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from Singapore asked a question

Is an Invisalign treatment less complex if I used to wear braces previously?

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Braces & Invisalign Dental

Hi doctor,

I used to have braces but my laziness and undisciplined self has made me very regretful. I believe I had an overbite condition and have removed 4 teeth previously during my braces treatment.

After not wearing my retainers regularly, my overbite condition returned, although not as serious as before. I am thinking of going through an Invisalign treatment to fix the problem again but am worried about the cost. So:

  1. I am wondering if the Invisalign treatment might not take as long as usual and hence lowering the cost?
  2. Would you advise that maybe a dentist would be sufficient for such cases? Since an orthodontist might charge higher.
  3. Is there any other alternatives that could help fix this problem?
  4. Will a polyclinic dentist be able to give me a referral for such cases, entitling me to subsidiaries? (I am guessing no)
  5. And, does going through teeth alignment twice weaken/loosen the teeth?

Thank you!

DOCTOR’S ANSWER (2)

Dear Shi Hui;

You may find that if your teeth have not relapsed too badly and you only need some minor adjustments, there is an Invisalign lite option. This option is for milder cases and therefore it will require less time and will cost less too. Do consult your orthodontist for an assessment first.

I recently saw a lady in her 30s, much similarly to yourself, she was too busy as a working mum to bother with her retainers and her teeth gradually become crowded again. It is very important that the current condition of her teeth, gums and roots are checked before re-starting orthodontic treatment. This is because, when you have braces the first time, root shortening may occur. This can be made worse when you wear braces the second or third time. Therefore for my patients who require a re-treatment, I often go through vigorous checks to ensure the optimum health of their teeth, gums and roots prior to start of treatment.

Lastly, please do note that even after treatment for the second time, you will need to wear your retainers long-term. You may even ask your orthodontist to consider a fixed retainer if you feel that you may not be disciplined enough about the removable retainers.

Good luck!

Consult Doctor
0 827 views 0 Doctors agree 26 Jan 2018

Hi Shi Hui,

Thank you for your question.

I am wondering if the Invisalign treatment might not take as long as usual and hence lowering the cost?

Yes, in general if the case is less complex, and expected teeth movement is lesser to achieve the desired results, there would be lesser number of sets of aligners needed to complete the case. This would result in cost savings for you. However if you are comparing Invisalign to conventional braces, the treatment time between the 2 treatment modalities generally do not differ that much, but the cost for conventional would be lesser.

Would you advise that maybe a dentist would be sufficient for such cases? Since an orthodontist might charge higher.

Personally, I would recommend you to consider returning to the dentist who did your orthodontic treatment previously as they would have all of your existing records, and probably would be more familiar with your case. Otherwise it is still useful to get your records before seeing someone else. I would think that an experienced dentist who has done many Invisalign cases would be able to treat you too.

Is there any other alternatives that could help fix this problem?

In very very mild cases, sometimes fabrication of a new set of retainers might help to shift the teeth back to its alignment. However it seems to have shifted quite an amount in your case, thus conventional braces/ clear aligners e.g. Invisalign would be the treatment modality of choice.

Will a polyclinic dentist be able to give me a referral for such cases, entitling me to subsidiaries? 

There is no subsidies available for orthodontic treatment as you have correctly pointed out. You could consider the NUH post graduate program if you have a financial constraint, the NUH post graduate program costs about $2k+ on average. However there are installment schemes in place now for payment at private clinics too, and most clinics work on a payment per session scheme too.

And, does going through teeth alignment twice weaken/loosen the teeth?

It would not weaken or loosen your teeth if you have good gum health. Your bone would constantly remodel with tooth movement, providing support to the tooth. As long as the force to move your teeth is not too excessive/ quick, and you do not have underlying gum disease which reduces the existing bone and gum support of the tooth, there is no cause for worry. I have colleagues who have done re-treatment twice or some thrice even!

Hope this helps!

Consult Doctor
0 826 views 0 Doctors agree 26 Jan 2018
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