Sheena returned for her first monitoring visit all smiles and reported that she had not experienced any problems. She found the aligners easy to seat and easy to remove. No discomfort was reported during aligner wear, and in fact, she reported that it was as if there was “nothing in my mouth”. She loves the esthetics of Invisalign!

The staff reinforced the importance of daily careful patient evaluation of the fit of the aligner. Sheena explained how she takes time to look closely at the attachments to ensure fit. She also repeated how she will check that the teeth fit intimately against the internal portion of the aligner with no gap or space.

We have found that one of the most important elements for Invisalign success is patient compliance. Spending time to involve the patient to understand what to look for to recognize movement lag pays tremendous dividends with clinical results. It allows us to adjust the activation time and detect lagging movements so that we can quickly execute proper correction. The minimum activation time of 22hrs per day with 2 weeks between each aligner change can be increased to 3-4 weeks in the case of movement lag and help get a case back on track. If we suspect movement lag early, we can check the IPR schedule, check the contacts with floss and carefully evaluate the fit of attachments.

Patients are instructed to contact the office when they have an observation of space between the aligner and the teeth. Additionally we ask them to contact the office if the “peg” of the attachment does not fit intimately into the attachment reservoir.

Sheena’s case is a spacing case and generally these cases progress very well given good compliance. Sheena remains very enthusiastic! She is looking forward to continued improvement as her teeth move to close the spaces.

Take a look at the close-up photos of Sheena’s aligner fit. This is what we want to evaluate for success. In our next blog, we will evaluate Sheena’s next monitoring visit scheduled for aligner 6.