How to Prevent Cavities With Invisalign
I lost a baby tooth as an adult. I didn't have an adult tooth underneath, and I wanted to get a tooth implant to fill the gap. In order to get the implant, however, I was advised by my orthodontist that I would need to wear braces for a year to widen the gap, and to move the tooth roots on either side. Only then would there be enough room for the implant.
My teeth are pretty straight and nice-looking (except for the gap, of course), so I was a bit upset about this added expense. I decided to visit several other orthodontists to get their opinions, as well as quotes.
All but one orthodontist told me I'd have to have braces not only the bottom teeth but on the top teeth, as well, because moving the bottom teeth would affect the top. This was due to the fact that I have what they call a "deep bite." I imagine that most orthodontists see people who want their top teeth to look better. I really didn't want anything done to my upper teeth; they were already naturally straight and even. But when three independent orthodontists raised the same issue, I resigned myself to the idea that I'd have to get braces on top, too.
Looking back, I sometimes wish I'd gone with the one orthodontist who recommended braces only on the bottom teeth (and some sort of holding plate for the top teeth). But he had estimated the whole process would take around 15-18 months. Instead, I went with the orthodontist who recommended Invisalign for both the top and bottom. She said the process would be completed within 12 months.
This orthodontist was a premier provider of Invisalign, which meant the process would be faster. She explained that I would be able to tighten my teeth on my own with new Invisalign trays every 2 weeks. She also brought up some good points about how having an implant is permanent; once the implant is in, unlike your other teeth, it cannot be moved. This was why she recommended having braces on both top and bottom, since she'd be able to better control the process.
One of the things I liked most was seeing her photo books of her Invisalign patients, with their impressive before-and-after pictures. Overall, I am happy with her as a clinician—although I do find the Invisalign appliances themselves annoying for many reasons.
Preventing Cavities: Invisalign vs. Braces
Preventing cavities is a big issue for me. I had assumed that Invisalign would be a better choice in this regard since I could take out the trays to thoroughly clean my teeth. However, I was surprised when I did a Google search and learned that a lot of people with Invisalign still get cavities, even when they practice excellent oral hygiene.
Dentists and orthodontists blame these cavities on poor dental hygiene, but I think differently. It's hard work to get your teeth perfectly bacteria-free, and when you are wearing the Invisalign trays you don't benefit from the constant, natural cleaning provided by your saliva and tongue. I feel that Invisalign can actually trap bacteria on your teeth. In order to prevent cavities, therefore, you have to work really hard to remove all that bacteria before you put the Invisalign on.
This not only takes some time—three times a day, or more if you eat more often than that—but it can often be pretty inconvenient.
What They Don't Tell You About Invisalign
What no orthodontist will tell you—and what I now believe—is that you are actually more likely to get cavities with Invisalign than with regular braces, even with good hygiene. This is because your saliva and tongue are constantly washing off your teeth, but the Invisalign trays prevent this natural cleaning process from happening. Even with proper hygiene, which means brushing your teeth after you eat and flossing before putting on your Invisalign, you are still at risk, because you're not able to "self-clean" your teeth with the plastic barrier.
Furthermore, there are a lot of things about Invisalign that I've experienced that I find to be a pain. Here are some pros and cons.
First, the Pros:
- My teeth look okay. The gap left by my baby tooth is now hidden by the white paint inside the Invisalign tray, so when I'm wearing it, it looks like I don't have a gap at all.
- The Invisalign are supposedly more comfortable than regular braces. The edges along the insides of my cheeks are plastic, so no need to wax the edges and no scratching or boo-boos in my mouth. I've never worn regular braces, but I can attest that the trays feel okay.
- I'm lucky in that since my teeth are relatively straight, I haven't had much of a problem with the tightness of the trays. After a few days of wearing them, they feel less tight.
- Overall, because I have a "premier provider" of Invisalign, my total time with braces is going to be a lot shorter.
- It is easy to brush and floss my teeth because I can take out the trays.
- The quote I got for the Invisalign was $50 less than the quote for regular braces (from the same orthodontist).
Now the Cons:
- Invisalign are expensive. On the other hand, based on my experiences when I was getting quotes, so are regular braces. My Invisalign cost around $6,000. I was able to get a 0% payment plan... but yikes.
- After I signed the contract to get Invisalign, I found out I was supposed to wear them for at least 22 hours every day. That leaves only 2 hours each day to eat and get my teeth back in excellent dental hygiene order before putting the trays in again. This has been the biggest pain that I think most people don't anticipate when considering Invisalign. The lack of flexibility with this appliance is really hard on most people's lives. First off, you have to have your Invisalign tray container, a good toothbrush, floss, and toothpaste with you at all times. When you eat, you always have to have a bathroom or clean water source nearby. You also have to give yourself time to properly clean your teeth after you eat. To give you some examples of the annoyance these things cause, for instance, if you go to a barbecue or picnic in a park you have to traipse around looking for a bathroom to clean your teeth after you eat—or leave earlier than you want to get to a bathroom. Or you can just weird out everyone and do your dental hygiene out in the open. If you go out on your lunch hour and eat at a restaurant with others, it can be really hard to fit in time in the restroom to really get your teeth clean after eating. At dinners out, everyone else will be enjoying their conversation at the table, while you're stuck in the restroom cleaning your teeth. No more eating in the car unless you're on the way back home or to a restroom to clean your teeth some more. If you're out and about and want to eat, you have to plan for how and when you'll get your teeth cleaned. It's a big nuisance. It's no wonder some people give up and go a day or two wearing Invisalign with only water-rinsed teeth. I don't suggest that. You are just asking for cavities.
- Besides the time annoyance factor, Invisalign often include what are called "buttons." These are tooth-colored, sharpish, enamel-like buttons on the teeth that help the Invisalign trays move the teeth. The buttons are attached to your teeth and don't come off. When I have my Invisalign trays out, I can feel the buttons with the inside of my cheeks. They're not scratchy, but they're not smooth either. They also making chewing pretty difficult. I don't know if it's my bite or what, but I really had to get used to my bite not meeting any more. If I bite down, my top teeth will hit the buttons on my bottom teeth. So I chew really awkwardly now and not as thoroughly as I was able to before. With the trays on, the buttons stick out and I gotta say, it looks really stupid and I'm embarrassed about it. So don't think Invisalign will be invisible. Most people in passing don't really notice—but when I smile the sides of my teeth really do have these weird tooth-looking parts sticking out. I think regular braces look better, and besides, sometimes you get to pick colors for the rubber bands.
- The other big con with Invisalign is how easy it is to get cavities with them. If you want to learn more, just do a Google search like I did and read the testimonials from real people who wore them. Don't limit yourself to the promotional materials provided by the dentists, orthodontists, or others who sell Invisalign. What I found out was that many people who took great care of their teeth got cavities when they wore Invisalign—sometimes their first cavity ever! That is not cool. Because of this, I decided to write this article to warn others about this risk. I also wanted to share all of the tips I've compiled about how to prevent cavities when wearing Invisalign.
- I have read complaints online that Invisalign is not able to do everything that regular braces can do. Since I'm not an orthodontist, you'll have to research that claim yourself. I have also read that whereas with regular braces the orthodontist is working with your actual teeth, with Invisalign they are working with a 3D model of your teeth in a computer program. I think this is somewhat true, but maybe it isn't a problem for everyone since there are a lot of happy Invisalign wearers out there. So if you have to have special kinds of work done, it is best in my opinion to be a very thorough researcher and ask a lot of questions.
- Taking the Invisalign out can be pretty gross, because your saliva slime collects in the trays. If I want to gross someone out and embarrass myself at the same time, I just pull my trays out in front of them. So think about this if you're considering Invisalign. Any time you want to eat with others and not gross them out you have to run to the bathroom both before and after you eat.
- In the morning the slime factor is even worse. You can tell how well you've brushed and flossed the night before by how bad your breath is in the morning. In order to prevent cavities with Invisalign, you're going to have to treat your nightly dental hygiene routine like you're about to kiss someone you love for the first time.
Tips for Preventing Cavities
These are the tips I've picked up from a number of sources: other Invisalign wearers, dentists, orthodontists, and my online research. If you follow of these tips, your chances of preventing cavities with Invisalign are very good.
- Do not wear Invisalign unless you've cleaned your teeth. By "cleaned" I mean brushed and flossed thoroughly. This means after every meal or any time you eat—not just flossing once at night or when you feel you need to. Understand that there is a lot more to preventing cavities than just good dental hygiene.
- Get your teeth sealed by your dentist if you can afford it before you get your Invisalign. This will really reduce your chances of getting cavities.
- I recommend eating less processed foods and more whole-plant foods. It's healthier, and the food is better for your teeth. It would also be wise to cut out hard candy, sticky candies, and sweet drinks like soda, juices, and sweetened coffee or teas.
- Take your trays out to eat or drink anything except water. The only thing you can eat or drink when you have your trays on is pure, clean water. That's it.
- Use a toothpaste that has Xylitol in it rather than other sweeteners. Xylitol is a natural sweetener that has been shown in studies to reduce cavities.
- Wait after you eat before starting your dental hygiene routine. Swish your saliva around and rinse your mouth with water. Give yourself 5-10 minutes or so, don't just immediately brush and pop the Invisalign trays back in. The waiting gives your mouth time to self-clean.
- Chew gum with Xylitol as the sweetener in it after you eat. This helps you get any food particles out of your teeth and increases the saliva in your mouth to help you self-clean your teeth. So the first step after eating is to self-rinse your mouth, then wait and rinse with water, and then wait a bit more and chew Xylitol gum.
- After you've chewed all the flavor out of your Xylitol gum, get rid of it and rinse your teeth with water again. Now you want to floss your teeth using a waxed floss tape. The floss tape is better than regular floss, which can be too cutting on the gums. Get a waxed floss tape with a little thickness to it, so it can easily get out anything in your gums. Carefully floss every single tooth and gum side. Rinse your mouth, as well as your floss, and try to use new floss as you go, rather than the same used section of floss.
- Brush your teeth gently and thoroughly using the Xylitol toothpaste. Remember to also brush your tongue and inner cheeks, as well as your gums very gently. Rinse your mouth again with water, a couple times if you need to.
- Before putting your Invisalign on again, clean them. I use a different soft toothbrush and liquid soap and water. Yes, just regular soap and water will do if you are thorough, or you can use an antibacterial liquid soap (preferable) and water. Make sure you use cold water only so the plastic won't warp or melt. It is also a good idea if you can to put your Invisalign trays in a bowl of cold soapy water (with a liquid antibacterial soap in it, like Dial) to soak while you eat. This isn't always possible, but it helps keep your trays super clean.
- Keep your "chewables" very clean. Soak them in soapy water (antibacterial, like Dial) and rinse them with water after you use them. (Chewables are these soft white rubber rolls that you chew with your Invisalign on to make sure the Invisalign fit right.)
- I don't recommend most mouthwashes, as I feel most of them just mask bacteria with scent and over-dry the mouth (which is not good since we need lots of saliva to help keep the mouth and teeth clean). The one mouthwash I'd recommend is called ClosysII. I like it because it works by using a patented Chlorine Dioxide (CIO2) to kill the sulphur compounds that cause bad breath. (By the way, another reason it's good to be eating a mostly whole-food plant diet is you reduce the sulphur compounds you eat.) This mouthwash is also alcohol-, zinc-, and flavor-free. When I use ClosysII, I do so after I've flossed and brushed my teeth, and then I rinse my teeth with water after using it.
- I recommend getting a good electronic toothbrush, like Phillips Sonicare. For one thing, it is automatically gentle. It's also thorough, since there is a timer on it. It's less work. It does more work in less time that you'd be able to do manually, and it cleans every single tooth. I got one based on the recommendation of my old boss who said he hadn't had a cavity since getting that toothbrush. You still have to floss thoroughly. I find it's easier to use a regular toothbrush to brush your tongue and inner cheeks, though.
- Get a prescription for Sodium Fluoride gel from your orthodontist. I expressed my worries about cavities to my orthodontist, and she gave me a prescription for 1.1% Sodium Fluoride gel, which you brush on with a dry soft toothbrush after brushing and flossing each night before going to bed. It only costs about $16.
- Remember, it only takes one time to ruin all the work you put in. So don't ever wear your Invisalign unless you've really cleaned your teeth. I'd rather wear the Invisalign a bit longer in the long run and not have to have more drilling done to my teeth. Just do your best to get to a bathroom as soon as you can after eating.