I think of Diana every single time we begin Invisalign Care. And there are numerous reasons.

Forget that I never really liked Orthodontics when I was a student and therefore never saw straightening teeth as part of my clinical future. But I’ll be the first guy to admit receiving orthodontic care changed my life. Back in The Day, I just didn’t see me on the giving side of the proposition.

I actually used to cover my mouth with my hand when I was speaking. If early patients didn’t have canine-type reception, hearing Bolton was easier for them than understanding me. So I started my practice here in Temple City as the expressive dentist equivalent of a flabby personal trainer or a food critic who counted catsup as a vegetable.

By the time Invisalign came along (Originally the work of two MBA candidates at Stanford) I was way more than seriously curious about all the new clinical advances in dentistry. The office was loaded with cameras and computers and lasers…and I still felt a little threatened by the dental engineering also known as Orthodontics. Finally, I figured if two non-DDS types had dreamed up the system, there might actually be something to it. I gained certification as soon as GPs became eligible for training.

I met Diana at a Pasadena Chamber breakfast. I love Chamber functions because the folks who attend are such dedicated networkers they don’t even run away screaming when you tell ’em you’re a dentist.

Diana won a free TCDC Zoom! Teeth Whitening in the raffle held at the end of every monthly breakfast. After a while, she made the drive down Baldwin and within an hour or so had a smile about 5 shades lighter. After folks visit us and walk away with whiter teeth I’m more likely emboldened to ask a few questions. One question is, “Do you have any other concerns about your smile?” This time the answer was, “I know darn well you’re looking at it.”

Diana had had great whitening results and everything was looking good…with the exception of one badly discolored upper front tooth that was also sticking out at an angle not much unlike Sarah Brightman taking a curtain call in front of the rest of the lined-up cast of The Phantom.

Diana helped head up a local non-profit, her children were all grown up, her family had always come first; you’ll never meet warmer person. On Zoom! Day, plus 10 minutes, Diana shared she’d hated that tooth for at least 40 years. She never smiled without posturing to hide the tooth, hated having her picture taken, and subconsciously screened her mouth from sight, using her hand as a prop. Hmmm, been there.

Diana had heard all about Orthodontics but didn’t want braces. “What if we straightened that tooth without using braces and matched colors by placing a porcelain veneer without removing more than about 0.5 millimeters of enamel? Would you be interested?”

“Can you do all the work here?”

“Would you prefer that?”

I still attend the monthly Pasadena Chamber breakfasts. The scrambled eggs continue to need some work; there are more chiropractors present than dentists in the state of Nebraska, and the guy who leads the meeting is an unapologetic bruin honk (poor devil.) And the whole experience is a total blast.

Especially when Diana delivers her 20-second commercial with a big, beautiful freely expressed smile.

Back when I was a dental student and O.J. was busy pitching Hertz rent-a-cars while he was running through airports, I sure did hate orthodontics. When I somehow escaped dental school in the dead of night and started out from scratch in TC, I couldn’t believe my one co-worker, Former Office Manager Diane, had previously been paid to bend orthodontic wires. If I had only known FOM Diane while I was a student, I’d have somehow raised the cash to pay her off for a wire job well done.

I’m not suggesting students should go out and hire folks to do their work; I’m just making clear the sort of fantasies this former student used to entertain (the Doc “wrath of” Kahn productions are not suited for impressionable readers younger than grandparents of Baby Boomers.)

Bending wires was tedious stuff and I basically stunk at it. Maybe that’s one reason why I’m always saying if you enjoy something, you’re going to be good at it. Orthodontics didn’t even seem like dentistry; it was more like engineering. I never tried engineering, but following the line of my enjoy/”excel at” tendencies and the way I fix stuff that isn’t teeth, I’d have probably stunk at engineering too.

And there’s more.

Until Doc Fong took me and my crooked teeth on as patients, my smile looked something like a cross between a piranha and a train crash. You would have thought when I was a D-student I’d have hung out downstairs waiting for some kind of Ortho Department handout. It wasn’t until I’d been practicing dentistry in town for a while that I noticed a few interesting things (we covered my slow study self last week.) Parents didn’t like it when I sent their kids to the orthodontist even though my teeth were the funkiest zigzags in the room. A friend also wondered why I tended to have my hand in front of my mouth when I spoke.

Doc Fong totally transformed my thoughts on orthodontics and then became one of my best friends and a valued mentor. Haven’t stopped smiling since.

One of the things I really enjoy about dentistry is esthetics or the cosmetic stuff. About five years ago, I heard about a new approach to orthodontics called Invisalign. Next thing you know, I was certified to do Invisalign orthodontics. Who knew?

Invisalign is delivered wire free with custom fit clear plastic aligners that are virtually invisible; the process combines typical restorative dentistry techniques and some amazing technology. Teeth are moved 0.2 millimeters every two weeks (that’s when the aligners are changed.) Active treatment averages 6 months to a year, followed by retainers just as with traditional orthodontics. Invisalign isn’t appropriate for all orthodontic challenges; consults regarding Invisalign as a viable alternative are recommended.

The process, beyond screening, involves a comprehensive exam, full-mouth X-rays, photographs, a bite record, and upper and lower arch impressions. The information and a treatment plan are submitted to Align Technology in Santa Clara. There, a CT scan is made from the dental impressions, producing an extremely accurate 3-dimensional model of the teeth. CAD (Computer Aided Design) software is then used to simulate the movement of teeth during treatment. The plan and virtual results are then reviewed by the dentist and patient off the Align website. The aligners are made only after the patient’s approval of the plan (it’s pretty cool seeing the projected result before care even begins.) Align then uses stereolithography (SLA, I looked it up) to build precise molds capturing each stage of tooth movement. Active treatment begins on delivery of the aligners to the dental office.

Invisalign works as a great approach to correcting crowding or spacing between teeth. A typical application would be retreatment of an orthodontic case that had relapsed; perhaps from the lack wearing retainers (don’t feel too guilty; we’re not asking for a raise of hands.) Another great application is the ability to move maybe only one tooth. A memorable patient had walked around for close to fifty years with one upper anterior tooth sticking straight out. “I hate that tooth but there’s no way I’m wearing braces,” she said. I responded, “What if there were a way we could straighten that tooth without braces?” The rest was history…and in only about four months. Invisalign can also be used to help set up minimally invasive veneer cases or help folks with bite related issues. The aligners are worn 22 hours per day and are removed for eating and oral hygiene.

Our first patient, back in the day, was none other than OM Dalila (guess I couldn’t find any blood relatives.) And the aligners didn’t even come close to slowing down the verbally gifted One on the phone or with patient/guests.

Most practices offering Invisalign also offer third party financing; orthodontic coverage as an existing part of your dental insurance plan should include Invisalign.

If you’ve always wanted straighter teeth but never cared for the metallic look, ask your dentist about Invisalign.

When I was a student I thought orthodontists were just a bunch of wire-bending tooth engineer dweebs who would do just about anything to avoid the sight of blood or the prospect of giving an injection (even if they had to stay in school another two years.)

And if I could have found someone willing to bend wires for pay, I’d have considered it—right up until the vision of my dad dragging me out of the clinic by the ear lit up the flat screen in my head that could also pass for a brain wave.

I graduated with seriously crooked teeth and even as a dentist I wasn’t all that troubled until I started noticing the kids I was referring to the orthodontist had straighter teeth than me. And friends were pointing out I spent considerable time with my left hand in front of my mouth (I’m half-Italian; I need one hand for gesturing.)

TC’s own Doc Fong famously straightened out my wayward smile and I still nominate him for Nobel recognition every year but sometimes those guys are even worse than the BCS.

But today, I love orthodontics. And I even dream about Invisalign. Yeah, and I used to be normal. Sure.

Invisalign is the technology that straightens teeth without braces. I signed up for Invisalign as soon as it was offered to GPs and as soon as I made sure no wire bending was involved.

Invisalign technology uses 3-D computer imaging to stage treatment from start to finish. Clear, virtually invisible trays or aligners are produced from the outlined plan; they move teeth approximately two-tenths of a millimeter every two weeks. The aligners are removable but come out only for eating and oral hygiene at the risk of serious time spent in Orthodontic Purgatory (OP). Personally, I think Invisalign is the coolest innovation I’ve seen in dentistry during a time when the profession has been revolutionized technologically.

Invisalign works great for my Baby Boomer buddies who had orthodontics but didn’t drink the kool ade when it came to wearing their retainers. Thing is, teeth are always moving sort of like glaciers; as we age, most folks experience a tendency toward crowding of lower anterior teeth. Some of our most satisfying Invisalign results have come from patients who haven’t liked their smile for decades but couldn’t bring themselves to wear braces.

Invisalign is often helpful in addressing TMJ-related concerns; the approach also works well for folks being treated for gum disease. About 80% of orthodontics can be treated with Invisalign. 100% of the TCDC team is benefiting from Invisalign.

If you have insurance benefits that cover orthodontics, they will cover Invisalign. Most Docs offer monthly financing (some even have no-interest options.)

If you’ve ever had any misgivings about the way your teeth line up or you’re self-conscious about photo-ops, please ask your dentist about Invisalign. One question could lead to some great results you never thought possible.