Category Archives: Invisalign

Invisalign and Missing Teeth

If I have a missing tooth and want to replace it, but have a crooked tooth too, how do I fix that? I was thinking of replacing the lost tooth with a dental implant and straightening my teeth with Invisalign. If so, would I do Invisalign before or after? If I have to do it after does Invisalign work with missing teeth or do I replace my teeth with something else?


Dear Theodora,

Invisalign aligner

You have picked two wonderful procedures. Nice work! Dental implants will be a great tooth replacement and Invisalign has one of the highest patient satisfaction rates of any dental procedure.

Between the two, you will want to straighten the teeth before replacing the tooth.

Invisalign does a great job of working around missing teeth. It uses a sophisticated software program to design the ideal treatment plan for you.

Aside from being comfortable, allowing you to straighten your teeth invisibly, and working in a fraction of the time of traditional braces, the aligners can also double as teeth whitening trays. This means you can straighten and whiten your teeth at the same time, giving you a mini smile makeover at a fraction of the cost.

Then, once all your teeth are in place it will be time to get your dental implant. You will want to go to a dentist who has post-doctoral training in placing dental implants. It is not something taught in dental school.

When you are done, you will have a beautiful straight smile.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

Invisalign As a Retainer

I am about to get my last two Invisalign retainers and then have to move. My dentist is just giving me the last pair because my treatment has gone well and he doesn’t want me to have to drive three hours for the final exam. Do I need to find an Invisalign dentist or can I just be done after my last pair?


Dear Mason,

Invisalign aligner

Because your treatment has been going to plan, you won’t need to find an Invisalign dentist if you are at the end of your treatment and have the aligners you need. There is a caveat we will get to in a moment. However, for the benefit of those whose treatment has not gone as well, I am going to add what to do in that situation.

Some cases are more complicated because teeth don’t always behave exactly as they are supposed to. When that happens and you need to move, your dentist is legally obligated to provide your new dentist with all the diagnostics, treatment plan, and notes. Especially if you are at the end of your treatment, there should only be a minimal fee.

Now, onto your caveat. After every orthodontic treatment, there is the need for a retainer or our teeth have the habit of going back to misalignment. The good news is you have a couple of great choices for that.

First, you could find a dentist to provide you with a retainer. They’re fairly cheap and won’t take too long. Almost any dentist can do that.

However, an easier option is to just wear your final aligner as a retainer. There is a procedure to follow for that. If you follow these instructions you shouldn’t have any trouble.

First, I’d wear them all the time, except for eating and oral hygiene, for a month. After that, wear them only at night for one to two months, From there, you can go to wearing them every other night. You’ll want to make sure your teeth aren’t shifting when you do that. The way to tell if that is happening is the feeling when you put your aligners back on. If they feel tighter than normal, the teeth have shifted and you should go back to them every night for a few weeks. then try again. Back off a little at a time doing periodic checks for shifting. Once you’re good with every other night, you can try twice a week, then once a week, then not wearing them at all. Again, make sure you are checking periodically for movement.

If you keep your final pair of aligners in good condition, you can also use them as teeth whitening trays. Simply ask your dentist for the gel and you can whiten your teeth at a fraction of the cost.

Best of luck in your move.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

What to do About a Huge Tooth GAp

I have a gap in my two front teeth. It is substantially large enough for another tooth to fit there. Would getting Lumineers help? They could make each of the teeth a little wider. One dentist recommended that. Another recommended orthodontics. I really don’t want braces though.


Dear Angie,

Invisalign Dental Aligner

I am trying to imagine that dentist thinking that extending your teeth out that far will look in any way normal if that gap is as large as I’m picturing. I wish I had a picture.

I will say that dentists who suggest Lumineers are not usually in the top tier of cosmetic dentists. That particular brand of porcelain veneers is often marketed to inexperienced cosmetic dentists as being easy to place. The type of cosmetic case you are describing is very advanced and would take the best of the best in cosmetic dentists. I wouldn’t let anyone except an AACD accredited dentist touch that.

However, that doesn’t mean you’ll have to have traditional metal and wire brackets. Orthodontics have come a LONG way. These days, you can get Invisalign. Instead of wires and brackets, they use clear aligners. These are invisible even at a conversational distance.

This will allow you to straighten your teeth without anyone noticing. If you want, the aligners can even double as teeth whitening trays which allows you to straighten and whiten your teeth at the same time.

It looks to me like you need to seek out a third dentist if the one who suggested orthodontics didn’t offer Invisalign, unless there is something else about your bite that wasn’t mentioned. If it is a simple matter of a gap then it is the perfect solution.

This blog is brought to you by Lafayette, LA Dentists Drs. Thimmesch and Foreman.

Dealing with Congenitally Missing Lateral Incisors

My daughter never received one of her adult lateral incisors. When the baby one fell out, our dentist said not to worry about it because the adjacent teeth would shift to fill in the spot. While they did, it left a bit of a gap, which leaves my daughter feeling embarrassed by her smile. This is her senior year and I’d like her to be able to go off to college feeling good about her smile. I spoke to another dentist and they recommended we open up the space and then place a dental implant there. I don’t think she’d be too keen with a mouth full of braces during her senior year of high school. Is there another option?


Dear Laurie,

a smile with missing lateral incisors
A smile with canine teeth where the lateral incisors would normally be.

The above image shows a smile with missing lateral incisors. In the place of them are her canine teeth. As you can see, the smile doesn’t look normal. Instead, it is almost vampiric. Your daughter’s smile would look even stranger with one canine tooth. The advice her childhood dentist gave you was horribly bad.

The second dentist’s advice is sound. Your daughter has other choices aside from a full mouth of metal. Her first option is Six-Month Smiles which will allow her to fix her front teeth quickly. A second option is for her to get Invisalign. These use clear aligners instead of wires and brackets. Most responsible teenagers do very well with these. Then, when that is ready, a dental implant will be a fantastic idea.

What Her Original Dentist Should Have Done

Ideally, when her baby tooth came out and there was no adult lateral incisor, her dentist should have provided her with a dental flipper. This would have held the spot open so when she was old enough you could have just placed the dental implant. Now, because of his bad advice, you are having to add orthodontics to the mix.

I say this as a cautionary measure to others reading this post in two ways. First, in giving them the correct way to handle this situation. Second, in knowing that anytime you have a major dental decision to make, there is never any harm in getting a second opinion before moving forward.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

A Serious Problem with smile care club

During a YouTube binge, an acquaintance come across this video by a young woman called Rosie Posie. She’s been documenting her experience and treatment with Smile Care Club. In one of her videos, posted directly below, you see her struggling to get her aligners in. It takes quite a while.

Eventually, after twenty mintues of trying to put them in, she gives up. In a follow-up video, the problem was discovered and resolved. Smile Direct Club inadvertantly mixed up her aligners giving her ones that were a month ahead of where she really was in her treatment.

To give you an idea of how serious this is from a medical standpoint, it would be like a surgeon accidentally doing surgery on the wrong body part.

The stress put on her teeth from being a month ahead and then going back to an earlier treatment often leads to root resorption. This can lead to premature tooth loss. It would be interesting to look at before and after x-rays of her teeth roots as a result of this mistake.

Patient Floundering

Here lies one of the big problems with services such as Smile Direct Club. Patients are left to flounder. If it weren’t for the fact that she’d been documenting her treatment on YouTube and it caught the attention of Smile Direct Club, she likely would have been left trying to shove these on every day, causing serious ireparable damage.

Many people are attracted to these mail order services because of their discounted prices. What makes their prices so low is you do not have a dentist you see regularly that check on your treatment. Bodies are unique. Because of that, even when someone is given the correct aligners, the treatment may not respond as it was supposed to. That is one of the important ways being under the care of a dentist is important. Early intervention in these cases can save the treatment and the patient’s teeth.

Affording Invisalign

If you want to safely straighten your teeth, I recommend Invisalign. It has one of the highest patient satisfaction rates of any treatment. If the cost makes you feel you could more quickly get your teeth straightened with a mail order service, consider talking to your dentist.

Most dentists are willing to work with patients under financial strain. Some have in-house payment plans that will allow you to pay things out as you go. Almost all dentists work through Care Credit. This is a medical payment service that pays for your procedure, and allows you to pay them back with extraordinarily reasonable interest rates.

A Hidden Benefit with Invisalign

There is a way to “double-up” your treatment in a way that saves you a lot of money while giving you a mini smile makeover. Because your aligners are custom fit and you are under the care of a dentist, your dentist is able to provide you with the professional teeth whitening gel that you can wear in your aligners as you straighten your teeth. This enables you to whiten while you straighten.

This blog is brought to you by Lafayette Dentist Dr. Emily Foreman.

Smile Direct Club

Is Smile Direct Club a viable option for me? I can’t get to my dentist with all the closures from Coronavirus. Plus, I just received a Groupon offer for them which makes it very affordable. Have you had any experience with them?


Dear Destiny,

smile direct club image

I have done some research into this program because I’m always on the lookout for options that are both good and bad for my patients both as a means to keep abreast of what is available and to protect them from unscrupulous perveryors of medicine.

Smile Direct Club is one I’m not just concerned about but wonder how it is even legal. First, let start with the fact there is no pre-examination. Any reponsible dentist would do a complete exam before beginning any orthodontic treatment. There are good reasons for this. First, you could have some underlying gum disease. If you move forward with braces of any kind while you have gum disease, you could end up losing some teeth. Other issues this exam would look for is TMJ Disorder and / or decay.

Another concern I have about this program is the impression. The mold of your bite is one of the most important steps. Without a proper impression, your whole treatment plan will be off-kilter. Most dentists won’t even let their assistants do it. There can be no defects, including bubbles or tears in the material. Somehow, they are expecting you to do this with no training at all.

Finally, inaequate monitoring. Most people end up needing extra space in order to get their bite straight. There is too much crowding. Sometimes to make that space you will have a tooth extracted. Other times, it requires soms shaving at the sides of the teeth. You need a dentist invested in your treatment. That is not going to happen with mail order ortho. Many times, our teeth do not cooperate. Each person’s bite responds differently to their treatment. Sometimes the teeth do everything exactly as they are supposed to. Other times, teeth don’t turn the way they are supposed to and the dentist needs to intervene in the treatment.

Unfortunately, for patients using Smile Direct, there isn’t anyone there keeping an eye on whether or not your teeth are doing what they’re supposed to. You won’t know either, which means your smile could end up not correcting properly.

Why Invisalign Is a Better Option

Though it may mean waiting for a bit to get your teeth straightened, because of the pandemic, I would wait until you can get your treatment done properly with Invisalign.

You’ll get a complete and comprehensive exam to ensure your bite is ready to have shifting done without risk to your teeth. You’ll have an accurate impression. Then, every two weeks, your dentist will be checking to be certain the teeth are moving as they should and no more shaving needs to be done for there to be enough room.

Invisalign also has a hidden benefit. The aligners can double as teeth whitening trays. Your dentist can provide you with professional strength teeth whitening gel to wear in your aligners during your treatment. By the time you are done with your treatment plan you will have a mini smile makeover, with a straight, beautifully white smile.

This blog is brought to you by Louisiana Cosmetic Dentists of Camellia Dental.

Smile direct Club Safety

I’ve been wanting to straighten my teeth for years, but wasn’t able to invest the amount of money into it required. I’d run across Smile Direct Club on Facebook. They are significantly cheaper than Invisalign.I did wonder in the back of my mind whether they were too good to be true. Is it okay to use this? I was especially interested because we can’t go in to see a dentist at the moment for routine care because of COVID-19. This seems like a quick, easy way to get my teeth straightened while still social distancing.


Dear Mercy,

Invisalign aligner
Invisalign aligner

Smile Direct Club advertises as a more affordable way to invisibly straightening people’s teeth by comparing themselves to Invisalign. While there are some similarities, the differences are the most striking. First, how they’re similar:

  • They use clear aligners
  • You switch your aligners out as your treatment progresses.

That’s about it.

The Shortcomings of Smile Direct Club

It’s the ways in which Invisalign is different that create my biggest concerns.

The Pre-Exam

With orthodontics under the care of a dentist, you get a thorough pre-exam. This is important. You need a dentist to look for things like decay, failing fillings, gum disease, and signs of TMJ Disorder. Ignoring these can have serious consequences. For instance, if you do orthotdontics with untreated gum diease, you could end up with you teeth coming loose.

With Smile Direct, there is no real exam, putting you and your teeth at risk.

The Impression

An accurate impression of your bite is essential for a proper treatment plan. It’s so imperative it’s done right that many dentists won’t even let their hygienists do it.

What you’ll get with Smile Direct is a do it yourself kit. If that impression isn’t free of imperfections, it will throw off your treatment.

The Treatment

Though many cases go as planned, not all of them do. Sometimes teeth don’t turn the way they should or you need more space opened up than originally planned. In that case, a dentist will need to carefully shave some of the sides to your teeth.

I honestly think you are safer waiting for COVID-19 to calm down. This will be the safest way to straighten your teeth.

An Added Benefit with Invisalign

In addition to being able to safely straighten your teeth, the Invisalign aligners can double as teeth whitening trays enabling you to straighten and whiten your teeth simultaneously. It’s like getting a mini smile makeover.

This blog is brought to you by Lafayette, LA Dentist Dr. Mike Malone.

Clear Braces versus Invisalign

This may sound strange, but I didn’t know “clear braces” and “Invisalign” were different things. I talked to my dentist about doing Invisalign and he sent me for a consultation with the orthodontist, who then began talking about clear braces. We went through the whole process of treatment plans, impressions, x-rays, insurance, and they even took my down payment. I don’t know if I ever should have caught on, but I know they never explained it to me.

So, the big day comes where I think I’m getting my aligners and they start messing around with my teeth, so I finally ask if all that is necessary since I’m just there to get my aligners. That’s when they tell me they’re putting real braces on my teeth.

I’m 34. I work in a professional setting. I didn’t want regular braces. So, then the orthodontist comes back over and explains how I really have to use regular braces to correct my smile and how he’s certain he explained that to me. He didn’t. I know he didn’t. But, he makes his case and I go along with it. Disappointed, but I figure, at least they’re clear.

We’re a month in and they’re a hideous shade of yellow. I look ridiculous. My teeth look gross, like I don’t brush them. And no amount of brushing them is helping.

Would this have happened if I did Invisalign? Should I have insisted on it? And, if I should have done that, is it too late to switch?



Dear Eric,

Invisalign aligner
Invisalign: The adult solutions to braces

I’m sorry you are having such a frustrating experience. Theoretically, any kind of plastic can yellow like that, but you don’t see it as much with aligners because people aren’t supposed to be eating or drinking with them in and you replace them every couple weeks.

You May Still Be a Candidate for Invisalign

The good news is, you still may be a candidate for Invisalign. While it used to be only the most ideal cases were candidates for Invisalign, these days they can take on all but the most challenging cases.

It sounds like this orthodontist’s communication skills are lacking. You can ask him about switching over, but it doesn’t address the underlying issue—they didn’t give you all the information you needed. It’s worthwhile to have a consultation with another dentist or two to see if you’re a candidate for the aligners.

You Might Also Be Able to Fix Your Yellow Braces

Usually, the bands get changed out once per month, so you’re either due for a change or coming due for one. That will give you a chance to start fresh. Unfortunately, if you have habits like smoking, it’ll be an uphill battle to keep them clear.

Ultimately, the choice is yours—only you know whether it’s worth the trouble of trying to switch at this point. However, if you’re a candidate, you can switch at any point. If you decide to switch dentists, which I would not blame you for, he is ethically obligated to send all the diagnostic x-rays, etc. to your new dentist.

This blog is sponsored by Lafayette, LA Dentist Dr. Mike Malone.

Invisalign with Missing Teeth

I have two missing second bicuspids and want to get my teeth straightened. I feel like I’m too old for braces. I was thinking of getting Invisalign. I went to see an orthodontist and he doesn’t think Invisalign is all it is cracked up to be. He wants me to get traditional braces. Is that my only option?


Dear Katherine,

Invisalign aligner
Invisalign: The adult solutions to braces

My guess is your orthodontist is more comfortable with traditional metal wire and bracket braces. However, Invisalign should work fine in your case, though you may have better success with a dentist who treats with Invisalign than with a traditional orthodontist.

It will do fine with the missing teeth. It could close the spaces so that you wouldn’t even need to replace them with dental implants. However, let your dentist evaluate that.

If he thinks replacing the teeth is necessary, just make sure he has post-doctoral training in restorative dentistry.

A Fun Benefit to Invisalign

There is another perk to Invisalign aside from straightening your teeth. Because the aligners are custom-fit to move your bite, they are very snug. This makes them ideal for doubling as teeth whitening trays.

Your dentist can provide you with whitening gel that you can place in your Invisalign aligners at a time convenient to you. This allows you to straighten and whiten your teeth at the same time. It’s like getting a mini smile makeover at a discount.

This blog is brought to you by Lafayette, LA Dentist Dr. Mike Malone.

Solution for huge tooth gap

I have a large tooth gap. It was last measured at 9mm. I thought about doing Snap-on Smile, but after all the tests and things, it turned out I wasn’t a candidate for that procedure. I’m too old for braces, so I’m thinking about Lumineers. I have scheduled an appointment with a Lumineers certified dentist in a couple of weeks but thought I’d check and see if you thought that was a waste of my time and money.


Dear Kevin,

I am very glad you wrote before going through with this plan of Lumineers. While I am sure you could find a dentist willing to do it for you, it would end up a disaster!

The size of your gap is enough to fit another tooth. Unless the dentist is a top of the line, expert cosmetic dentist you are going to end up with something that looks ridiculous. And I will tell you right off the bat, dentists who advertise as placing Lumineers tend to be at the bottom of the barrel of cosmetic dentists.

The Lumineers company markets themselves to inexperienced cosmetic dentists as being easy to place because they don’t require any tooth preparation, the way other brands of porcelain veneers do. There are two problems with that.

One, that rarely turns out looking anything but bulky. Some people have described it as horse teeth. And, two, there is a whole lot more to creating a beautiful smile than just the tooth preparation.

An Invisible Alternative to Braces

side by side compairison of braces
Braces versus Invisalign

You mentioned you were too old for braces. Has your dentist discussed Invisalign with you yet? These are sometimes called invisible braces.

Both people in the image above are wearing orthodontics. The one on the left is wearing traditional braces. The one on the right is wearing Invisalign. No one will be able to tell you are wearing them even at a conversational distance.

With the size of the gap you are talking about Invisalign would be my number one recommendation for repair. It has an added benefit as well. Invisalign uses clear plastic aligners to straighten your teeth. Those aligners can double as teeth whitening trays. This will allow you to straighten and whiten your teeth all at once.

If you don’t like the idea of any orthodontics, then you will need to go with porcelain veneers. However, as I mentioned above, you will need an expert cosmetic dentist in your case. I would only see an AACD accredited dentist to do your porcelain veneers case, if that is what you decide on.

This blog is brought to you by Lafayette, LA Dentist Dr. Mike Malone.