The advances made by Invisalign over the last five years have been nothing short of remarkable. When Invisalign first came on the scene in 2007 it was little more than a fascinating quaint idea on broadening the availability of orthodontics to a broader range of patients. The additional bonus of this type of care could be delivered by a general dentist. They have now elevated the capability of this product to almost mimic that achieved by traditional braces, and for certain procedures it is superior to the traditional treatments. Here in lies the present-day problem.
In order to appropriately treat even mildly complicated orthodontic cases, one requires a deeper understanding of orthodontic concepts then just straightened teeth. Invisalign case treatment is determined by the lab (who has no greater understanding of dental biology than the average consumer). The training of an orthodontist is presented with entails, mechanics and dynamics of tooth movement, bone biology, the physics of forces, force vectors, and the implications when acted upon in the oral environment. Much time and energy is spent understanding what is most effective in any given circumstance. Once must also have a deep understanding of the anatomy associated with the bones, teeth, and underlying bone. Many orthodontic programs require 3 additional years of training after one has completed their requirements for dental school. This often entails anywhere from 7-10 additional years in training.
The reason for this required knowledge is to address any of the problems that may be encountered in a given case. My reasons for not embracing Invisalign before was due to the material not achieving the results I had come to expect in my cases. But as stated before, the new attachment designs have enhanced the product enough where it can handle a much broader range of dental malocclusions. This is where the additional training provided within an orthodontic residency becomes valuable. Once a case is set up by a technician it is my responsibility to make the necessary changes so the desired movements can be achieved. This will often require between 2-5 modifications. This is done with the realization that there may be additional appliances required at the end of treatment to achieve and maintain the desired results. This is not to diminish the skills of my colleagues but merely to point out that what one does not know, one does not know. This makes it advisable if you wish to move teeth, you are still best served by an expert.
Dr. Roland Nentwich D.D.S., M.S.