November 6th, 2019
Invisalign For Difficult Cases.
Hi, this is Dr. Donald Fox. I'm an orthodontist in South Florida. I have offices from Deerfield beach near Boca Raton, all the way to South beach. Today what I wanted to discuss with you is how you can do Invisalign with complicated cases. Many patients come to me who have been told they can't have Invisalign. Let's go over some of the simple things in this video. One of them is a person comes in and this is a model of the upper and lower teeth and the lower teeth are all crooked and you don't want, there's no way to do this without taking teeth out. But what you can do is, and it's kind of unreal to hear this, but we can actually take out one front, lower tooth and we put on metal braces on the lower cause last time when people smile and talk, they don't even show their lower teeth.
So we do the treatment, but it has to be done with lower braces because the Invisalign trays, you get one every two weeks, only move your teeth about 0.25 millimeters per tray. Braces move teeth faster than that. So this is Invisalign by the way. So there's also one for the lower, but the plastic will not move. When we take out this front lower tooth, the bone is going to be so thin that the teeth, the bone will start disappearing before we get the space close. So what we did is we use metal braces on the lower, we put them on first so that we take out the tooth and then within a week or last we start moving right away cause you can't be running around with a hole in your mouth and the bone will start dissolving away. If you don't show it back up for two months or you get the 2001st and then you put the lower brace on, that's bad too.
So we put the braces on first metal and we get the tooth removed and we line it up. Of course only at the teeth are so crooked that we don't have enough space to line up the teeth in a matter of four months, five months. We then switched you over, we take the braces off and then we've put the upper and lower. Invisalign. okay. And then we do the treatment on that. The second problem I see all the time, um, is that if you look at this upper teeth, this is OPERS. And this tooth here, the canine, the canine is a very unusual tooth that's very long. It has the longest root. So what you see here in the mouth is a certain height. But what you don't see up in the bone is the root. So the teeth are like this lined up, okay?
But the canine is like this, but many patients all of a sudden come in and their root is like this on the upper canine and the tooth. Instead of being what you see, like my hand here, this canine is actually rotated. So you have a rotation problem and the root problem and the plastic tray here cannot grab a hold of the tooth. Like this is a tooth. It just can't grab it and turn it and move the root as if the root is my arm. So, um, what we again are showing you on this model is the roots like this, but the patient has the root like this and the plastic has a hard time moving that very long, big route. And the place a lot of dentists, um, by the way, general dentist do Invisalign. I've only had a one day course. Uh, they're not fully trained, embraces, they didn't have any training really in school.
I'm not saying all of them, but I'm saying both. Um, so they're, they're doing the Invisalign, which is a little bit out of their expertise and the actually what they're doing is having Invisalign, um, tell them what to do and they're putting everything in the treatment hands of the, um, the company. And not all the doctors are at Invisalign and looking at every case. There's the many technicians. So you need to know the truth about that. But why am I saying this? Is because you can go to 10 different general dentists and then come to me and then I would tell you like, um, we can't do Invisalign alone because of your upper canine is rotated. But what we do is we, like if it's the upper canine, we can put upper clear braces on the three or four months and then switch you over after we get the route in a better alignment.
If the route gets moved that fast, sometimes it takes seven or eight months and then we can do the upper and lower. And Invisalign, the same thing can happen on the lower canines. So we see that most often. Like that canine right here or this one over here, and again, the root is not lined up. So we have the teeth are like straight like this, this, this, this. But the canine is like this. It's slightly tipped. The route is slightly tipped to the back of their mouth, but the patient comes in and the roots like this, and again, from when you looked down the tooth doesn't like this, it's turn. So we've got two, three, two problems that are three dimensional problems that Invisalign knows. They can't fully correct that and they know it. And the, and the rotation, some teeth are so rotated, they, they cannot turn teeth that are more than 35 degrees.
Here's your zero degrees. Um, let me turn my hand. Zero. This is 45 and then all the way is, um, um, well this is zero. This is 90. So you know, in geometry you have 90 is this 45 degrees is this Invisalign has a hard time rotating a tooth that's only 30 degrees or more. So what we do in those situations, again put on the braces to handle the rotations and to get those properly handled and then switch the patient over 10 busy line. So, um, I hope this helped because um, many patients don't know that they can come see me and I can try to figure out a problem so that they can still have Invisalign. I deal with a lot of celebrities, um, can exactly give you their names, but um, somehow I can prove it to you. Um, I deal with a lot of lawyers.
Lawyers don't want braces in court. There was even shows like a LA law and all where there's a lawyer as braces on and the judge thinks less of him or not as powerful of a person or something. Two lawyers dialogue, lawyers like braces, but I deal with them and I deal with celebrities who don't want it to be seen with the braces or not for so long. Um, and we do different other things to try to unmask the problem. One other thing is Invisalign does not widen the mouth as wide as if you can use the fixed or removable expanders. We use removable expanders that are virtually, uh, clear. Uh, they don't hurt so we can widen the mouth so that the teeth fill up the width of your mouth because a busy line can only widen about that much versus we have expanders that can wide as much as this and avoid extractions, get all the teeth to fit were Invisalign, wasn't going to work. So again, um, I hope this help again, this is Dr. Donald Fox orthodontist. I'm a orthodontic specialists and braces. I treat children as early as age seven for geography problems. Um, but particularly you can go to my website at www.reallystraightwhiteteeth.com, and find the location of one of my offices and come visit me to do an exam. And, and especially if you'd been to someone, they said you couldn't have Invisalign. Anyway, thank you for listening to this again. I hope this help.