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Orthodontics/Microbrasion and Clear Aligner Braces

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Question
QUESTION: Will doing microbrasion or tooth etching affect the fit of clear aligners/invisalign? I'd like to get rid of flurosis spots on my teeth.

ANSWER:
Hi Chila,

Wow, what a modern and interesting question.  Very up to date ! Here here for Canada !! Let me preface by saying what I write here are only my opinions based on very limited information. My comments should not be viewed as any form of diagnosis, definitive or otherwise,  or any form of  treatment recommendation.  Indeed, in the ultimate analysis all final decisions, particularly clinical ones, should  only be made by qualified doctors who have had a chance to see you in person and who have had an opportunity to take and analyze proper diagnostic records.

In general, the answer is probably not. As I am sure you are aware, microabrasion seeks to cosmetically correct any discrepancies in the enamel which can affect aesthetics. Fluorosis manifests itself at many levels, and those afflicted with severe fluorosis may not be able to resolve their condition with simple micro abrasion. For such cases sometimes more advanced restorative procedures such as thin porcelain veneers or cosmetic bonding is called for.

A second concern I have is that many aligners utilize various shaped "attachments". These are very small small round or square shaped  "pegs" if you will which are first bonded to the tooth. They help allow the aligner to better "grip" the tooth to provide movement. Imagine an artificial indoor  rock climbing wall that has all these small "grips" available for the climber. Similarly, "attachment" bonded to the tooth provide the aligner a better means of grasping the tooth to achieve the desired rotation, tipping, or other needed correction called for in the orthodontic treatment.

Anyway, it can not be ruled out that f such "attachments" are part of your aligner treatment, that microabrasion might compromise the efficiency of these attachments by either reshaping them, dulling some of the sharper angles, accidentally loosening them, etc.

Ask your dentist what he or she has in mind. Then check with the doctor (assuming another doctor is involved )providing your aligner treatment. If two or more doctors are involved, perhaps they can consult with one another so as to avoid any conflicting procedures which might compromise your overall treatment.

Overall, it is difficult to answer your question not knowing th4 extent of your fluorosis. In addition, the specifics of the microabrasion procedures can vary. I hope Chila that this has been of help.I am sure, given your diligence, that you will end up with a beautiful smile. Please feel free to submit any follow up questions you may have.

Paul Supan, DDS, MA, MPH
Board Certified Orthodontist

Specialist in Orthodontics
Specialist in Dental Public Health
http://www.braces.com
http://www.leesburgbraces.com

Please allow a week for a reply. I am in full time Private Practice, lecture on occasion, and involved in many volunteer activities. I am therefore not always able to respond to questions straight away. Your understanding is appreciated.










---------- FOLLOW-UP ----------

QUESTION: Thank you Dr. Supan for your detailed response! I contacted the treatment coordinator and she recommends that I don't do anything to my teeth until after treatment is over, since, (as you also suggested(, it could possibly affect the fit of the aligners. I am still only waiting on the aligners so it will be a long way to go until t hen...I suppose I will just have to wait out 12 months to up to 2 years potentially before I can do something about the fluroisis. It's too bad you aren't in Canada as I'd love to have been a patient of yours!

Answer

Dear Chila,

Thank you for the follow up.  The treatment coordinator is giving you good advice. I am sure things will work out just perfectly for you.  I think your case demonstrates an important principle that many can learn from, namely to not hesitate to ask questions of your health care providers.

A provider that cares should always have the time to answer your concerns and to make you feel comfortable about the treatment you are but to receive. If you are not comfortable abut a certain proposed procedure, ask the provider about alternatives. Generally there are many ways to approach an issue; find one that is right for you.

All the best Chila, and thank you for writing. As the English often so quaintly will say...  "...My pleasure entirely...."

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Paul Supan, DDS, MA, MPH

Expertise

First may I say please set your questions to Public so other readers can benefit from the response. Also, if you look at my comprehensive answers, they are not short 1 or 2 paragraph quickie replies that anyone can type out in < 5 minutes. Instead I often will ask other colleagues in other specialties for their advice in order to provide you the questioner with a more interdisciplinary perspective. This all takes time. I ask for readers to therefore allow 5-7 days. You will be rewarded with a very detailed response.

Because of the nature of Orthodontic questions, any pictures of the teeth and X-ray images would be very helpful. If you write to me and explain that you have crooked overlapping front teeth can be interpreted in many many ways, and my goal is to provide a specific response that meets your needs.

I hold double specialty credentials. I am Board Certified in Orthodontics and Board Eligible in Dental Public Health. I welcome questions regarding Braces, Invisible Braces, & Invisalign, as well as issues involving combination Cosmetic Dentistry and Orthodontic treatment. Orthodontics alone sometimes is not enough to achieve that perfect smile. Gingival (gum) re-contouring, tooth reshaping, bonding and other services are sometimes needed. I also have substantial experience in the areas of Infection Control and Sterilization in the Dental Environment. My personal websites braces.com and Leesburgbraces.com are non-commercial for information purposes only and may provide you with some background to more precisely frame your question for allexperts.com.

Please allow a week for a reply. I am in full time Private Practice, lecture on occasion, and am involved in many volunteer activities. I am therefore not always able to respond to questions straight away. Your understanding is appreciated.

Experience

Board Certified Orthodontist (ABO Diplomate) with over 25 years of Private Practice experience. Second Specialty Certificate in Dental Public Health with research experience at NIH, and Epidemiology Training & Research at Harvard, NIH, and the Centers for Disease Control (CDC) in Atlanta. Postgraduate Masters degree from the Harvard School of Public Health, as well as a Master of Arts Degree in Education.

Organizations
American Dental Association, American Association of Orthodontists, Academy of General Dentistry, College of Diplomates of the ABO, OSAP - Office Sterilization & Asepsis Procedures Organization, Others

Publications
Available upon Request.

Education/Credentials
BS College of William & Mary, DDS Medical College of Virginia, Masters of Public Health (MPH) Degree Harvard School of Public Health. Dental Public Health Specialty Certificate from NIH. Orthodontic Specialty Certificate from University of Rochester Eastman Dental Center. USPHS clinical research experience at NIH, and Epidemiology Training & Research at Harvard, NIH, and the Centers for Disease Control. Fellow of the Academy of General Dentistry (FAGD), and Fully Board Certified Diplomate of the American Board of Orthodontics. Board Eligible in Dental Public Health. Visiting Adjunct Associate Professor at the Meharry Medical College School of Dentistry, Nashville, Tennessee.

Awards and Honors
Available upon Request Please see my personal websites braces.com and Leesburgbraces.com for further personal background.

Past/Present Clients
Available upon Request

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