30 FOCUS - SEPTEMBER 2018 Some Clear Facts about Clear Aligners A beautiful smile is a great boost to one’s self confidence, and has the poten- tial to enhance one’s social and profes- sional life. It can also contribute to better health and longevity. Making the decision to undergo a tooth straightening procedure might, given the benefits, be an easy one. Given the the labyrinth of orthodontic facts and figures, the decision of which tooth straighten- ing technique to choose perhaps isn’t so straightforward. There are basically two techniques for moving and straightening teeth: 1) traditional braces, with the well recognized conglomeration of fixed brack- ets and wires, and 2) clear plastic custom aligners. There are advantages and dis- advantages to both methods. In a nutshell, traditional braces are like handles on the teeth with the wire, en- gaged in the braces with tiny wire or elastic ties, being the force that moves them. Braces are fixed to the teeth, which requires special care in the way of diet and tooth cleaning routines, as well as regular office visits (usually every four to six weeks) to keep teeth activated and moving. In addition, they are very obvious, especially when the clients wearing them indulge in the fun of self expression with coloured ties and elastics. Custom aligners are completely differ- ent. They are different in how they look, how they move teeth, how removable they are, how they impact lifestyle, what appointments are like, and even how fast they work. Finally, who is a candidate? Let’s look at these in turn. 1. Appearance This of course is the first thing that stands out with clear custom aligners, and why so many people choose them: they are virtually invisible, only imparting a slight shine to the teeth that is noticeable at a very short distance. Because all the tooth surfaces are covered with a thin coating of shiny clear plastic, many imperfections like crowding or small spaces are immediately glossed over and actually look better right away. 2. How they move teeth When a patient starts treatment, the orthodontist submits a precise set of cus- tom, individual and prescribed instructions to the aligner company (the biggest and most commonly recognized is, of course, Invisalign). This is where the magic hap- pens: it is the prescription, and the experi- ence of the orthodontist who creates it, that brings the result. These are then, with the help of advanced 3-D computer graph- ics technology, translated into a sequence of delicately calibrated aligners. Every person’s treatment is different, depending on the orthodontic issue, teeth present, age, facial pattern, and level of difficulty. The aligners are worn in sequence to incrementally move the teeth closer and closer to their final, ideal position. 3. Removability Custom aligners are completely remov- able, which means there is very little im- pact on someone’s lifestyle: there are no dietary restrictions, as with fixed braces, as the aligners are simply removed for meals and snacks. All the usual “forbidden” foods can be enjoyed with gusto: gum, popcorn, hard, crunchy and sticky treats, raw fruit and vegetables. Just remember that, to be effective, aligners need to be in the mouth for 21 out of 24 hours every day. This still allows for a daily three hour (budgeted over the twenty four hours, not all at once) orthodontic holiday! Do not ex- ceed this time limit, as biology and physics do not allow for negotiation! By the same token, removable appli- ances allow for meticulous oral hygiene, as there are no impediments to thorough brushing and flossing. This can be a problem with fixed braces, where swol- len, bleeding gums or white areas on the enamel from decalcification due to imperfect plaque removal can spoil the or- thodontic result. Cemented brackets and wires present brushing challenges. 4. What appointments are like In order to get started, a patient’s den- tal information is first sent to the aligner provider company with the orthodontic prescription. The most accurate way to submit a patient’s information is not through a traditional dental impression, but through a digital scan. Digital scans are fast, comfortable, and do not require time spent with a mouth full of putty or cheek and lip extenders. Scans are sent electronically, and are extremely precise. When treatment starts, there is usually a one hour appointment where small bond- ed bumps called “attachments” are applied to the pa- tient’s teeth. These are completely in- dividualized depend- ing on the tooth movement required, and allows the aligners to subtly apply the tooth moving forces in the right direc- tions and dimensions. They are discreet, and are removed at the end of treatment. Follow up appointments usually happen at approximately two month intervals, or even longer if the patient’s schedule and lifestyle so requires, and involve checking the fit of the current aligner while handing over several new sets. Pretty easy! 5. How fast they work Because teeth are virtually “plastic wrapped”, tooth moving forces are applied to several tooth surfaces at once by the aligners. This makes for more individual- ized movement with less side effects on other teeth, as typically can happen with fixed braces. Because of the elasticity of the plastic material, forces are gentle and consistent, something that teeth love! For both these reasons, teeth typically move faster with aligners than with fixed braces. 6. Who is a candidate? Initially, custom aligners were used for more straightforward cases of spacing or crowding, and only in those cases where all permanent teeth were already erupted. With the evolution and advances of re- search and development, however, the possibilities have hugely expanded. Now, even most complex bite problems can be addressed with Invisalign, while everyone from children who do not have all their permanent teeth to seniors can also enjoy the benefits. It is never too early or too late to have a beautiful smile!! Do not be shy to see an orthodontic provider with your questions. Most consultations are free! Dr. Barbara Frackowiak is a certified orthodontist who has been practicing in Durham Region for the last twenty plus years. She is passionate about Airway Centered Orthodontics. This is the sec- ond of a series of four articles. Dr. Barbara Frackowiak port perry dental centre 238 Queen Street - Port Perry 905-985-8451 - www.iluvmydentist.com 2017 Readers’ Choice Awards PORTPERRYSTAR BUSINESS OF THE YEAR Dr. J. Cottrell Dr. J. Hardy Dr. C. Banfield Dr. J. Isenberg Dr. M. Pearson Dr. C. Richardson Dr. B. Frackowiak (Orthodontist) Dr. M. Dhillon (Periodontist)