Download ANNEX A –INVISALIGN TECHNIQUE GENERAL INFORMATIONS

ANNEX A –INVISALIGN TECHNIQUE
GENERAL INFORMATIONS, POTENTIAL RISKS, LIMITATIONS
ORTHODONTIC AND DENTO-FACIAL ORTHOPEDIC
Although it is more recognized that an orthodontic treatment is the solution for several
problems of facial balance and dental alignment, it is important to all persons who begin
such treatment under our responsibility should know how to act in order to obtain
optimum results. Also, the risks and limitations of such treatment must be fully
understood just like any interventions on the human body. The phenomenon described
hereinafter occurs rarely and in most cases, they are largely offset by the advantages of an
orthodontic treatment.
APPOINTMENTS
At every appointment, please bring your last aligner
-It will be occasionally necessary for the patient to miss school or work in order to
respect the appointment.
-Approximate frequency of an appointment: 8 to 18 weeks for 30 to 60 minutes.
-Missed appointments will be rescheduled according to our own availability. It will be
the patient responsibility to call us to get another appointment.
-Appointments are not confirmed on a regular basis.
-Emergency visits will be given between 9h00 to 1h30.
-We will not accept patient without an appointment.
-Fees of 50.00$ will be charged after three missed appointment.
-The cost to replace an aligner lost or broken is between 200.00$ and 400.00$. Those
fees are payable the day the impressions are taken. Please, always call the office when
something broke even if you have an appointment the same day.
-Fees can be increased without notice.
-It is important to mention that extraction, impacted tooth surgery, gingival graft or other
procedures required for processing performed by a dentist or a specialist before, during
or after treatment are not included in the price of the orthodontic treatment.
If during holidays or after office hours something broke or cause discomfort and you
cannot wait for us, please refer to our website at www.MonOrtho.ca for clever tips. Also,
your dentist may be able to help or call Urgence Dentaire Laval at 450.669.9999 (with
this service, there will be fees).
COOPERATION
Successful treatment is a team effort between orthodontist/staff and patient/parent.
Aligners must be worn as instructed or the final result may be compromised and the
treatment could be longer. Lost aligners and missed appointments will also extend the
treatment. Even with an excellent cooperation, the treatment could be longer, if so, there
will be no extra fees.
DIET
If your treatment includes appliance like CBJ, Pendulum or Haas before the
invisalign aligners, you will have to develop new eating habits;
-DO NOT EAT ANY HARD OR STICKY FOODS like candy, caramel, fruit rolls,
gummy bears, popcorn, nuts, liquorice, ice, popsicle and Mr. Freeze.
-Do not chew gum of any kind (for denture or sugar free).
-Granola and tender bars without chocolate coating must be crushed into small pieces.
-All hard fruits and vegetables such as corn on the cob, apples, etc. must be cut into
pieces. Avoid biting directly into those types of food and be sure to extract the pit.
-Raw vegetables such as celery, radish, pickle, carrot must be cut into small pieces.
-Thick crust bread or pizza must be cut in pieces, do not tear it up with your teeth.
-Before eating, separate meat from the bones such as spareribs, chicken, T-bone, etc.
-DO NOT BITE PENCILS, FINGER NAILS AND AVOID ALL SWEETS.
Wearing orthodontic appliances do not necessarily deprive you of little treats of life…
Chocolate bars such as Aero, Caramilk or KitKat can help brighten your day and for
salty snack, chips or rice cakes can be acceptable. On the other hand, reality will remind
you that a good oral hygiene immediately after this little moment of pleasure will be
necessary.
During the invisalign aligner transition, there are no food restrictions.
DENTAL CHECKUPS AND HYGIENE
-You should brush your teeth with the proper technique immediately after eating. If
brushing right away is not possible, rinse vigorously with water.
-Use a mouthwash with fluor to prevent decalcifications.
-If the patient has a poor hygiene at the scheduled visit, we will be available to show
again the proper way to brush but the control will be postponed.
A neglected dental hygiene will extend the duration of the treatment and may cause
cavities, decalcifications, gum disease and bone loss.
SPORTING ACTIVITIES
You can practice almost every sport. Aligners even offer some protection during an
impact.
VISIT AT YOUR DENTIST
Continue to visit your dentist regularly. It may be possible that doctor Fournier ask for a
periodontal visit before and after the treatment. This evaluation is necessary for adult
who prone gum disease. IMPORTANT: No dental work must be done during
invisalign active treatment.
DISCOMFORT
-There will be some pain for 3 to 7 days following the installation of the appliance
or the aligner. We recommend Tylenol or Advil to alleviate the discomfort.
-A soft diet the first week is recommended (pasta, soup, etc.) If your threshold is
low, we will act accordingly.
-An absence of pain can be normal.
-It is possible and normal for some teeth to be mobile (to a certain point) during the
treatment. If you have any concerns, let us know.
RETENTION
The vast majority of patients should wear retention device at least one year after the
active treatment. The first retention devices are included in the cost of the treatment.
There will be additional costs for all types of device damaged, lost or replaced. If the
retention devices are not worn properly, the teeth will move into their initial default
especially to the region of the lower incisors. Even when the correction is done properly
and the retention devices are worn properly, light rotations can appear even if there was
no overlap.
MOVEMENT AFTER DENTAL TREATMENT
Braces or not, our teeth will move all through our life. The possibility that teeth move
after the retention period exists. Some of these changes may be desirable while others are
not. Rotation and overlapping of mandibular incisors are among the most common teeth
movement during aging. Also, you can see spaces created at tooth extraction sites
(especially among adults) and between the upper central incisors that were previously
apart.
WISDOM TOOTH
Despite their bad reputation, wisdom teeth are excellent teeth if they have enough space
to erupt. For this matter, Dr. Fournier relies totally to your dentist diagnosis.
RISKS AND LIMITATIONS
RESORPTION OF THE ROOT (rhizalyse)
This is the shortening of the root of a tooth, which occurs in a very small number of
patients. In most cases, this has no effect. However, if developed, the longevity of the
tooth may be affected. Root resorption may occur as a result of an accident, a root canal,
glandular disorders and other unknown reasons. Treatment goals have to be revalued if a
severe resorption is observed after the x-rays study.
ANKYLOSIS
For inexplicable reasons, a tooth may refuse to move or to erupt.
TEMPORO-MANDIBULAR JOINT
This is not a common phenomenon but pain in the jaw can occur before, during or after
the orthodontic treatment. Usually, these problems disappear or diminish over time but
also they may not completely disappear. Stress affects directly the severity of the pain.
Today, we know that these disorders are not related to the good or bad position of the
teeth, but rather to the inappropriate movement of the lower jaw or to bad habits such as
nail biting, chewing gum, pencil or the inside of the cheeks.
DEVITALISED TOOTH
It is possible for the pulp of a tooth to be none vital. The nerve of a tooth who has
suffered a deep restoration or a slight blow can degenerate slowly. A none vital pulp can
develop an abscess without any connection to the orthodontic treatment and in that case,
a root canal will be necessary.
NEGATIVE GROWTH
An abnormal growth or the bad habit of always breathe with the mouth may develop a
prognathism mandibular (prominent chin). If the growth is out of proportion, the final
result of the orthodontic treatment may need a revaluation. The imbalance of the skeletal
growth is an unpredictable biological phenomenon. In rare cases, a surgery would be
necessary to restore the balance and the facial harmony.
MOUTH BREATHING, LIP SEAL, LINGUAL POSTURE AND
MYOFONCTIONAL THERAPY
With or without an orthodontic treatment, mouth breathing has a direct effect on growth
and facial shape even when the growth is completed. The patient should consult an otorhino-laryngologist before, during or after the orthodontic treatment if the upper airways
are obstructed due to allergies, large adenoids\tonsils or a deviated nasal septum.
By expanding the arch of the palate and the nasal floor, the orthodontic treatment can
reduce the resistance for the air passage. By reducing the gap between the teeth, the lips
closure will encourage the nasal breathing. The patient will receive instructions and
exercises for face posture, lips closure and position of the tongue (on the palate when at
rest).
However, patients who failed to keep their good facial balance, lips and tongue position
will have fewer chances to maintain the final position of the teeth but the orthodontic
treatment will have greatly improved the situation. The risks of developing problems to
the temporo mandibular joints will be higher.
We strive for perfection but there are no guarantees of success in the medical legal
field. Therefore, be assured that we will do our best and we will expect the same
from our patients to achieve the best possible results.
Dr. Christian Fournier
orthodontist
You will find additional information on your treatment
by visiting our website at www.MonOrtho.ca
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Since January 2013, invisalign has chosen Dr. Christian Fournier as a clinical advisor
and lecturer for the province of Québec. In addition, Dr. Fournier is the only
orthodontist in Québec to receive for six consecutive years the title *Premier
Preferred Provider*.