Category Archives: Check ups and cleaning

WHAT’S GOING ON WITH INVISALIGN?

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The post is dedicated to the recent opening of Invisalign shops and the new advertising company Invisalign.

The introduction of aligners by Invisalign has been one of the most significant developments in orthodontics. As a result, Invisalign has become a major orthodontic company supplying aligners to orthodontists and dentists. Invisalign recently acquired a large stake in Smile Direct Club (SDC). Smile Direct Club delivers aligners directly to patients, bypassing dentists.I have already written about this earlier.

It is now clear that Invisalign has decided to adopt this business model by opening Invisalign stores in California. The scheme of work is as follows:

A person interested in orthodontic treatment comes to the store.

Store employees, who may not have a dental education, discuss treatment and scan his teeth.

Technician makes a ClinCheck and discusses it with the patient.

The patient then selects a dentist / orthodontist to “oversee” the treatment.

Invisalign sends data to the “observing” dentist / orthodontist. He, in turn, decides whether he accepts the patient and makes changes to the treatment plan if necessary.

After that, the patient is transferred to the dentist / orthodontist for alignment fittings and “observation”.

Invisalign has also launched an ad campaign claiming that braces are an obsolete technology. Here is a screenshot of an advertising banner.

Interestingly, to this day, I have not seen a single qualitative study that proves that Invisalign aligners are as effective as braces. The image in the ad for dental extractors is also odd. Is this a hint that treatment with braces must necessarily be with the removal or enhancement of the effect of the words “tightening”, “twisting”, “twisting”? (tightening, cranking, twisting)

In connection with the publication of this advertisement, AAO and CAO contacted Invisalign, after which the latter wrote an open letter of apology… However, in his letter of apology, the CEO of Invisalign writes:

“We know that doctors and clients are free to make their own decisions about the method of treatment, and although we believe that aligners are the best and most modern method of treatment, we decided to take our claims back so as not to harm our brand.”

Invisalign appears to advertise aligners as superior to fixed devices.

Is there a problem with this?

I will only evaluate the actions of Invisalign from the point of view of the British Dental Care Regulatory System. I think there are some nuances here. I have concerns about the qualifications of the people doing the examinations at the Invisalign shops.

I’ve sent emails to Invisalign but they haven’t responded. However, visits to Invisalign shops indicate that non-dentists work there.

Dental health assessment

The first step in any dental intervention is to assess the patient’s dental health. Such an assessment can only be carried out by a professional with appropriate training and qualifications. I do not know how this requirement can be met in Invisalign shops, because patients are not directly examined by dentists. This is a serious problem.

Consent

The informed consent must be signed by the patient prior to starting treatment. The only person who is entitled to obtain consent from the patient is the dentist. Therefore, the patient cannot give consent directly in the Ivisalign shop. And if the patient signs the consent in the store before receiving the aligners from the “observing” dentist, then this will be a retrospective consent. In this case, there are potential risks. However, if the “observing” dentist again conducts his own examination and then again gives the patient consent for signing, the risks can be eliminated.

Illegal dental practice

I’m not 100% sure, but my assumptions are: dental scans are performed by unregistered dentists. And since these scans are later used for treatment planning and aligner production, the scanning process can be considered a dental practice. In the UK, only registered dentists are allowed to practice dental practice. As a result, in the UK, such a business model could be regarded as illegal dental practice, and employees of Invisalign shops were prosecuted.

Who is responsible for the treatment?

Everything is obvious. The dentist “overseeing” the treatment. The shop workers who planned the treatment are not responsible. As a result, in case of problems with treatment, the responsibility will lie with the “observing” dentist.

I don’t know about the regulation of dental care in the United States. Probably the rules are different in different states?

Smile Direct For The Poor – Straight Teeth Direct.

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Aligners are transparent aligners for teeth straightening, made individually from impressions. The number of mouth guards depends on the complexity of the situation, each mouth guard is worn for two weeks, then changed to a new one until the dentition becomes even.

Teeth aligners are gaining popularity and are becoming cheaper due to increased competition. Already in Russia, they began to produce a domestic analogue to the American invisaline (Star Smile). In the USA, a competitor to Invisalign is Smile Direct Club, which offers to correct teeth remotely without visiting the dentist. They only need impressions of your teeth, they will send aligners and instructions for them, and any questions you can ask “your ” dentist through the application.

Recently, such an opportunity has appeared in Europe – to correct teeth with aligners without going to the doctor. The company name is very similar – Straight Teeth Direct.

I decided to try to fix crooked teeth with aligners after an unsuccessful attempt with a silicone mouthguard. My one year experience is described in this review .

Before contacting Straight Teeth Direct, I still went to the orthodontist to find out what methods of correcting teeth would be right for me. The doctor said that in my neglected case there are only two ways: either invisalign or braces. Treatment with invisalign aligners would cost me 4,500 euros and the treatment would take a year and a half. Treatment with braces for about 2500 euros and two to three years.

I still didn’t have that kind of money, but I found out the main thing – in my case, aligners fit. I started looking for an alternative to expensive invisalign and found it! These are aligners from Straight Teeth Direct, which I refer to myself as “poor man’s invisible.”

Stages of treatment with Straight Teeth Direct aligners

1 . You need to order a box with tools for taking impressions. The price includes further analysis and compilation of a demo video of changing the dentition. Determine the time of treatment. If everything suits you, then proceed to the next stage.

2. A contract is concluded, a treatment program is signed and paid (1500 euros). The company sends aligners approximately every two months and monitors changes in my monthly photo reports.

3 . Fixing the result with removable retainers (included in the price).

How it looks in practice.

Taking casts. Taking casts is not very difficult. There are three attempts for each jaw, so even if you screw it up somewhere, the rest will be saved. I was told that a computerized model of teeth is built on the basis of all six impressions, even unsuccessful ones. As if uniting the results.

Having sent back the box with the casts, I was looking forward to the demo video. The resulting video shows how the lower and upper dentition will change. In my case, all the front teeth on both jaws should protrude strongly forward in order to form a free space, and their inclination will change slightly. The contract said that there would be no changes in the bite, as well as displacement of the teeth in the center (although I would need to). So the goal is just straight front teeth. It was also indicated that I did not need any tooth extraction or tooth separation.

Here I made screenshots from the demo video. My teeth as they are and what they should be.

Duration of treatment. The contract determined the duration of treatment: for the upper jaw 11 months, for the lower 12. The lower ones are more crowded.

If after this time the teeth do not stand exactly as in the video, then the treatment continues at no additional cost.

Aligners. Aligners are sent in two types: soft and hard. They need to be alternated, each pair should be worn for two weeks at least 22 hours a day. Soft aligners prepare teeth for hard ones. Numbered 1a (soft), 1b (hard), 2a (soft), 2b (hard) and so on.

How aligners are felt on the teeth. The soft aligners are easy to take off and on. The pressure on the teeth with the soft aligner is felt only for the first two hours. With hard ones, the jaw sometimes hurts and it hurts to chew solid food for two or three days, then it passes. Then there is a feeling that nothing is happening, that the teeth are not moving and in general there is no sense from them. Rigid aligners are difficult to remove (I use the plastic hook that came with the kit, otherwise there is no way).

Lisp occurs only with rigid aligners and only in the early days. Some people around me noticed this. My husband said that I talk as usual. Some have noticed that I correct my teeth only because of the lisp; visually, no one sees anything point-blank.

Profuse salivation was when I first put on the aligners. It also stops after a couple of days, when the body gets used to the presence of a foreign object in the mouth.

Aligners in the mouth – is it noticeable? When I saw my first mouthguards, I was upset, because they are not completely transparent, not smooth. The structure is clearly visible in the photo.