As a practicing orthodontist who specializes in Invisalign care, I know how excited patients are to see the results of our teeth straightening efforts. Typically, these patients have made a significant investment of time, effort and money to achieve their ideal smile, and they track the movement of their teeth on a regular basis.
Unfortunately, there are times when straightening your teeth with Invisalign doesn’t go according to plan. This can be frustrating for people using clear aligners, but fortunately we can get them back on track with a little extra effort. In this blog, I share five reasons why your Invisalign is not working, and what you can do to get back on schedule. But first, let’s answer the common question, how does Invisalign work, by describing what we mean by “teeth tracking” so you can better understand the advice I’m about to share.
What is tracking?
Tracking describes how Invisalign works by moving teeth move in accordance your treatment plan. Orthodontist’s can’t straighten your teeth overnight, so they use gradual and successive force to train your teeth into new positions as defined by your treatment plan. In the case of Invisalign or an Invisalign alternative like Smile Direct Club, each new set of trays continues this gradual tooth movement.
Orthodontic professionals work with incredibly sophisticated software to design your treatment plan. For example, Invisalign’s powerhouse software is called ClinCheck (if you go to your Invisalign doctor site, you will probably see example images like the ones below). Since you probably had your teeth digitally scanned by an intraoral (inside the mouth) scanner, ClinCheck presents an incredibly precise representation of the size, shape, and position of your teeth. It’s very cool, and you owe it to yourself to ask your orthodontist to see it! It’s available to be shared via email as well, which may be the easiest way to enjoy it.
Image Credit: http://www.invisalign-g6.com/en-XA/clincheckpro.aspx
Whatever software program your provider chooses, it defines how your teeth will move into new positions which requires all kinds of complicated adjustments. Individual teeth have to move in their own unique way depending on the type of correction you need, which can introduce many variables that even the best software cannot predict. When things don’t follow according to plan, your orthodontist or provider may suggest mid-course corrections during treatment, or refinements after treatment to account for those variables and produce an end result that reflects your ideal smile.
So then why are your teeth not tracking? There are five common reasons that we can share here in this blog, but if you are really concerned about your progress it is always best to consult your orthodontist or provider.
1) Individual differences
Our computer models run thousands of scenarios to devise your treatment plan. These models account for common variables but they are unable to predict individual differences that result from your body’s specific response to orthodontic treatment. Plain and simple, some teeth are more stubborn than others, and if they don’t track in accordance with the plan, it has downstream impacts on the desired movements for your other teeth.
For example, your lateral incisors (the small teeth next to your two front teeth) are the most difficult teeth to move even with metal braces. If you’ve got some stubborn teeth, your provider may apply Invisalign attachments or buttons onto these teeth to give them more attention and encourage them to track in accordance with the plan. Once affixed, the buttons will be used to anchor rubber bands that can apply extra force to move those teeth.
Image Credit: http://www.invisalign-g6.com/en-XA/clincheckpro.aspx
2) Your teeth are colliding during treatment
If you’ve ever ridden public transportation during rush hour, you know how difficult it can be for crowds of people to squeeze through an open door. After a bit of bumping, grinding, and shuffling, people eventually get on the train, but not after a good bit of contact with each other.
Invisible braces can create the same crowding effect in your mouth, albeit on a much smaller scale. When two teeth are colliding with each other during treatment, your provider uses a solution called interproximal reduction, or IPR. These procedures are typically performed in the office, where your orthodontist will literally reshape your teeth to avoid collisions. But don’t worry! IPR is a safe and effective way of making more space so that your teeth can be straightened.
3) When they say 22 hours a day, they mean it
Even with the best intentions, many patients find it difficult to comply with the 22 hours of daily wear time that Invisalign and other at home clear aligner companies recommend. The fact is, it’s tough to find 22 hours in a day to wear invisible braces. And ironically, it’s the flexibility to remove trays during those two (ish) hours that can cause tracking issues which may lead to refinements and mid-course corrections during your treatment.
To minimize the variables introduced by removing your trays and help you achieve the 22 hours of wear time, we recommend TrayMinder’s free smartphone app to keep a record of your smile journey. It has a timer that tracks “not wearing” time and a reminder function that will help you set a limit for your trays being out.
It’s also helpful for keeping up with tray cycles, whether you are on the 2 week change plan or a 1 week plan which is a common practice for many experienced Invisalign providers. We also like the selfie feature which is awesome for capturing Invisalign before and after pictures. The developers just released a version of TrayMinder for android, so no matter what smartphone you have you will be able to use the app!
4) You aren't doing your chewing exercises
Aligners work by creating orthodontic tooth movement that guides your teeth into their new positions. The trays “push” your teeth each time they are seated, which provides a little extra “oomf” for moving your teeth. So getting from the first tray to your last is really a numbers game; every time you swallow, your teeth come together and your trays tighten. Every time you clench your teeth due to stress or determination, you tighten your trays. However, swallowing and clenching only applies force to your molars, and not to your front teeth. Go ahead and try to swallow; where do you feel the pressure?
To apply seating pressure to your front teeth, perform the chewing exercises recommended by Invisalign specialists all over the world. I tell all my patients to do them 3-5 times each day, for 3-5 minutes per time, focusing on those front six teeth that don’t get the natural seating your molars enjoy. Chewing exercises will help deliver more predictable results because you’re giving your teeth that extra motivation to move. For a long time, my orthodontic colleagues only had one device to promote chewing exercises, and that was the foam Invisalign chewie. I thought there should be a better alternative, something fresher that would encourage people to perform what I know is an essential way to achieve more predictable results.
This is why I created Movemints, the mints that fit your clear aligners. The patented grooves in each of our sugar-free mints are designed to fit comfortably between your top and bottom trays and are specially formulated to be hard for long lasting enjoyment with no sticky residue. Place Movemints between your teeth with aligners in, and use gentle pressure to keep your trays properly seated. Repeating this process can help reduce the discomfort associated with wearing clear braces while keeping you on track to achieve the results that you and your provider are hoping for.
5) Handle your trays with care
Keeping Invisalign braces clean and clear is top of mind for many patients, and for good reason. From a basic hygiene perspective, clean trays reduce the potential for cavities and will keep them (and your breath) from smelling funky and unappealing. Clean trays are also clearer and free of any ecru or eggshell tint which will make them more noticeable while you wear them.
We have an entire blog dedicated to keeping your clear aligners clean and clear, but there are a few points we need to reinforce here that can prevent potential tracking issues. The first is to never clean your trays with hot water. It will weaken the tensile strength of the trays and ultimately warp your trays. Even if you don’t think this is happening, the precision of your 3D printed invisible braces is so important to your treatment that even minor, even imperceptible alterations can throw everything out of whack.
Second, while many people will say they brush their aligners with their toothbrush and toothpaste, the harsh particulate in some toothpastes can scratch the trays. And when trays get scratched, they will retain more stains and bacteria and lose their clear qualities. Now we can’t ignore the convenience of being able to clean your trays at the same time you are brushing your teeth, so there’s a method we recommend that will keep your aligners from getting scratched up. Wait until the end of your brushing session, when there’s a little bit of paste left in your tooth brush. This diluted paste won’t be as harsh as when it first comes out of the tube, so can then go ahead and brush your trays as you normally would.
Remember that the smile journey is a process, and even with advanced technology, 3D printed trays, and the best possible care, there will be things that don’t always go according to plan. A few adjustments along the way might add some time to your treatment, but isn’t it worth it to get the smile you’ve always wanted?
Hang in there, and ask your questions about why your teeth aren’t tracking in the comments section below. We’ll have one of our in-house orthodontists share their feedback with you.