Invisalign Questions and Answers Archive

Aug
2001

Q&A: I have braces, take an anti-convulsant which makes my gums swell, and some gum was surgically removed for the braces. What can I do?

Question:

I am an adult with braces. I also am taking an anticonvulsant medication that causes gum swelling, which is especially severe after each orthodontic treatment. I was told by my orthodontist before putting the braces on that my medications would not be a problem in the treatment. Obviously, he was wrong. The braces have so aggravated the gum swelling that I have already had to have part of my gum removed to reduce the swelling caused by the braces/medications. I have not had the braces tightened in over five months because of the severe swelling that always happens afterwards. My orthodontist's solution to this problem is for me to either find a new anticonvulsant medication or keep having my gum cut out. However, I cannot switch medications now because of the two year restriction of driving priviledges that would be necessary in order to make sure the new medication works. I cannot keep having part of my gum cut out because I cannot afford numerous periodontist bills in addition to the orthodontist bills. My orthodontist will not remove the braces until his entire fee is paid, which I cannot afford up front. I am on a payment plan, and it will not be completely paid off for quite some time. Meanwhile, I am stuck with braces that are not able to be tightened or removed. I am considering retaining legal counsel in this matter since the orthodontist obviously was in error about my medications, but I fear that it will be cheaper to just pay the orthodontist his entire bill so he will remove the braces. I am also hoping to be ale to find another orthodontist that will remove the braces for me, but I suspect that a different one will not "step in" on this matter. So,what exactly should I do now?

- Danyse

Answer:

 Debra Gray King, DDS - LocateADoc.com

The Internet can do a lot, but it is difficult, if not impossible, to properly diagnose your condition without seeing you. Therefore, my general comments should not be considered a substitute for second opinions from appropriate dental and medical doctors who have the benefit of your case history and a thorough in-person examination. Having said that, let me share with you that I am very sorry to hear of your problems. As you are aware, certain anti convulsant drugs may cause swelling of the gum tissues in certain patients. It is extremely difficult to predict how and to what extent a person's gums will swell due to a medication. This is because side effects from a medication can and do vary from person to person. Also, as discussed below, there are a number of other factors in play beyond the medication that may be contributing to your gum swelling. Therefore, I do not think that the orthodontist can be held responsible for your present situation. Patients who notice a change in their gums while taking a medication should consult with their physician and their dentist to get a diagnosis and to see whether they can or should change medications. Swollen gums make it easier for bacteria to accumulate on the teeth, invade gum tissue and spread to a tooth's bony support. If too much bone is lost, teeth can fall out. When dealing with gum enlargement, the patient must be especially vigilant about oral hygiene while they are on the medications causing it. This is because it can become a vicious cycle. The initial gum swelling caused by the medication can make it harder for patients to properly brush or floss away bacterial plaque from teeth. That can increase the risk of plaque, infection, etc., etc. Many times, however, if the swelling is caught early enough, it is easier to treat and bring under control. At this point, it seems like you should have your teeth professionally cleaned every 2 - 4 weeks. You should also maintain a vigorous home care program such as brushing and flossing at least 3 times a day and rinsing each time with something like Peridex. Follow this regimine until you see some improvement in your gums, then re-evaluate with your dentist. Hopefully, this therapy will allow your braces to be tightened on schedule. I would also recommend that your physician consider switching you to another medication. I understand that this may impact your life in connection with driving privileges, etc. but your health is of the utmost concern. Here are a couple of more things to explore. A removable orthodontic device like Invisalign may be an option for you. Also, an alternative to braces in many cases is porcelain veneers. You may want to look into them in lieu of braces. Go to the American Academy of Cosmetic Dentistry (www.AACD.com) to find an accredited cosmetic dentist to discuss this option. Good luck. I hope this helps.

-- Debra Gray King, DDS
Atlanta, Georgia



Jun
2001

Q&A: Are there invisible braces that act like a retainer braces for my 14 year old daughter?

Question:

My daughter who is 14 has pretty straight teeth. Our dentist said she could be happy and look fine just like that or get braces if she really wanted them straight. She didn't mind before but she has gotten into some modeling and wants to get the new invisable braces. Are they only for Adults and are there any other options? She seems to think there are braces like a retainer. Is there such a thing?

- Emily

Answer:

Debra Gray King, DDS - LocateADoc.com

Your daughter is probably referring to Invisalign. You can learn a lot about this new technique on www.invisalign.com. The website says that "Invisalign is not intended for children and is not appropriate for everyone." You should contact one of the authorized dentist offices performing the procedure to see what age would be appropriate and whether your daughter is a candidate.

--Debra Gray King, DDS
Atlanta, Georgia



Jun
2001

Q&A: Is there a surgery to fix an underbite?

Question:

As an adolescent I had braces to correct an underbite. The braces did their initial job. However, my bite has since slipped back a little. I am in my mid 20's and do not want to go through the ordeal of braces again. Is there a surgical procedure that can fix this once and for all? If so what is involved and how long is the approximate recovery time? Thanks in advance for you assistance.

- Kathleen

Answer:

Debra Gray King, DDS - LocateADoc.com

Generally speaking, a slight underbite in many people can potentially be addressed in a few different ways. First, there is traditionaly orthodontic treatment. As you indicated that braces were not something you wanted to deal with again, you may want to consider the Invisalign system. It is a a system that uses a clear splint to move your teeth into position. You may also get the results you are looking for from porcelain veneers. They are thin shells of porcelain that are bonded to your teeth to give the effect of perfectly straight teeth. These can usually be applied over the course of a few weeks. If you are interested in this procedure, I would go to www.aacd.com, which is the website of the American Academy of Cosmetic Dentistry, to obtain the name of an accredited cosmetic dentist in your area. Good luck!

--Debra Gray King, DDS
Atlanta, Georgia



May
2001

Q&A: How much would the new Invisalign braces cost to have them for 2 years?

Question:

How much would the new Invisilign braces cost to have them for 2 years?

- She

Answer:

Debra Gray King, DDS - LocateADoc.com

This is what the Invisalign website says: Q: How much does Invisalign® cost? A: As with other types of orthodontic treatment, the cost of Invisalign® is heavily dependent on the complexity of a patient?s case. The cost is generally more expensive than traditional braces, however, since Invisalign® does not dictate what orthodontists charge their patients for treatment, we are unable to provide specific cost information. Invisalign® offers a low monthly payment option through the Orthodontists Fee Plan (OFP). The cost for a typical case under this plan can be as low as $138 per month -- with no down payment.

--Debra Gray King, DDS
Atlanta, Georgia