Awful Invisalign Results - now what? {added pic}

Roro4Brit

Really need some advice and help here.

I am coming to the end of my Invisalign treatment. I started in February, got my clincheck, loved the results shown, got my aligners and have been following the treatment to a t. I've never had my braces out of my mouth for more than 2 hours per day and have changed every 2 weeks as per the schedule.

After my course, I went back to dentist and told them I wasn't happy with x, y and z and they sent off for refiners, of which I got 3. Now I've only one more tray left and my teeth are still only ok looking and I know there are no more aligners to come.

I paid nearly €4500 for this treatment, worked hard to get the money together, and considering my teeth were never that bad to begin with the result a ****ing terrible.

There is still a gap in my bite between my right and left laterals (getting tooth names of google here) as the braces failed to pull those teeth down to the level of my centrals. The dentist has left me with at least a mm gap between my lower right central and lateral teeth due to poor filing, and one of those teeth looks unnaturally narrow and lots it's natural tooth shape due to that filing.

Since I've started my refiners I've noticed that my midlines of upper and lower teeth has gone slightly misaligned.

Friends tell me I have nice teeth now, but these imperfections are glaring to me, and after spending €4500 for 7 months treatment I feel so let down and robbed by this treatment.

Has anybody got any advice or suggestions? Should I go for second opinion?

flahavaj

Did you go to an orthodontist for the treatment?

Roro4Brit

flahavaj wrote: »

Did you go to an orthodontist for the treatment?

No. A well known cosmetic dentist that I have seen recommendations for on here.

I guess I'm not allowed to say on here where it was.

I was told, and I quote, 'you are a perfect candidate with great teeth to begin with, we should see some amazing results'.

Bolox. My teeth don't even match my clincheck, my bite doesn't even resemble what it does on there.

flahavaj

Roro4Brit wrote: »

No. A well known cosmetic dentist that I have seen recommendations for on here.

I guess I'm not allowed to say on here where it was.

I was told, and I quote, 'you are a perfect candidate with great teeth to begin with, we should see some amazing results'.

Bolox. My teeth don't even match my clincheck, my bite doesn't even resemble what it does on there.

For 4500 an orthodontist could have given you the perfect smile. You should have gone to see a specialist in the area tbh.

Roro4Brit

flahavaj wrote: »

For 4500 an orthodontist could have given you the perfect smile. You should have gone to see a specialist in the area tbh.

Thanks for that. Really helpful.

kkth0360

Sorry to hear that you're having problems.

Invisalign can sometimes be unpredictable, and is certainly not suitable for all cases. In particular, moving teeth downwards (extrusion) is generally not well handled by aligners.

However, all of this is your dentist's problem, not yours. You have consented to, and paid for, Invisalign treatment on the basis of your dentist recommending this treatment as suitable in your case, and the type of result he expected to achieve. If the treatment has, so far, failed to produce the anticipated result then the treatment is not finished. It may be that the dentist has to request a further mid-course correction (at his expense, not yours), or it may be that a different type of appliance is needed to make the required changes, such as extruding your lateral incisors. If your dentist only does Invisalign treatment he may need to refer you to someone else if fixed appliances etc are required, but again this should not result in any extra charges to you.

At the end of the day you have paid for a certain result and you are entitled to receive it, and you should not be expected to pay any more for it than you already have.

I'm sure that the dentist is as anxious as you are that you are satisfied with the outcome of your treatment - after all, the saying goes that a happy patient will tell another about your practice, an unhappy one will tell 10 others! So discuss your concerns at your next visit and find out what he thinks is the best way forward.

Best of liuck

Roro4Brit

Thanks so much for your reply. Can I ask what you are basing this on? Is this the official line of consumer rights, or is what you're saying more of a best practice issue.

The way my dentist has spoken to me is that he thinks the results are great. The last time I was there, it was mentioned that my refinements would sort out the tiny few tweaks I still needed. I'm posting a picture of what my teeth look like today, and you will see that more than a few treaks are needed for sure...



This is what they look like when I close my bite fully. They certainly do not look like they're at the end of 7 months of €4500 worth of treatment.

Do I need to be a hard ass with this dentist and demand more invisalign or proper braces - am I entitled to do so?

vishal

I don't think there was any bad filing. what you see is just related to the positions of the roots.
even the upper left lateral being higher is related to something called torque.
you obviously want perfection.
fixing these type of issues is very difficult without a brace.

what you are entitled to depends on goodwill and what your consent form says and the explanations referred to
i am sure your dentist will make you happy either way.

Big_G

I for one would like to see a before photo. It is difficult to pronounce judgement here without that and invisalign is a very limited treatment modality.

Roro4Brit

Well I don't have a before pic, but here is my clincheck side by side of the before and after. As you can see my after looks nothing like my actual result.



The filing is bad on the bottom, there is a visible 1mm gap between the 2 teeth on the middle left, just the angle of my photo doesn't show it.


What I really need to know is what do I do - I doubt I'm going to be offered a proper metal brace free of charge as was suggest above, so should I go to an othro for a 2nd opinion or what?

kkth0360

My comments are based on best practice - there is no official charter of patients rights or similar; however dentists are bound by a code of ethics and are obliged to ensure that they act at all times in the best interests of the patient, and to ensure that patients are fully informed from the outset as to the nature, risks and expected outcomes of treatments (and are made aware of any other possible options) to enable them (the patient) to make informed decisions about their treatment. Where things don't go according to plan (which inevitably happens sometimes) the dentist must inform the patient and do whatever is necessary to put things right, which may include referring the patient to a colleague where appropriate.

As I mentioned above, I'd imagine that your dentist will be as anxious as you are that you are happy with the eventual outcome of your treatment, and will be keen to put things right.

In the photo it looks like you are biting on your front teeth - if you bite with your back teeth together it may look a bit more like the Clincheck image?

In any case, wait and see what they look like after the final aligner, and discuss things with your dentist at that stage. If you're not happy, tell him what your specific concerns are and ask what options are available to put things right.

From the photo, it does appear as though the left lateral incisor is higher than in the Clincheck, and I would agree with Vishal that this would be difficult to correct with aligners at this stage. Both lateral incisors are undertorqued, but this is reflected in the Clincheck and correcting torque problems is not generally possible with Invisalign or other aligner systems.

Hope this helps

BryanL

your result is not too far from where it needs to be. A bit of patients with your dentist would go a long way to getting a better result.
Your midline was off before treatment.
Your laterals can be brought down further for more overlap with "buttons" and elastics on those teeth.
You might need more reduction on your lowers to increase your overjet and overbite.But it would be hard to offer that to you if you are now so critical of the shape of your teeth after they've been reduced. If there is space between your lower teeth(which i can't see in the picture, it'll make treatment easier)
Your clincheck shows spacing between your lower centrals after treatment? But this has been avoided by well placed reductions.

Getting angry with your dentist before your treatment is finished, doesn't help anyone. You've gone a long way from where your teeth where and don't have much further to go to get a good result.
Bryan

P.S. 7 months of treatment is very little and often refinement can take longer than the initial treatment.

Roro4Brit

Thanks for the advice guys. That is my actual bite now and to bite any other way takes unnatural effort, that's the way my teeth meet naturally.

I'm not angry with my dentist as a person, he is very polite and gentle, but what I am angry at is the prospect that perhaps I've been mis-sold a treatment that was never suited to my teeth to begin with. I would hve had no issue going with metal or ceramic braces had I been told it was what i needed.

To me my teeth/bite look nothing like my clincheck. Im just so disappointed with the results, and 4.5k is a lot of money to have wasted...

btkm8unsl0w5r4

Your anterior open bite is difficult to correct with aligners as extrusion is needed and intrusion of the back teeth. Also the after picture from clinicheck is far from perfect, the canines are rotates and the entire anterior segment is proclined.

If you want a more perfect result you may need convention fixed appliances.

I dont know if you expected more than the system could deliver, of the dentist sold you more than the system could deliver, but those issues are between him and you. I would also like to point out that boards.ie and the dental issues forum does not recommend any clinician, infact no names are allowed, any recommendations are from private individuals the validity of whose advice is not verifiable.

PCros

Would I be correct in saying that:

Train Tracks = full teeth straightening & correction of bite if needed.

Inman Alligner/Invisalign = one or two teeth at the front to be straightened.

Thanks