This morning I met with one of our new Invisalign patients. He said he was comfortable enough but found that he would rather keep them out during work. When I asked how many hours that translated into per day he said "Maybe 12". Ooooh not good. The whole purpose of the Invisalign is to put pressure on the teeth. This pressure is the same as fixed appliances (metal braces) but it needs to be in the mouth and on the teeth to do this. The great thing about Invisalign is it can be removed to clean the teeth properly BUT this is the bad thing as well. The reason we need to keep the aligners in at least 20 hours per day is simple and yet very complex. When pressure is placed onto any living thing it will respond. Put sunlight on our skin after a while it will turn red. Put pressure on muscles they grow. Put pressure on bone and it will change shape. The same applies to the bone around teeth. If you put pressure on the teeth half of the day and release that pressure for the rest of the day there is no NET movement. As the aligner places pressure the body responds in a very complex concert of events. The pressure translates into signals that move from tooth to ligament to bone to the circulation to the brain and back. Many chemicals are released and the bone shape changes. This all allows tooth movements.
It is also important to follow the prescribed time. Each aligner will be changed at a maximum of 2 weeks. There is a maximum speed that the bone can change and the teeth can move.
I find that our patients who are very diligent in wearing their aligners follow the prescribed treatment and time very well. The more patients give "excuses" for themselves (and some may be very necessary) the less the teeth will move and the longer treatment will last.
This is one of the reasons that I meet monthly with my Invisalign patients. It is easy to take for granted how complex the movement of teeth is because Invisalign makes it feel so simple.
And with a bit of commitment it is!
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