks ago a patient came in to have a large silver filling removed from a molar. When the amalgam was removed, three separate fractures were evident under the old filling. The crown that we make for this tooth should protect the tooth from further cracking. It is quite clear that we saved this patient the need for an implant and all that it entails. A proactive success.
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