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Oshawa Braces and AcceleDent Studies Show No Effect. What's the Deal?

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There have been some articles recently showing no difference in speed with AcceleDent and non-AcceleDent patients.  Further analysis into the design of the studies is necessary, because it does not seem like they are well designed (click link and look for study by Woodhouse).

Our anecdotal experience for Oshawa braces patients is that we seem to find more rapid movement when using AcceleDent with Invisalign and less of a difference than with braces.  It does not make a lot of sense, but it could be because we are not seeing the AcceleDent braces patients early enough.    Invisalign patients continue to get new movements with every tray and braces patients have to come in to have their braces adjusted for that to happen.  We thought bringing patients in every 4 weeks for braces instead of 8 weeks would make the difference, but it appears we probably have to bring them in more often than that.  This is the problem in the studies being published recently.  Teeth may have already moved and stopped by the time measurements were taken on the patients using AcceleDent and they were using braces only rather than Invisalign.

The flipside is that we have tried to reduce the number of days per tray without using AcceleDent and found that we cannot change trays nearly as often.

In terms of comfort, we had patients who started without it and then used it mid-treatment.  They say there is a world of difference.  We also have patients who have left their unit somewhere on business or lost it on a vacation and desperately want to buy a new unit.  We have had braces patients who insisted on having their braces off for discomfort, but were offered a unit and were able to be comfortable for the rest of their treatment.  The studies say there is no difference in discomfort but they are comparing this across different people, not within the same person.  Each new patient has no idea what they are supposed to feel and there will be some discomfort.  Again, from an anecdotal point of view, our patients have expressed more comfort when using the unit than not.

This post isn't out there trying to be pro-AcceleDent, but simply to discuss our experience.  With over 200 cases treated now with Invisalign and AcceleDent, we have treated one of the largest patient populations using it.  There are several cases we would not have attempted with Invisalign unless we used AcceleDent.  Part of this is because using the unit acts like a high powered "chewie", which seats the aligners well against the teeth.  It seems like more studies that are well designed are necessary to come up with a definitive conclusion on its efficacy.

In summary, our offices experience has found little difference in braces treatment timing (although we may need to see patients more often) but increase comfort, and a difference in Invisalign treatment with AcceleDent in terms of proper tracking, speed, and comfort level.

Oshawa Orthodontist to Present at Top Meeting in Dallas

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There are many ways to look at orthodontic treatment.  Some people view it as  commodity where braces are braces are braces.  This causes price shopping and people looking for "deals".  Unfortunately, unlike TVs and appliances, orthodontic treatment is a service where your results and experience will differ depending on where you have your treatment.

Top Durham Orthodontist speaking at MKS in Dallas.
This fall, there is a conference in Dallas that is designed to help orthodontists to this end.  Your Oshawa and Whitby Orthodontist will be speaking at Mindset Knowledge Skills to discuss office design and how to implement new procedures and protocols in the office that will provide better orthodontic care and experiences.

Toronto Invisalign Doctor Discusses: Invisalign Makes a Change to Mid-Course Correction and Refinement

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Your Whitby Orthodontist is happy to let you know about a new development with Invisalign treatment.  A couple of weeks ago, Align Technology changed their policy on Mid-Course Correction and Refinement, eliminating them for a process called "Additional Aligners".

Oshawa Orthodontist Share Banner for Additional Aligners on Align Website
Previously, offices taking a new scan or impression for a patient before finishing their whole cycle of aligners was known as mid-course correction.  If due to a lack of patient compliance or new dental work, a lab fee was required to be paid by the office requesting more aligners.  At the end of a cycle of aligners, regular Invisalign and Invisalign Teen treatments were eligible for up to 3 refinement sets.   The next set of refinement could be ordered before an expiration date set by Align, after which the case would be closed, and a new lab fee required.

There were many scenarios where this caused an issue, particularly with more complicated treatments where aligner plans were much longer.  Align has now changed their policy to allow for unlimited additional aligners for up to five years for regular, Teen, and Assist cases.  They will no longer distinguish between mid-course correction and refinement.  However, they will charge a lab fee of up to 40% of the current lab fee cost if there has been a significant lapse between when treatment should have ended and when additional aligners are ordered.

Note that this does not necessarily present and difference to individual patient treatments, because what is included in an orthodontic plan depends on your financial contract with the office you have selected.  Since most of the work is completed by the office during the planning stages of the ClinCheck, many offices will still likely continue to charge a professional fee for developing extra simulations, depending on the specifics of your contract.

Molar Tipping and Incisor Torque with Invisalign in Oshawa, Ontario

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One of the more difficult movements to complete with Invisalign involves movement of the roots.  Often times, this is one of the limited factors of making someone and "Invisalign Candidate".  "Invisalign Candidate" is in quotations because the other major factor is the skill of the doctor.

The first image below is an example of a patient who saw a general dentist for Invisalign treatment to close a space.  The result shows improper alignment of the upper first molar and poor torque of the incisors


The patient was not happy with their result and saw us for a second round of Invisalign.  Below is a scan of the teeth AFTER our first round of aligners.  There are still teeth to be moved, but you can see the molar alignment and anterior torque have changed significantly.

More Comfortable Invisalign Aligners

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Invisalign aligners have come a long way since the first generation.  A few years ago, the SmartTrack material made aligners more comfortable and maintain pressure on the teeth for a longer period of time.

Recently, Align announced some further changes to the aligners to increase comfort:

The first change involves the use of real gingival data for a better fit along the gum line and to reduce incidences of sharp edges and papilla impingement.



To address sharpness and lessen irritation to the gingiva and tongue, there are improvements to the edge quality of the aligners by rounding the pointy edges on the anterior areas along with making modifications to the edge angle on the lingual side.


For further reduction of tongue irritation, there is improved trimming of the aligners to minimize incidence of rough surfaces. 


Invisalign aligners have been quite comfortable for most patients with the above items being "sore" spots for some.  With these improvements, patients will now experience far fewer issues and enjoy their treatment more.

Markham and Oshawa Orthodontists at Orthodontic World Congress Meeting

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As a part of bringing the best Oshawa braces and Invisalign treatment in possible to our patients, our doctors constantly seek out opportunities to learn from both a clinical and customer service perspective.  This is what makes MCO Orthodontics so special.  We realize that just providing good treatment results is not enough.  We have to make you enjoy the experience as well.

Recently, Dr. Haroun and Dr. Tam were in Florida for the GAC Orthodontic World Congress in Hollywood, Florida.  They heard several excellent speakers and managed to get some time in at Marlins Stadium as well as part of the experience.

Our doctors look to bring back what they've learned to help provide beautiful MCO smiles and memorable experiences for you!

Continuous Improvement for Oshawa Orthodontist

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Over the past week, your Oshawa Orthodontist at MCO Orthodontics, took some time away from the clinic to meet with two orthodontists in Miami, Florida.  While we strive to provide the best service and results for our patients, it is always important to determine if there are ways to improve.

Dr. Tam met with Drs. Chandy Samuel and Michael Goldstein in Pembroke Pines and in Miami.  They discussed office efficiencies, interdisciplinary care, Invisalign, as well as orthodontics in the near term and longer term.  This dedication to learning is one of the reasons why we are the choice for orthodontic care in Markham, Stouffville and Oshawa.

Top Toronto Invisalign Doctor Trains Align Techs in Costa Rica

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If you're reading this blog entry, you have some interest in Invisalign treatment.  One of the key items when selecting an office for your treatment is to understand that your results are not determined by Invisalign, but rather by the office and doctor that plans your treatment.  In other words, results will vary depending on your choice, so price is only one of the factors that should be taken into 
consideration.

Toronto Invisalign Specialist with his Invisalign Team in Costa Rica
Recently, MCO Orthodontics visited the Invisalign Treat Facility in Costa Rica for the 5th time to meet with doctors, team leaders, and technicians to train them on the best protocols for successful Invisalign treatment planning.  With a dedicated team that has worked together on over 1300 Invisalign cases, this is one of the most experienced groups around.  They discussed Invisalign with extractions, Invisalign with deep bites, Invisalign with open bites, and Invisalign with severe crowding or spacing.  With an international speaker for Align Technologies, it is no wonder MCO Orthodontics is the choice for Invisalign in Toronto, Oshawa, Markham, Whitby, and Stouffville.

Toronto Invisalign Doctor Meets Orlando Clear Correct Orthodontist

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Two of the biggest manufacturers of custom aligners are Invisalign and Clear Correct.  Recently, your Markham and Stouffville orthodontist spent some time (through MCO airport) for a family trip after the AAO meeting.
Dr. Tam and family meeting Mickey!
For those of you who know Dr. Tam well, no trip would be complete without some work and learning.  He spent some time with Dr. Jason Battle from Premiere Orthodontics in Orlando.  Dr. Battle is a top Clear Correct aligner provider.  The two exchanged ideas on patient care and customer service.  Dr. Tam looks forward to bringing back some of this knowledge to help improve out braces in Oshawa, and Toronto Invisalign experiences!
Dr. Tam with Dr. Battle

Why Choose Your Oshawa Orthodontist? The MCO Difference

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Many people are looking for the best price for braces in Oshawa or the cheapest Invisalign in Whitby.  The major issue with this is that it assumes that what you are paying for is the same.  The truth is that orthodontics is a treatment and a service, where you will get different results and have a different experience depending on the office you choose.

MCO Orthodontics has produced thousands of beautiful smiles.  We have also provided our patients with an excellent experience along the way.  There are several reasons why MCO Oshawa Orthodontics is the choice for orthodontist for many people in Oshawa.

The MCO Orthodontics Difference-  How to choose the best orthodontist in Oshawa.

Five of the top reasons our patients choose us:

1.  The MCO Retainer Warranty-  A feature to allow for retainers at very affordable price compared to other offices.  This helps our patients maintain their lifelong MCO smile.

2.  The MCO Smile Promise-  If for any reason, your teeth have shifted, including not wearing your retainer, we will happily help you redo your treatment without a contract.  Simply pay a low monthly fee until you are satisfied with your teeth again!  This way you can always get back to your MCO smile without the high cost of full braces fees.

3.  Direct Billing of Orthodontic Insurance-  Very few orthodontic offices in Canada take your insurance because it is a lot of work and there is no way to electronically bill.  MCO has developed a system to allow for direct billing to save you the hassle of monthly paper work and to save your out-of-pocket costs in your orthodontic investment.

4.  We treat our patients like VIPs-  Many of our patients come from great distances including patients looking for an orthodontist in Peterborough, London, Keswick, and Port Perry.  They enjoy our care packages, treats at each visit, and exceptional service.

5.  Award-winning doctors-  Our doctors are consistently rated 5 stars on Google when searching for Orthodontist in Oshawa, Markham, and Stouffville.  Our team has published treatments for Invisalign and taught other offices and doctors internationally.

Please get in touch with us to schedule your consultation today!

Stouffville Orthodontist at Stouffville Strawberry Festival!

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MCO Stouffville Orthodontics, your Stouffville braces and Uxbridge Invisalign specialists, was happy to participate in the Stouffville Strawberry Festival again this year.  Every year, our team supports the festival and enjoys spending the day with our booth.  This year, our team had a photo booth where guests could take pictures with fun props for a chance to win an iPAD mini.  Congratulations to our winners of our contest!

Stouffville Orthodontist Contest Winners!

Daily Change with Braces Video - Before and After Markham Orthodontist

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Recently, one of our Markham braces patients completed treatment and told us he was working on a video of his treatment.  We had no idea what to expect from him.  He sent us this video yesterday of his treatment having taken a photo every single day of his braces with us!  What an awesome video!  

If you're interested in seeing what we can do for your smile, contact us for your free no-obligation consultation including x-rays and photos!

*NOTE* The treatment is long because we combined two stages of treatment and had to wait for some permanent teeth to come in.   Most treatments 2 years or less.  Enjoy!


Toronto Invisalign : Top 5 questions to ask before choosing a provider

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While the popularity of Invisalign in Toronto has increased, there are still a lot of misconceptions about this clear orthodontics technique.  It is viewed as a commodity where you are purchasing Invisalign from Align Technology via a doctor, instead of looking at it as a technique where it is being used as a tool by the doctor.  The issue is that the experience and skill of the doctor and their team will play a large role in the success of your treatment, which is why the cost of Invisalign can be so variable amongst doctors.

The choice for your Toronto Invisalign Provider is not so clear!

Here are the top 5 questions you should be asking your Invisalign doctor before deciding on your treatment.

1.  Are you an orthodontist or a dentist who is certified with Invisalign?
2.  How many Invisalign treatments have you completed and can you show me some examples?
3.  How many treatments like mine have you completed?
4.  Do you have a dedicated Invisalign technician working with you?
5.  How often is Invisalign treatment in your office unsuccessful, requiring you to use metal braces?

Our next several entries will discuss why these questions are so important before you choose your Invisalign doctor.


Oshawa Braces Orthodontist - Choosing an Invisalign Provider Part 2

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In our last entry, we introduced the 5 questions to consider when choosing an Invisalign provider.  The first question was "Are you an orthodontist or a dentist who is certified with Invisalign?".

Dentist or Orthodontist For Invisalign in Oshawa?
This is a great question to ask because Toronto Invisalign certification is granted to both Oshawa dentists and Oshawa orthodontists.  Invisalign certification is granted to any dentist or orthodontist that has taken their weekend course.  This course is more about how to submit treatment to the company rather than how to move the teeth.

A dentist would be akin to your family doctor while an orthodontist is a specialist trained in moving teeth.  Orthodontists have to become dentists and then study and treatment orthodontic patients only for an additional 2-3 years.  Moving teeth is all orthodontists do all day.  Therefore, orthodontists will generally have more knowledge about moving teeth.

However, this is not always the case, which makes things more confusing for the average person looking for an Invisalign doctor.  Orthodontists usually train to move teeth with braces.  They become experts at it because that is all they do.  The acceptance of Invisalign has been slow by orthodontists and many of them are now starting to work with the appliance.  1% of the doctors as designated by Align technology have worked with more than 800 Invisalign patients in their lifetime.  Now this does not speak to the quality of the work provided, but you can see how being an orthodontist alone does not mean they have experience with Invisalign.

When all things are equal, choose an orthodontist instead of a general dentist for your Invisalign treatment, but be aware that not all orthodontists are experts at moving teeth with Invisalign!  Stay tuned for Part 3 on how to choose the best Invisalign provider for your treatment.


Invisalign Recommends Aligner Changes Every 7 Days - Comments by Your Toronto Invisalign Specialist

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Recently, Align Technology sent a memo to all providing doctors that aligners can be changed every 7 days.   The previous recommendation was that aligners be changed every 2 weeks.

Many offices have been changing aligners for patients on a faster cycle using appliances such as AcceleDent and Propel VPro5, or for teens and midcourse correction or refinement aligners.  Other doctors have been asking patients to change aligners every 7 days by reducing the amount of movement per aligner.  In other words, the total treatment time remains the same, but there are double the aligners.

Our Toronto Invisalign treatments have been selected 3 times for publication by Align Technology and our team has taught doctors internationally how to use Invisalign.  There are definitely indications for faster cycle changes, but just like any braces treatment, the rate of tooth movement will depend on a number of factors including patient compliance, density of the bone, individual physiology, and the level of difficulty of the movement requested.

It is currently our position that due to the level of difficulty of many of the movements that our doctors perform, changing aligners every 7 days at this stage UNIVERSALLY is not condoned.  Note that this information comes after a "study" of 200 weekly changes.  Our patients have noticed that aligners may fit during the next few sets, but tracking of aligners will generally fall off later in treatment.  Of course, the shorter the treatment, the less likely treatment will go off track.

At the end of the day, there are many variables contributing to the decision on a cycle change schedule.  We have patients that change aligners on 3 week, 2 week, 10 day, 1 week, 5 day, and 3 day cycles.  Only your doctor who is familiar with the goals of the treatment and experienced with Invisalign will be able to determine exactly what the best aligner cycle is for you.

Read more about their release here:

 
 
Invisalign Weekly Aligner Changes
 
A lot can happen in 7 days.
 
Shorten treatment time with weekly aligner changes.
 
Now it is possible to give patients the new smiles they want—sooner. As of today Align Technology recommends weekly aligner changes* to shorten treatment times without compromising outcomes.
 
2 weeks to 1 week
 
2 weeks to 1 week diagram
 
Weekly aligner changes, prescribed at the doctor’s discretion, simply involve instructing the patient to change aligners every week rather than every two weeks. No staging or velocity modifications in treatment planning are required. Analysis of progress data from 200 weekly wear cases shows that there is no difference in predictability or refinement rates with weekly wear cases compared to cases with two-week wear.
 
Weekly aligner changes may reduce treatment time up to 50%, compared to two-week changes. Consider using weekly aligner changes for your patients.
 
*Weekly aligner changes are recommended for all Invisalign treatments (with default staging protocol) for Invisalign Full, Invisalign Teen and Invisalign Assist products [The decision to prescribe weekly aligner changes is at the doctor’s discretion. Monitor tooth movements such as rotations, extrusions, and significant root movements; particularly blue and black movements in the Tooth Movement Assessment (TMA). Depending on the patient response to treatment, particularly mature adults, consider longer periods between aligner changes.

Oshawa Orthodontist Selected for Expert Panel

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There are many choices for orthodontist in Oshawa for braces and Invisalign.  Recently, your Invisalign specialist at MCO Orthodontics was selected to be on an expert panel, fielding questions from orthodontists across North America.  The expert panel, called the "Shark Tank" was a part of the MKS Forum 2016 in Dallas, Texas.  Those looking for braces in Whitby and Invisalign in Oshawa have an option to see the award winning and expert team.


Whitby braces dentist
2nd Annual MKS Orthodontic Forum
Invisalign Oshawa
MCO Oshawa Orthodontist on Expert Panel


Choosing an Oshawa Invisalign Provider Part 3: Show me your work!

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In Part 2 of this series on how to choose the best Invisalign Provider in Toronto for yourself, we looked at the difference between an orthodontist and a dentist.  In Part 3, we will look at figuring out if a doctor has experience with orthodontic treatment with Invisalign.

One of the best ways to figure out if someone has experience with Invisalign is look at a portfolio of their completed treatments.  Now there are privacy issues surrounding sharing all work from every patient, but doctors who have worked with enough happy patients will generally have a large selection of various treatments to show you.  This could be in print, on a website, or in a video.  Beware also that many doctors take treatments from stock photos or from other sites to show as examples.  They are technically not doing anything wrong because they are not saying it is their work, so a clarification asking about this might be in order.

When looking at these Invisalign treatments, see if there is a variety of different types of correction required.  Many cases involving crowding and spacing are simple, but treatments involving correction of Class 2, Class 3, open bites, deep bites, crossbites, and extractions will generally show a greater experience level with the Invisalign appliance.  In other words, showing a greater range of treatments with higher complexity is generally a good way to determine how skilled your doctor is.

For those of you who still think Invisalign is only for simple treatments, here's are two great videos to show you what can be done with Invisalign with an experienced team and cooperative patient.

Oshawa Invisalign Before and After Video


Toronto Invisalign Before and After Video


Oshawa Invisalign Orthodontist Recognized by Align Technology

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If you've been following our blog, you understand that Invisalign is a technique, not a product.  It is like a guitar and a guitarist.  Just having a great guitar doesn't mean the result will be beautiful music.  I takes a skilled guitarist to use that guitar to make the music.

Whitby Orthodontist for Invisalign
MCO Oshawa Orthodontics Invisalign Treatment Selected For Publication


For the 3rd consecutive time, MCO Oshawa Orthodontics, your Whitby Invisalign specialist has had their work published by Align Technology, highlighting the top Invisalign treatments through the past 2 years.  This is an impressive track record, but no surprise as one of best Toronto Invisalign doctors based upon a case volume of experience, with well over 1000 treatments.  Our team teaches Invisalign internationally so that doctors can learn how to use the appliance properly.

Invisiline Toronto over 1000 cases
MCO Orthodontics recognized in Las Vegas for over 1000 treatments.
Congratulations to the team at MCO Orthodontics on another wonderful treatment and being recognized for their Invisalign care!

Oshawa Invisalign Orthodontist- How to Choose a Doctor Part 4 of 5

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In Part 4 of How to Choose an Invisalign Provider in Toronto, we suggest you ask your provider if they have a dedicated Invisalign technician working with them.  At this time, despite the advanced computer algorithms, orthodontic treatment planning using Invisalign still requires excellent communication from the doctor to the technician in Costa Rica, with that technician needing a keen understanding of what the doctor is looking for in planning the movements for the teeth.

The other reason to ask about this is because only those doctors who have performed a certain number of treatments are granted dedicated technicians by Invisalign.  Working together with the same person over the course of hundreds and thousands of treatments is going to obviously produce better simulations.  Of course, the volume of treatments certainly does not speak to the quality of the care provided, but it does give a good indicator that your doctor has at least a base volume of experience.

Oshawa Invisiline
This is where Toronto Invisalign plans get developed...  lack of personal detail and attention for most treatments.
MCO Orthodontics has created well over 1000+ beautiful smiles using Invisalign and Invisalign Teen.  When our technician changes or is away, we can very much see the difference in the simulation produced.  Of course, with our doctor’s direction, we are still able to help achieve the smile we are looking for our patients.  Our team has been to Costa Rica to meet with our technicians many times and speaks with them regularly to make sure everyone is on the same page.

Our MCO Invisalign team is in regular communication with technicians, doctors, and team leads.

Stay tuned for Part 5, asking how often Invisalign treatment is not successful and requires braces.

Choosing your Invisalign Dentist or Orthodontist in Toronto- Part 5 Do You Need Metal Braces?

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In Part 5 of Choosing the Best Oshawa Invisalign Orthodontist, we look at suggesting potential patients ask how often metal braces are required to finish Invisalign treatment.  There are a few reasons for this.

Many Invisalign providers do not actually do braces.  They have taken an Invisalign certification course for a weekend and may not be orthodontists.  General dentists provide braces as well but not nearly as many as provide Invisalign.  This will give you a decent indication of how experienced the doctor is with orthodontics.  Having an understanding of braces is an advantage for the doctor when planning Invisalign treatment and being able to help you achieve your smile if the Invisalign treatment does not run on track, or if you feel you are struggling with wearing the aligners.

One of the biggest factors here is that there are still some movements that will work better with braces than Invisalign, although not many.  It is important that the doctor have this as a part of their “arsenal” to help you achieve the exact results you are looking for.  Common issues that might require braces might be severely tipped molars or extreme rotations that might move faster with braces.  In these situations, the treatment should still be completed 90% with Invisalign and about 10% with braces.  Be cautious if there is a doctor who is regularly finishing treatments with braces after Invisalign.

Metal braces or Invisalign
Almost everyone can get Invisalign in Whitby.  Some might require 10% of the  work done with braces.
Knowing that your doctor has experience with metal braces is certainly a good thing, although it does not always translate into an ability to perform treatments with Invisalign.  When all else is equal, an orthodontist is going to likely have a greater understanding of how to move teeth, and what the final results should look like from the perspective of health and aesthetics.

Hopefully this 5 part series has been helpful in helping you ask the right questions before you choose your Invisalign provider.  Remember that Invisalign is a technique, not a product.  Price should only be a small factor because the results will be different depending on the doctor you choose.  For more information, please visit the most comprehensive Invisalign site around for Toronto Invisalign.  Good luck with your treatment and we’d be happy to hear about how it goes!
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