Dr. Noah's Dentistry Blog

Questions About Dentistry Answered

Can Invisalign Cause TMJ Problems

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I’ve been using Invisalign for about three months now and most of the time it is awesome. One thing that does worry me is that whenever I put in a brand new pair of aligners, it causes my jaw to ache for a few days. Is it possible that this treatment is actually causing me to develop TMJ Disorder? My friend who has that said her first symptom was her jaw aching.

Missy

Dear Missy,

Upper Invisalign Aligner

TMJ Disorder is when there is a problem with the temporomandibular joint in your jaw. It’s the hinge joint. Sometimes, TMJ problems can be caused by having a bite that is out of alignment. However, you are working to straighten your teeth and are getting them in alignment, so that would not be an issue. In fact, sometimes orthodontics is the “cure” for TMJ Disorder.

Of course, it is possible, if you went to a horrible orthodontist who provided you with braces that messed up your bite, you could end up with some TMJ problems. However, Invisalign is designed with sophisticated computer software and is more accurate than what you would normally get.

What is Causing the Ache?

So, if Invisalign is so awesome why is your jaw aching when you first pop in those new aligners? The most likely cause is that your teeth are shifting. In the first couple of days when you place in your newest set of aligners, you will notice that they are a bit snug. That is because they are shifting your teeth into the new position. After two or three days, the aligners will feel looser and the aching will subside. This is because they are now in the next designated position for your treatment plan.

Don’t Try to Speed Up Your Treatment

Some patients, in an effort to speed up their treatment, will put in the next pair of aligners as soon as their new ones loosen up a bit. However, this is a dangerous thing to do. Yes, your teeth are in their new position. However, the remainder of the time you are supposed to wear those aligners is so the bone has time to integrate with the teeth in the newer position.

If you don’t give it that time, there will gradually be an ever widening gap between your teeth roots and the bone, which can cause your teeth to come loose and even fall out. So, make sure you use them as prescribed.

If the achiness of the first few days is getting to you, I have a couple of recommendations that should help. First, you can try changing out your aligners at night, so you can sleep through most of the initial achiness. A second thing you can do is take an over-the-counter anti-inflammatory.

A Secret Benefit to Invisalign

Did you know that your Invisalign aligners can actually double as teeth whitening trays? This means you can straighten and whiten your teeth simultaneously at a fraction of the cost it would normally be. Simply ask your dentist for some professional strength teeth whitening gel and wear it in your aligners at your convenience.

This blog is brought to you by Tulsa Dentist Dr. Ryan Noah.

Is Smile Care Club a Good Option?

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I recently saw an advertisement for Smile Care Club on Facebook. It seemed like the people are really happy with the results they received, though they could be just paid actors. It is cheaper than Invisalign so I was wondering if it is as good a deal as I am hoping?

Drake

Dear Drake,

Smile Direct Club Ad

I’m glad you wrote. This company was founded in 2013 as an inexpensive alternative to Invisalign. Like Invisalign, they use clear aligners to straighten your teeth. It is cheaper than Invisalign. For some people, it works out. When it does, you can save a lot of money. However, there is a lot that can go wrong with their method.

Before Invislaign treatment, you have an examination to make certain your gums are healthy. If you have gum disease and have orthodontics done, it will exacerbate the condition and you risk losing your teeth. The way Smile Care Club is so much less expensive is they eliminate regular visits with the dentist. You will send in a picture and a dentist will look at it and “determine” whether or not you have gum disease. I have little confidence that they can tell this from an image.

Two other issues that require a dentist are overcrowding and possible problems. One of the major reasons people need orthodontics, to begin with, is overcrowding. That can mean you will need some teeth extracted or shaved to make room for the teeth to move into their correct position. How Smile Care Club handles this is by sending you to a dentist to whom they pay a straight fee. This dentist will not be invested in you or your case. Shaving teeth takes some skill and if it is not done right you will end up with a weird-looking smile. You want a dentist who cares about how your smile ends up.

If your teeth don’t cooperate, which happens more than you would think, a dentist can restructure the treatment. With Smile Care Club, you won’t even really know that it is not going according to plan because no one is regularly examining you.

As for the people praising them, that would be the people where it worked out, which does happen. However, Smile Care Club has a reputation for squelching negative reviews by only offering a refund if they do not say anything negative about the company.

In my opinion, while you could save money with Smile Care Club, you want to be careful because you could end up with a disaster.

This blog is brought to you Tulsa Dentist Dr. Ryan Noah.

Invisalign and Missing Teeth

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If I have missing teeth, can I still get Invisalign? I’ve seen an orthodontist for a consultation and he said Invisalign only works on the most ideal cases, but my dentist thinks I can still get Invisalign if I want to. I’m not sure which is right. They both have “motive” to get my money. Hahaha. As I live in a completely different state from you and you can’t get any of my money, do you think Invisalign is possible for me?

Elinore

Dear Elinore,

Upper Invisalign Aligner

I like your style. It is always a good idea to ask for your advice from someone who cannot benefit from the answer given. While it used to be in its early days that Invisalign only worked on the easiest cases, there have been quite a few advancements in the technology and it is now on the opposite ends of the spectrum where it works on all but the most complicated cases.

Invisalign does fine working around missing teeth, so you shouldn’t have any problems with Invisalign if that is the most complicated thing about your case. So, you may be wondering why your orthodontist was saying it cannot. I don’t think it was a completely financial answer. Orthodontists were trained to work with braces. They have more confidence in working with that procedure. He’s telling you what HE can do the best job with.

If you decide to get Invisalign, you should know there is one other hidden benefit to Invisalign. The clear aligners they use can also double as teeth whitening trays. This means, if you want to, you can straighten and whiten your teeth at the same time. It is like getting a mini smile makeover for a fraction of the cost.

I would consult with the Invisalign dentist you choose about replacing the teeth. In some cases, the teeth can just be shifted, depending on the placement of the teeth, without it having a negative impact on your smile. However, in some cases, your dentist will need to open up space for you to replace those teeth. In that case, you can replace the teeth once your case is done. The best tooth replacement is a dental implant. However, one step at a time.

This blog is brought to you by Tulsa Dentist Dr. Ryan Noah.

Invisalign Didn’t Work For Me!

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I’m hoping you can help me!

My dentist recommended Invisalign to fix my midline and make room to put veneers on my lateral teeth. The agreed-upon price that I paid was $4,675.00. Initially, I was supposed to do a period of 9 months, but after the 9 months and my first set of trays, my midline was still not straight.

My dentist ordered a new set of trays and recommended that I do it for another 9 months. I have spent a year and a half working with my dentist and trying Invisalign to correct my midline, with no success.

I am extremely frustrated having spent so much time and money without any results. I decided to speak with other dentists that work with Invisalign and traditional braces. They all recommended traditional braces, stating that Invisalign would not give me the results that I was looking for.

I’m wondering how I should go about getting a refund from my dentist so that I can afford braces?

Thank you for your time and advice.

-Jennifer

Jennifer,

First, the doctors you are now seeing that recommend traditional braces are most likely right that Invisalign wasn’t the best option in this case. However, many orthodontists tend not to give Invisalign enough credit. Many believe that traditional braces are the only way to correct crooked teeth.

two people smiling. One with traditional braces and one with invisalign

Traditional braces are typically the most recommended option, but Invisalign can also be very successful. I believe that many orthodontist specialists feel that because you don’t need to be an orthodontist specialist to use Invisalign, that they are protecting their status as specialists by using traditional braces.

It can be challenging moving a midline and keeping it straight, so seeing an orthodontist specialist is a good choice.

Every dentist handles refunds differently. Some dentists will, without hesitation, give you a refund if you aren’t satisfied with their work. While others will not be so willing. The first step is to simply request a refund, and if that doesn’t work, then you will need to increase the pressure by:

  1. Politely request a refund from your dentist.
  2. Ask your new dentist to call and ask for a refund.
  3. Threaten that you will make a complaint to the state dental board. Make sure to follow through if they still don’t refund you.
  4. If everything else failed, get a lawyer.

Make sure you stay polite and calm but also firm to show them you are serious.

I hope this helps.

This blog is brought to you by Tulsa Dentist Dr. Ryan Noah.

Can Invisalign Help a Narrow Smile

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I needed braces when I was younger, but the dentist said I needed a palate expander. My parents decided that was too expensive and never went through with treatment. Now I’m an adult and still need orthodontics. I have heard Invisalign is a way for adults to straighten their teeth without anyone knowing. Will that work for me, as someone with a narrow smile or will I still need a palate expander?

Kelly

Dear Kelly,

Upper Invisalign Aligner

You are too old for a palate expander at this point in your life. Those are designed to be used on children whose mouths are more malleable. Once you get past around twelve years old, these are no longer going to work. That doesn’t mean things are hopeless.

You can still have orthodontics as an adult. Invisalign could be a good choice for you. In the past, it only worked for the most ideal cases. These days, they can take on all but the most challenging bites.

When you have a narrow bite and there is no longer the option of using a palate expander, it often means you have to extract some teeth to make room for a correctly positioned bite. Fortunately, with computer-aided orthodontics, such as clear braces like Invisalign or Clear Correct, you can often see what your smile will look like before you go forward.

Giving Yourself a Mini-Smile Makeover with Invisalign

One hidden benefit of Invisalign is the aligners can double as teeth whitening trays. Your dentist can provide you with a professional strength whitening gel. You can wear the gel in your Invisalign aligners for a set period of time each day.

You’ll simultaneously be able to straighten and whiten your teeth without anyone knowing.

Advantages of Invisalign

You’ll find there are quite a few advantages to Invisalign over traditional braces:

  • You’ll be able to straighten your teeth in half the time as traditional braces
  • No uncomfortable metal wires and brackets
  • No one will know you’re wearing orthodontics
  • Your final aligners can double as your retainer when your procedure is finished.

The key for you will be to get with a good orthodontist who can look at your case and make some recommendations specific to your bite.

This blog is brought to you by Tulsa Dentist Dr. Ryan Noah.

Don’t Like My Invisalign Dentist

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I’m probably sounding like a prude but I don’t like my dentist who has been providing me with my Invisalign. He is crude and tells off-color jokes every time I’m there. I did mention it to the desk once and they apologized and said, “That’s his way of keeping things light.” He’s not my normal dentist anyway. Mine planned to get Invisalign certified but hadn’t done it yet, so I’ve just bee seeing the other dentist strictly for Invisalign. Do I have to stick it out with him or can I switch to another dentist? Will I have to start over? I’m happy with the Invisalign, just not the dentist.

Kim

Dear Kim,

Upper Invisalign Aligner

You don’t sound like a prude to me, just refined. That’s a good thing. It sounds like your dentist lacks some professionalism. I’m glad to hear you are happy with your Invisalign treatment, though. It has a very high patient satisfaction rate.

You can certainly switch dentists at any time, even if you are in the middle of a particular treatment. Ethical obligations require your dentist to cooperate with your new dentist by providing all the materials, scans, x-rays, treatment notes, etc. needed to continue your treatment.

While you’re looking, keep wearing your aligners. Be sure to check the dentist’s reviews to ensure you don’t end up with another dentist who makes you uncomfortable.

Invisalign Pro Tip

When you switch dentists, you can ask him to provide you with tooth whitening gel during your treatment. Many patients don’t realize their Invisalign aligners can double as teeth whitening trays. This allows them to whiten and straighten their teeth simultaneously.

It’s like getting a mini smile makeover. There is only a minimal cost for the gel, which saves you money having your teeth whitened later.

Obviously, this isn’t necessary, it’s just a way to be proactive saving money down the line. Best of luck finding your new dentist.

This blog is brought to you by Tulsa Dentist Dr. Ryan Noah.

Solution For My Tooth Gap

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I have a huge tooth gap. It’s about 8mm in width. I don’t want braces. I’m too old for that. One dentist suggested snap on smile. Another suggested porcelain veneers. Which is better?

Carl

Dear Carl,

I’m very glad you wrote. I think we can prevent you from some serious disappointments here. First, I’ll go over the options you’ve been given, then I’ll make an alternate suggestion.

Snap-On Smile

image of snap-on smile

This will cover the gap you are concerned about. Snap-on Smile is a decent way of improving the look of your smile. However, I want to manage your expectations. These snap over your teeth, which some patients find make their teeth look bulky. They’re not meant to be permanent.

Usually, when well cared for, they’ll last a few years. You can eat with them, but will have to take them out afterward to rinse them off as well as brush and floss your natural teeth.

Porcelain Veneers

This is considered the top of the line smile makeover. Bear in mind it is expensive and requires someone with expertise. Your case, especially, would require one of the best cosmetic dentists in the country.

The reason for that is the size of the gap between your teeth. It’s large enough where you could fit an entire tooth there. It will have to be handled by someone at the top of their field. That will come with an additional price tag.

The pluses for this is it will look much nicer than snap-on smile and is considered a permanent solution. The veneers are bonded directly to your teeth.

Invisalign: A Better Solution

Two images: one of a woman placing her Invisalign aligner. The other, she's smling with it in.
Invisalgin is comfortable and Invisible

There is another permanent solution which won’t cost you a fortune. I know you said you didn’t want braces. When most adults think of braces, those horrible middle-school years come back to mind with a mouth full of metal wires and brackets.

Fortnately, there have been many advancements in orthodontics. We now have Invisalign. These are clear aligners which straighten your teeth without anyone knowing. They’re truly invisible, even at a conversational distance.

This can naturally close your tooth gap, giving you the smile you want. It has a side benefit too. The aligners can double as teeth whitening trays. So, if whitening is somethng you’re interested in, it’s like getting a two for one.

This blog is brought to you by Tulsa Dentist Dr. Ryan Noah.

Choosing the Right Orthodontist

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I’ve had three consultations with orthodontists. I’m looking for clear or invisible braces to straighten my teeth and give me more confidence at work. The first two orthodontists gave me similar treatment options for braces. The treatment period would be about two years and would correct my bite and straighten my teeth. The cost was about the same, too. The third consultation costs less and treatment time is shorter. This is strange to me that there is such a difference in time and cost. Are the first two orthos prolonging treatment or is the third one rushing it and trying to get my business with an offer that sounds better but isn’t really going to give me good results? I am on a budget, but I don’t want to waste time on treatment that doesn’t really work. Thanks. Lorna

Lorna,

Your first two consultations with orthodontists propose aligning your bite and your teeth, which can be done with traditional braces or clear aligners. An estimate of two years for orthodontic treatment is in line with the average time, but a thorough examination and digital x-rays are the only way to get a true estimate.

Two images: one of a woman placing her Invisalign aligner. The other, she's smling with it in.
Invisalign works faster than traditional braces

It seems that your third consultation didn’t include bite correction in the treatment. If the estimated treatment time is one year, it seems that a shortcut will be taken somewhere. Tooth movement takes time, and if you’ve never received orthodontic treatment, accurate alignment often takes longer than a year.

It’s reasonable that the cost for the third option is less expensive than the others because your treatment time is shorter. It’s unclear whether the third option is for full orthodontic treatment or for cosmetic treatment that corrects only the teeth that are seen when you smile.

Orthodontic Treatment with Traditional Braces vs. Invisalign

Although you didn’t mention it as a factor, the type of orthodontic appliance used has an effect on your treatment time. For example, Invisalign invisible braces move your teeth with greater precision than traditional braces. And treatment with Invisalign is often shorter—often half the time of traditional braces?

What’s Next?

You can consider calling the third orthodontist and asking what is included in the cost, the type of braces you would receive, and the results you can expect. Weigh your decision carefully, and don’t base your choice of treatment on time and cost alone.

This post is sponsored by Ryan Noah, DDS of Region Dental in Tulsa.

Invisalign for Spacing Problems

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I had braces as a young teenager, but over the years I’ve had some spacing develop between some of my teeth. I don’t feel like I’d be comfortable with traditional braces at my age. In that case, would I be able to get Invisalign for this type of issue?

Andrea

Dear Andrea,

Two images: one of a woman placing her Invisalign aligner. The other, she's smling with it in.

It’s normal for our teeth to move some over the years. If your teeth and gums are healthy, you would be a fantastic candidate for Invisalign. This is a lovely way to straighten your smile without anyone even knowing you’re wearing anything. In your case, you can probably get Invisalign Express which works in even faster.

Aside from enabling you to repair your smile without anyone knowing and without a mouth full of metal, the Invisalign aligners can double as teeth whitening trays. This will give you a sort of mini smile makeover.

Orthodontist Versus Dentist

It used to be that you’d have to see an orthodontist anytime you needed to straighten teeth. Now, it’s not necessary in most cases. Dentists can do Invisalign. Some even do braces. There are still times you would have to see an orthodontist when you have a very complicated case.

That’s not you, so you shouldn’t have any problems. You just need to find a dentist who provides Invisalign. I think you’ll find it a wonderful way to get the smile you had and loved.

One Word of Caution

While some movement of teeth is natural as the years go by, you want to make sure there isn’t another reason for your shifting. Specifically, you’ll want to make sure you don’t have any gum disease. If you see a dentist regularly and have good oral hygiene at home that shouldn’t be an issue.

Your dentist will do an exam ahead of time to make sure you’re gums are healthy enough. If not, you’ll just have to treat the gum disease and then you can get the Invisalign treatment.

This blog is brought to you by Tulsa Dentist Dr. Ryan Noah.

Will a Dental Flipper Make My Teeth Look Straight?

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I really don’t want braces. They take forever, hurt, and look horrible. Would a dental flipper work to just make them look straight?

Ben

Dear Ben,

A woman placing her Invisaliagn aligners

Orthodontics no longer has to mean metal braces

I like how you like to think out of the box. That shows a creative mind open to new ideas. Unfortunately, the dental flipper won’t be a viable solution for you. It’s meant as a temporary tooth replacement option. However, I do have two great solutions for you.

The first will do what you were hoping a dental flipper would accomplish. Snap-on Smile will fit snap over your teeth and make them appear straight. However, because they fit over your teeth they tend to make your smile look bulky. You also need to understand their limitations. These aren’t going to be a beautiful smile makeover like porcelain veneers. They’ll look okay. They can even look attractive. But, they won’t be stunning.

Invisalign—The Modern Alternative to Braces

You no longer have to wear traditional braces with their ugly, uncomfortable wires and brackets. Invisalign uses clear, comfortable aligners. You wear them in two-week intervals and switch them out for the next set. They’re nicknamed invisible braces because no one can tell you’re wearing them, even at a conversational distance.

Because they’re removable, you can eat whatever you want. Additionally, it makes it easier to brush and floss. You simply remove your aligners and brush and floss as you normally would.

A little-known side benefit of Invisalign is the aligners can double as teeth whitening trays. This allows you to get two procedures knocked out in one go. It’s like getting a mini smile makeover. You’ll look and feel great. You’ll also be surprised how much more confidence a nice smile brings you.

This blog is brought to you by Tulsa Dentist Dr. Ryan Noah.