Hello everyone,
In today’s post I will tell you about my third orthodontic treatment.
After moving to Porto in September 2022, as I had already been told in Valencia that I had to have a gum graft, I went for consultations with several dentists.
The first one was a clown who was not even a periodontist (although he told me he was) recommended to me by the insurance broker. This misnamed professional told me that I was about to lose several teeth and that I had to get braces again since my bite was a little open. I never went back.
Still, I was traumatized and began to feel uncomfortable with my bite.
I finally went for a consultation with a periodontist that my orthodontist Covadonga Balaguer had recommended.
This periodontist told me that my bite was not so bad and that one of the hypotheses of gum recession is that the open bite generates more pressure on the teeth that do make contact, but that it was not my case since my gum recession came from brushing and because the lower teeth had been brought forward a lot during the first orthodontics.
I continued to check with the periodontist every 6 months and after two check-ups, I found that my recession was not increasing. So, for the time being gum grafting was optional but not mandatory and the most important thing is that I was not going to lose any teeth.
To give you some context, I spent most of high school with braces and at that time my orthodontist never mentioned dental hygiene or told me to have my teeth cleaned by the dentist. As a result, I spent almost 5 years without a cleaning at the dentist and my oral hygiene was terrible.
When my braces were removed, I had a lot of cavities and fixing all of them was a traumatic process. Besides, since they had been repaired with amalgams, I then had to replace them all with composite.
I was so traumatized that I started brushing my teeth super hard until the dentist told me to be careful because my gums were receding. Since I bought the electric toothbrush, I have been brushing my teeth much more carefully.
After 2 visits to the periodontist without my gum recession having increased, I was calmer but then I realized that a tooth had moved.
The right central incisor had moved up about a millimeter.
Initially I reconstructed it with composite so that it would not bother me visually and as I continued to feel discomfort with my bite, I decided to get orthodontics again. In addition, although I had reconstructed the incisor, I was not happy with it and wanted to fix it.
I had thought about going to the clinic where I had the reconstruction done with composite, but as they had been so incompetent with the issue of the retainers, I decided to go back to my orthodontist in Valencia.
I was clear that I did not want braces as it was going to be my third orthodontic treatment, so I asked for an estimate for Invisalign treatment.
First, they scan your mouth to obtain a 3D image that they send to Invisalign.
Then Invisalign sends a treatment proposal that the orthodontist must evaluate and approve. If she does not approve, she must make corrections and send it to them to modify the treatment.
I went for the scan on April 17 and was waiting to meet with the orthodontist and have the treatment explained to me.
I imagined that they would call me at the beginning of May, but it was delayed because they had sent 4 proposals to my orthodontist that she did not like, and she had asked for modifications.
Finally, I went on June 3 to meet with the orthodontist and together we made the final modifications to the treatment.
I was impressed because it was a very complex and millimetric procedure. The orthodontist explained to me that I would have several teeth filed down and that I would also have attachments.
I was not expecting this as my idea was not to have to glue anything to the teeth and that is why I did not want to have braces. Even so, Invisalign attachments are smaller than braces.
We had to be very careful with my gum recession and so the bottom teeth were going to move in a way that was expected to improve the recession.
Normally, the attachments are put on the third aligner so that the patient can get used to wearing the aligners. As I live in Porto, we agreed that they would put the attachments from the first aligner so that I would not be obliged to return to Valencia the following month.
I was offered the comprehensive model because this way I would have unlimited aligners for 3 years. The other models have a limited number of aligners, and my orthodontist said it was better this way to be covered.
They told me that in 10 or 15 days they would call me to pick up my aligners.
On July 4th I went again to Valencia to get the aligners. It was a 1h30 appointment in which they put 9 upper and 6 lower attachments. In addition, they polished the teeth, especially the lower ones, because with Invisalign the teeth must be well separated for the treatment to take effect.
When they were filing the upper teeth, I began to regret having chosen Invisalign.
I asked the orthodontist if I would have had to file my teeth if I chose braces and she told me no, that the biomechanics of the aligners were different.
Although the orthodontist told me not to be overwhelmed by the gaps underneath as they would be fixed, I felt like a monster.
I was given 12 aligners out of 22. The first 2 I would wear for 15 days each and thereafter, one week each.
Since it is mandatory to wear the aligners minimum 20 hours a day, you must eat fast and run to brush your teeth to put them back. I was told that with this treatment dental hygiene is vital because even a little tartar can make the treatment not work.
On October 18 I would have to return to Valencia to have another set of attachments put on my molars and the other 10 aligners delivered.
In other words, in almost 3 months I was not obliged to go to the dentist’s office.
As I was not going to be in Valencia, they gave me access to an application called “virtual care” so that I could upload the photos of my teeth every time I changed aligners.
The first 2 days with the aligners were difficult because I was stressed about taking the aligners out and having to eat quickly to run to brush my teeth.
Then, photos with the app also seemed like mission impossible because there was no way the app would accept them. In the end, I started using the light ring and the problem was over.
On October 17, I went for another consultation in Valencia. Although I felt my teeth looked practically the same, the orthodontist told me that I was doing very well.
They put 8 more attachments on my molars and I felt like Frankenstein; there I thought it was almost better to have chosen braces.
Putting the rubber bands on the attachments the first day was traumatic and my mouth was sore. Then it got better and better.
On December 12 was the next consultation.
As I had two aligners left, 15 days of treatment, we made the appointment before finishing to make the images of the mouth in 3D and try to have the following aligners without wasting time.
I talked to Covadonga because the right side of the mouth was almost perfect, and the left side was still bad. We did tests and the whole left side was open; she polished several teeth that were rubbing and preventing the aligners from working properly.
Here I think it is very important to emphasize that the doctor, when she saw the images of the supposed final result in the Invisalign program, said that “that was a lie”. This means that it is very likely that things will have to be adjusted, and your teeth will not be perfect with the first set of aligners. In addition, there are factors that can affect the proper functioning of your aligners that Invisalign will most likely not be able to foresee.
Seeing what the problem was, the doctor wrote down the movements that the teeth that were still bad had to make.
Since we were in the last half of December, we would see if it was possible to have the second batch of aligners before the 15 days were up.
On January 3, 2025, I went to consultation again. They put more attachments, so I had practically no more space left in my teeth for them to stick anything on.
They had made 13 more aligners, of which I was given 11. As the last 2 had the function of retainers, we would make the appointment at the end of aligner number 11, to see if anything else needed to be adjusted in the orthodontics.
In other words, the new appointment would be in almost 3 months, so it was already 9 months of treatment.
On March 21 I returned to Valencia. As the result was still not what expected, I had my teeth scanned again and they removed the 4 metal attachments from my molars; at least I had that relief.
At this point the doctor told me that maybe the bite was not going to get completely closed, and I was shocked.
While I was having the dental cleaning, I was told that a composite had fallen out of my lower central incisor.
As it was too late, I could not find a dentist in Valencia to fix it. The following Monday, I called CEPI to see if Tiago, who had done another of my composites in Porto, could see me urgently and it turned out that the earliest he could see me was April 10th.
Since I was going to Amsterdam the first week of April, I looked for another dentist who could see me sooner, big mistake.
I ended up going to the office of the sister of a CrossFit teammate. The first thing she told me was that I had a lot of mobility in my lower teeth and that’s why I had gum recession. As I have told you in other posts, I have had gum recession for many years.
She told me that he could not guarantee that the composite would last long because of the mobility of the teeth (which has nothing to do with it).
In addition to being traumatized until the next appointment with my orthodontist, the composite fell out after 3 days, so I still had to go to CEPI on April 10 and go on a trip with the gap in my tooth.
During the trip, one night, after brushing, I saw that one of my teeth had moved more than usual and I got very scared, so I wrote to my orthodontist and told her that I was not going to put the lower aligners back in until she saw me again.
Within a week, those teeth were no longer moving.
Since I only had 3 aligners left, on April 15 I went back to Valencia to get the third set.
On this day, the mobility of my teeth had already been gone, so I was calmer.
As the Invisalign system said that certain teeth had to be filed again, they proceeded to floss my teeth to check that there was enough space between the teeth and fortunately, it was not necessary to file any more.
Then Covadonga checked my teeth well and explained how I could loosen the aligner a little if it felt too tight.
I was given 11 aligners and would finish this third round on July 1, 2025. There died my hopes of leaving for the Iceland trip in June with my teeth already perfect.
Supposedly, July 1 would be the end of treatment. Since that was the day I was returning from my trip, I made the appointment for July 8.
At the end of May, I contacted the clinic again because the two lower central incisors were once again slightly loose. It was only a little, but even so, it was necessary to be cautious.
They told me to extend the treatment period per aligner to 10 days, or even 12 if necessary, so by July 8, it was clear that the treatment would not be completed.
On July 8th, I went back to Valencia for my appointment with the orthodontist and, as I suspected, the treatment wasn’t finished as originally planned. That day, they did a new scan of my mouth, and I spoke again with the orthodontist, who explained that, in reality, only about 60% of Invisalign’s planning is fulfilled. The problem was that I only had one set of aligners left.
Even if you pay for Invisalign’s Comprehensive plan, which supposedly offers unlimited aligners, in reality, it’s only four sets. If after those four sets your teeth still aren’t as they should be, you have to pay extra.
So, in my case, I only had that fourth and final set left. I went back to Valencia on July 30th —I took a same-day round-trip flight— so they could give me those last aligners.
They gave me 16 aligners, which really surprised me, because my teeth were already looking so good and I was so close to reaching perfection in terms of both functionality and aesthetics, that I didn’t expect to still have 16 more weeks of treatment ahead. It felt like the orthodontic process would never end.
When I started this fourth set, I realized that I still wasn’t seeing the progress I had expected. I got in touch with the orthodontist because, even though the treatment was officially supposed to end on November 19th, I already suspected that by that date I would still be in the same situation. It’s true that my mouth had changed a lot, but I still needed to close my bite properly and align the upper central incisors with the canines —something that remained unresolved.
The orthodontist suggested scheduling a follow-up appointment before the treatment officially ended, just to check how things were going, so I booked an appointment for October 24th.
It’s also worth mentioning something here: Invisalign is great for people who can’t go to the clinic frequently, since the monitoring is done through the app, but that app isn’t actually very useful. There’s no way to compare the photos you upload with the original treatment plan images, so until you finish a full set, you really don’t know if the treatment is working as it should or how much progress you’ve actually made.
On October 24, I went back to Valencia for a new appointment with my orthodontist. I had already been noticing that something wasn’t quite right: my teeth were moving in ways they shouldn’t, and the bite on the left side was opening — exactly the opposite of what was supposed to happen. She confirmed that the bite on the left side was indeed opening because two molars were making very strong contact, which was affecting the proper functioning of the aligners.
She also explained that the treatment would probably not be finished by November 19, which I had already suspected. During this appointment, they placed three buttons on the molars on the left side so I could use elastics and apply more pressure to help close the bite on that side.
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