Factoria Dental Care
Dr Jason Chan DDS
Dr Raymond Chan DDS
(425)746-5907
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Overdue update

12/26/2012

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Apologies for the delay on this update. The transition from the end of the year into the new year is always a busy time for us so I haven't had a time for an update yet. Since then I've gone through all my aligners from the proposed refinement treatment plan. Here's a picture from a week after my last post.
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To review, this was about 4 aligners into the refinement treatment plan. I started to notice that the gap you see on the front close slightly. My lower teeth have been pulled inward more to try to establish some more overjet/overbite (which is basically the overlap of the top teeth with the bottom ones)
Since the last post, I've completed all my refinement aligners. I've had to do some more IPR in the lower right teeth in order to help pull the front lower teeth back more and ultimately close that gap on that side. I've noticed that my lower teeth have gradually been pulled inward (toward my tongue) more. Also I've noticed both upper and lower, lateral incisors and canines, come closer together in hopes of closing that gap. 

I will post later about my completed case and how I've decided to manage the retention.
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About halfway through

10/30/2012

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I'm on aligner set #4 of 8 through my refinement plan and things are going swimmingly! 

What I've done: Aside from the typical routine of changing out the aligners every 2 weeks, I had to replace my first attachment! (Probably only exciting for me) I didn't even realize it had came out until I had noticed one day that the attachment on one of my teeth didn't feel as big. Luckily, it's a breeze to put back on. Our talented assistant, Alex, was able to do most of it. Just clean off the old attachment, and re-bond a new attachment back on. Then you're good to go!

What I'm feeling: By now I'm pretty much used to the soreness that happens the first couple days of a new aligner. Other than that, I've noticed a change in my bite along with the shifting of my teeth. I know that there will probably be some adjustment of some teeth after treatment, but I'm hoping that there won't be too much to do. Appearance-wise, there isn't a huge difference, but I'll post a picture in the near future anyway. (Camera is out of battery now! doh!)

Progress: Onward! Picture to come!
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Starting Refinement!

9/13/2012

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Going back into treatment can be a tricky decision to make, but in the end, I know that I'm going to get a result that will make me happier and healthier. The fact that Invisalign is easy to use/wear made the decision easy for me to continue!

To recap, after finishing initial treatment and speaking with my orthodontic colleague about my case, I decided to make a few tweaks to my teeth. Refinement is almost like another treatment plan, but much shorter, because we've already done the bulk of the treatment in the first plan. This extra phase is designed to make any minor corrections that weren't satisfied from the initial treatment such as closing up any remaining small spaces, or fully rotate teeth that may not have rotated all the way. In my case, my front teeth were hitting a little too hard than I had liked, they weren't quite rotated all they way, and I still had a couple of gaps that I wanted to close up between my teeth. 

My refinement will consist of eight additional aligners and a few more attachments (the bumps on the teeth that help the aligners move your teeth). As you can see from the picture, I've got some on the upper arch as well as some on my lower arch. Since I've already been through this once, I know what to expect and how to take care of myself! We'll see where the next 16 weeks takes me. I'll keep you all updated as we progress. Thanks for reading!

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Onward!

8/30/2012

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Greetings! I hope everyone is having a good week so far as we enter Labor Day Weekend! I apologize for long absence. I've been thinking about my case, with my colleague Dr Shafeena Chatur (our neighboring orthodontist!), and what I want to do. After a bit of deliberation, I've decided to enter "Refinement"! 

What's "Refinement" you ask? Refinement is the optional stage after the proposed treatment plan with Invisalign has been completed. The objective is to make any other small changes in order to reach the desired outcome if they were either not reached from the original treatment plan, or if the final outcome was not quite satisfactory. Some examples would include closing up spaces that didn't get closed all the way or rotating teeth a little more if they didn't make it all the way. We just need to take new impressions at the end of the original treatment plan, after the old attachments have been removed, and send them into Invisalign. Refinement stage treatment is typically much shorter and does not require as many aligners.

I've already approved my proposed treatment plan so I should be starting up the treatment again soon. Stay in touch as I move onto the next chapter of my self-treatment! 
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Finishing initial treatment!

7/16/2012

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It's been a while since my last update! To date, I have finished my initial treatment plan with Invisalign and thought I'd show a few pictures of what my teeth look like currently. There are a few adjustments I'd like to make, so this will not be the final result. Things are looking very good so far though! The following pictures are from my initial photo's from back in November 8th, 2011. 

To rehash from before, the main concerns for me going into the treatment were to rotate my upper central incisors back into proper orientation (as you can see from the side photos, they are rotated inward and toward the middle), establish better overjet/overbite than my existing edge-to-edge bite (overjet/overbite is basically the overlap of the top incisors over the bottom incisors), and to close up as many of the gaps between my teeth as possible. I knew this would be a challenge because of my skeletal class III (my lower jaw grew slightly longer than it needs to be). I had straighter teeth before when I had braces as a kid, but I was bad when I didn't wear my retainers as often as I should have! But my teeth are looking better now, thanks to better technology to straighten my teeth back again with Invisalign! 
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So the photos you see below, are the most up to date photos so far. They are taken after my treatment plan, as initially proposed with Invisalign, was completed. This is after 12 sets of aligners on the top and 8 aligners on the bottom!
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Things have improved quite a bit with the upper incisors as you're able to see, they are not nearly as rotated as they used to be. They face more forward, and from the side view, you can also see that I've managed to improve my overjet/overbite slightly, over the edge-to-edge bite that I used to have. There are also fewer and smaller black spaces between my teeth. So all in all, I'm pretty happy with the result so far. However, I feel that my central incisors can be rotated a little more, as well as be proclined a little more to establish a little more overjet/overbite. Hopefully with that, I can get minimize that tricky black space on my right side a little more! I will be starting a refinement, so I'll be going through a few extra aligners over the next couple months. So the saga continues! Thanks for following me through this journey!
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Happy May Day!

5/1/2012

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It's May, and our beautiful Seattle summers are getting closer! Here's a new update, with pictures!

What I've done: Everything has been progressing the same, I'm on my 8th set of aligners. This is the bottom set for my lower teeth, which means they won't be moving anymore for now. The upper teeth still have another 4 sets of aligners to go. So far things are looking good and I can see great progress!

What I'm feeling: All subsequent aligners have been pretty much the same, and it's all routine now when I get to the next set. I learned some great tips about making the first day of wearing a new aligner more comfortable and manageable! First, you should put on that new set of aligners in at night. This way, the aligners have all night to work on your teeth before the first time you'll remove them, which will be the next morning when you eat/brush your teeth. It will make it much easier, especially if you have a tough time removing those aligners initially. Another thing that helps with seating the aligners is running them under hot water right before you try to seat them because even though the aligners are heat resistant, a little hot water may make them flex just enough to get them over your teeth. Good tips for any Invisalign patient!

Progress: As you can see from the pictures below, and from where I started, my front two upper incisors have straightened up a bit and look less rotated. There's a very small gap between the adjacent incisor and the lower incisors that I may have to make a refinement on later. We'll see how things progress over the next couple aligners. 
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3rd Update!

3/21/2012

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Hi guys! Spring has come and the sun is out! Time for another update on my invisalign treatment!

What I've done: Just been checking my contacts, making sure they aren't too tight. I'm currently on my 6th set of aligners! About halfway there! 

What I'm feeling: The last set of aligners felt a bit tight for a little longer than the previous ones. I am thinking that this is just because of the movements that each aligner takes you through. Some aligners may have more subtle movements, while another may take a tooth in a new direction. Teeth are naturally allowed to move (which is why orthodontics is possible!), but every tooth can be different in how quickly it moves. As long as the aligners eventually get easier to take on and off, I know that they're doing their job of moving teeth into their new position.

Progress: I've recently received some comments by people who know about my treatment, that they're starting to notice change. I've been told that my front upper incisors are straighter (woohoo!). Personally, I've noticed my lower incisors pulled in a little, and I also notice that my upper incisors have rotated some as well. It feels good to see the progress! I will probably take pictures in the future to post here. Stay tuned! 
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2nd Update!

2/13/2012

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Time for another update! Things have been going great so far, which is why I haven't updated in a while. I've gone through two sets of aligners and am on my third set already!

What I've done: I decided to do a little more IPR between a few teeth where the contacts had become a little tighter. Now I did not do very much to begin with (the initial suggested amount was roughly 0.2mm on each side of each tooth, but I decided to gradually take off a little at a time), so I only do as much reduction as I really need to get my teeth in the position that I want. This way, I avoid taking away more tooth structure initially than I need to. Other than that, I've just been trying to be diligent about wearing my aligners all the time! 

What I'm feeling: I hardly notice them anymore! I've gotten so used to them that it's almost weird to not have them in. My speech has adapted very well and no one even notices I'm wearing anything. I can eat whatever I want without any concerns and when I'm done I just clean my teeth as I normally would. As I mentioned last time, the aligners accumulate a lot of plaque just from being in your mouth, just like your teeth, so they need to be brushed as often as your teeth. Keeping them clean will reduce the amount of plaque on your teeth as well as prevent them from getting dirty looking when you wear them.

Progress: I'm starting to notice my teeth shifting more and making very gradual movements. After the initial day of soreness with a new aligner, I don't feel any discomfort at all from them. I'm so used to them that I hardly notice them!  
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First Update!

1/17/2012

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Hi everyone! I thought I'd give everyone an update after one week of treatment! So far things are progressing pretty smoothly and I haven't had any issues at all with my aligners.

What I've done: Worn my aligners for at least 22hrs a day for the last week like I'm supposed to!

What I'm feeling: My teeth got used to the movement/soreness pretty quick. After the first day of some soreness, I haven't had much at all since then. The aligners fit on and off pretty smoothly, but I do not have very many attachments. From what I've seen, the more attachments you have, the more difficult it may be to take on and off your aligners. 

I've also been surprised that so far only one person was able to notice my aligners! And she only knew because she was one of the first people to hear me speak after inserting the aligners in (Kim from our front desk). Everyone else has been surprised that I even had anything in! They really are hardly noticeable!

The one issue that I have noticed is that these aligners must be kept clean on a regular basis. They accumulate plaque fairly quickly, so it's important to brush your teeth AND your aligners as often as you can throughout the day. Mouth rinse may also help keep your breath nice and fresh. 

Progress: Teeth are gradually moving! My bite has changed ever so slightly, but I knew that was happening already. We'll keep track as time goes on!  

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Starting Invisalign Treatment!

1/9/2012

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I (Dr Jason Chan) have started self-treatment with Invisalign! I will be keeping a log here of my treatment with some pictures for you to observe as I go through all the hurdles with Invisalign treatment. This is a new experience for me and should be fun and rewarding!

What I did: Today, I have started by doing some IPR (Interproximal reduction - removing small amounts of tooth structure at the areas where they contact; this gives us more room to move the teeth) on a few of my teeth, adding composite attachments (small pieces of tooth color filling material that allow the aligners to hold onto the teeth better), and finally fitted the first set of aligners in. 

So what am I feeling: My initial feelings were that the aligners felt really tight. This is pretty normal as with each set of aligners, they will be placing slight pressure on certain teeth to move the teeth. My speech was slightly changed because of the aligners sitting on the tongue side (lingual) side of my front teeth. My tongue will eventually get used to this and I think my speech will be back to normal soon. Having to remove the aligners when I eat or drink (anything but water), is a little annoying, but not much trouble. These aligners are by far more comfortable than the metal braces I had before that were always scratching my lips. All of the things that I've been feeling have been expected. Now I can sympathize with patients when they go through it! 

Progress: We'll see in a few days!  
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Attachments

These are the small tooth-colored filling materials that are added to your teeth to help the aligners move your teeth. 

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IPR

Here i am, doing my own IPR (polishing the sides of my teeth down tenths of millimeters) to make more space for the teeth to fit together.  

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