In the last few weeks, I’ve had two patient experiences that have motivated me to write a post explaining what Invisalign IS NOT (for a post about what it IS, see this post).
The first was a patient who was coming in for a second opinion. Her general dentist evaluated her and told her that Invisalign’s treatment plan anticipated a short 4-8 month treatment time. As I evaluated her, my orthodontic training told me there was no way that the movement of teeth she desired could occur within 12 months. I thought the movements would take 18-24 months!
The second was a mother who works for a dentist. That dentist, in addition to general dentistry, does some orthodontic work through a program called Six Month Smiles. She brought her daughter in for an orthodontic consultation because “she doesn’t trust Six Month Smiles to give good results.” She also mentioned that she has not been impressed with Invisalign because “treatment always takes about twice as long as it says it will.”
By way of explaining what I think is going on in these two cases, I hope you gain an understanding of Invisalign and its limitations:
Invisalign is a number of things, but one of its attributes is that it is an algorithm for tooth movement. At the beginning of the process, doctors enter a prescription for what they want to happen. The algorithm spits back a treatment plan for how that prescription can occur. The problem is that it is an algorithm; NOT A DOCTOR!
Very frequently, the algorithm cannot account for how fast or slow movement can realistically occur. It cannot account for unique considerations like how the medications a patient might be taking will affect tooth movement. It cannot account for how growth (in the case of a teen) will affect movement of teeth. It cannot, in many cases sequence movements properly. These are just a few examples of the limitations of the algorithm.
Am I saying that Invisalign should not be used? Absolutely not. I use it extensively. The key is HOW I use Invisalign. In particular, I have NEVER accepted the initial treatment plan that has come back to me from Invisalign. Rather, I use the knowledge I gained during my orthodontic residency and my experience practicing orthodontics to make changes to the initial treatment plan to account for the intricacies of each individual patient. Making those adjustments requires a human eye (and preferably, a human eye that has been specially trained in tooth movement!).
To circle back to the experiences that motivated this post, in both instances, Invisalign’s algorithm spit out a plan that was not realistic.
My recommendation for anyone considering Invisalign is to get two opinions, with at least one of them coming from a trained orthodontist. Most orthodontists (Joosse Family Orthodontics included) offer free consultations, so while taking the time to schedule two visits is a time commitment, it is not a financial one. If the time estimates given to you for treatment differ greatly, that’s a red flag and I would recommend you ask the doctors about how they came to that estimate.
