Dr. Noah's Dentistry Blog

Questions About Dentistry Answered

Am I Too Old for Invisalign?

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I’m seventy two years old and have always been embarrassed by my smile. Growing up, my parents could not afford braces. They worked hard, but such luxuries were still out of reach. Now, I’m way to old for a mouth full of metal and my skin is pretty paper thin so it cuts easily. Several of the young teenagers at my church are getting their teeth straightened with this thing called Invisalign. You can’t even tell there is anything on their teeth. I asked them about it and they said it doesn’t hurt. Am I too old to get this? I like the idea of getting my teeth straightened. There’s a widow in my book group and I’ve always wanted to smile at him and get his attention. This might give me the confidence.

Esther

Dear Esther,

Upper Invisalign Aligner

First, let me say right off the bat that I think you are awesome! You chat with the teens at your church and have your eye on a fella. You ROCK. Second, you are emphatically NOT too old to get Invisalign. Though it is popular among teens, it was originally designed for adults. To put you even more at ease about your age and Invisalign, there is a study group (The Molis Group) who get together and discuss various cases and techniques. They did a survey of dentists in the group about the ages of their patients. There were several in their 80s. However, that is not an age limit. That was just from that particular group.

You are perfectly safe to get Invisalign as long as your teeth are healthy. There is a hidden benefit too, that may help you get the attention of that widow. The aligners can double as teeth whitening trays. Your dentist can provide you with teeth whitening gel that you use in the aligners at your convenience. By the time you are done with your orthodontic treatment, you will not only have straight teeth, but youthfully white ones too! You’ll look at least a decade younger.

You’ve got this!
This blog is brought to you by Tulsa Dentist Dr. Ryan Noah.

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.

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.

Can Teeth Whitening Trays Double as a Retainer?

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I’ve worn out my normal retainer. My teeth haven’t budged but I know I’m supposed to still wear them. I’ve been whitening my teeth and those trays are pretty snug. My dentist will charge me over $300 for another retainer. I don’t have that kind of money at the moment. Is it possible to use my whitening trays as a retainer for now? I only wear the retainer at night. I can just use the whitening gel at the same time and sleep with it. Is that safe or do I need to suck it up and get a new retainer?

Andie

Dear Andie,

Teeth whitening trays in a blue case

Teeth Whitening Trays Can Double as a Retainer

I think that it would be fine for you to wear your teeth whitening trays as a retainer in the short term. However, I say that with a precaution. If you notice even the slightest change in your teeth, then it will be time for you to get a true, customized retainer.

For the benefit of others who may be reading this, I’m saying this because these teeth whitening trays are recent. That means they fit her teeth in the new position. If her teeth whitening trays were from before the time she had her teeth straightened, this would not work at all.

As for the cost, I have to say I am a bit surprised at the price tag they quoted you for a retainer. It is a fairly simple thing for them to do. The process is simply a matter of your dentist making a good impression of your teeth, then pouring a model of that impression they will send that to a dental laboratory.

If it turns out the teeth whitening trays aren’t adequate to keep your teeth in place, I suggest shopping around to other dentists or orthodontists and see how much they’d charge you to make a retainer. I’m pretty sure you’d end up saving a good amount of money. There are some procedures where you are perfectly safe by price shopping. This is one of them.

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

Fixing a Black Triangle

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I’ve just finished my braces and am starting my retainer. My orthodontist ended up shaving off about 2mm of space on the teeth. This ended up creating a black triangle at the gums. Will this go away or will I need to have another procedure done? Would grafting gum tissue to the space fix it?

Emma

Dear Emma,

example of black triangles at bottom teeth

Black Triangles

My guess would be your orthodontist is planning on fixing this by closing the space and just has it this way at the start of your retainer treatment. The first thing I would do is talk to him about it. If he doesn’t plan on doing anything about it and the gums don’t adjust when you’re done wearing a retainer, then you’ll need to take steps.

Gum grafting won’t be a useful procedure for you in this case. Your gums position themselves based on both the positions and shapes of your teeth. Even if you grafted gum tissue there, it would shift to a position based on the teeth in the area.

If your dentist doesn’t close this space and it bothers you, the procedure to fix it would be dental bonding. However, you don’t want to have just any dentist do this. It’s a tricky procedure to get right. You’ll need an expert cosmetic dentist to work on this.

One thing to be aware of with braces is to make sure you’re really getting in there when you brush your teeth. The areas surrounding the brackets gather bacteria. If you aren’t super careful, you’ll end up with white spots on your teeth. You haven’t mentioned this as an issue for you. I’m only bringing it up for the benefit of others who may still be wearing braces.

The Modern Alternative to Braces

These days, there are been tremendous advancements in orthodontics. The best of these advancements is Invisalign. These are sometimes called invisible braces because they use clear aligners to straighten your teeth instead of metal wires and brackets. They are completely invisible even at a conversational distance.

They have another, mostly unknown, benefit as well. The aligners can also double as teeth whitening trays. This will allow you to straighten and whiten your teeth at the same time.

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.

Splotchy Teeth After Braces

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My daughter had braces done. They did straighten her teeth but now several of the teeth are splotchy from being two different colors. She does have thin enamel and I’m wondering if the orthodontist took this into consideration before giving her braces. Are they permanently damaged? Will insurance help me fix them? Would teeth whitening help?

Amelia

Dear Amelia,

Smiling young woman with braces

White spots are a sign of decalcification. This means your daughter wasn’t brushing quite enough where she needed to during her orthodontic treatment. Braces catch food which will sit there and start the decay process until it is cleaned off. It’s very important to brush your braces right after every time you eat. Snacking should be severely limited, and it would be smart to keep a toothbrush with you at all times in order to brush after each meal.

Your daughter was particularly susceptible because of her thin enamel. Your daughter’s spots will turn into decay if they’re not dealt with.

Dealing with White Spots After Braces

One thing you could try is Tooth Mousse. This sometimes helps re-mineralize teeth. However, it usually has better success when the cause is from something else. Either way, it’s worth a try.

Unfortunately, teeth whitening won’t work. This will whiten your teeth evenly which will just make the splotchy color more obvious.

Usually, the best solution is for a skilled cosmetic dentist to grind down the soft enamel down to solid tooth structure and then to do dental bonding over it to restore the tooth. This isn’t an easy procedure, so make sure the dentist who does it has the skills necessary.

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

Yellowing Crowns

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I’ve had my dental crowns for about 7 months. They’ve really begun to turn yellow, which surprises me. My dentist told me they’d be stain resistant. I do drink coffee every morning, but I brush my teeth twice a day so that shouldn’t be too bad. Do you know what’s going on?

Alice

Dear Alice,

porcelain crown being placed on prepared tooth

This shouldn’t be happening to your crowns, if indeed that’s what your dentist gave you. There have been tales of dentists saying they gave porcelain crowns or porcelain veneers but actually gave them a composite resin.

There are some other issues which could be causing this as well. Seven months means you’ve had enough time for another checkup and cleaning. This is making me think your hygienist could have done something to them unknowingly.

Sometimes a hygienist doesn’t realize that certain tools and materials she uses can damage the glaze on porcelain. If your hygienist used something like a power prophy jet in your cleaning or even an acidulated fluoride it can remove or etch the surface of your porcelain crowns, causing them to pick up stains.

Repairing Stained Porcelain Crowns

You cannot use teeth whitening to repair the stains. Unfortunately, you’ll have to have these replaced. I’m going to suggest you give your dentist a chance to make this right. If he’s unwilling, you’ll have to get tough.

You can get a second opinion from another dentist about what happened to these crowns. I’m going to suggest you don’t tell the second dentist who did the work. Just tell him you want his unbiased opinion. There is always a chance they are friends and he’d feel disloyal saying his friend made a mistake.

Sometimes, when a dentist isn’t willing to listen to a patient, but will not want to look bad in front of a peer. That’s unfortunate but it does happen.

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

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.

One Orthodontist Thousands Less

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I don’t know how it is possible for one orthodontist to cost so much less than another. It’s appealing, but I don’t want to make a mistake about this. I’m out of college and in my first PR job. My appearance is important which is why I want to straighten my teeth. However, I’m still paying off student loans, and will be for a while, so I don’t want to spend a fortune. The first dentist suggested Invisalign. The next one suggested Six-Month Smiles. The second one seems to work faster and is thousands of dollars cheaper. How is that possible?

Karyn

Dear Karyn,

A woman placing her Invisaliagn aligners

Do you remember in Algebra when they said you can’t add x’s and y’s? Well, this is sort of like that. Invisalign is a complete orthodontic treatment It will shift your bite into proper position, changing aligners every two weeks.

Six-Month Smiles is a completely different orthodontic option which doesn’t correct your complete bite, but just straightens the front visible teeth. This is also why it takes less time and doesn’t cost as much.

This means the second orthodontist isn’t charging less but offering a completely different treatment option.

Which Option is Best?

Which one you choose really depends on your goals for your smile. Do you just want it to appear straight and beautiful and saving money is the higher priority or are you wanting your bite fixed, while looking straight and beautiful?

There’s not a right or wrong answer unless you’ve had jaw pain or persistent headaches. If you have had those, fixing your bite would likely alleviate both of those. Not fixing it could lead to TMJ problems. I don’t say that to scare you. Headaches don’t necessarily mean TMJ, it is just a symptom.

Combining Procedures

One thing you can do with Invisalign which you can’t do with the Six-Month Smiles clear braces is whiten your teeth at the same time. The aligners can double as teeth whitening trays. Then, by the time your treatment is finished you’ll have both straight teeth and a white smile.

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