Invisalign and teen compliance

[Cecropia]

We have a week to decide whether to get conventional braces for ds14 or Invisalign.  The price is the same for both (expensive!!!).  He is pushing hard for Invisalign (I think mainly for social embarrassment/aesthetic reasons).

The problem is that this child has a history of not being honest with us about doing things he is responsible for taking care of.  We just discovered another one this winter that had been going on for a number of months until it was discovered, and it was deliberately done.  It was school related, and we are still catching up to where we should be!  We know this is not unusual for adolescents, but it makes us lose trust in him to do things unsupervised.  I am worried about his compliance with braces in any form, but there seems to be a lot more involved with Invisalign, and it will really be impossible for me to constantly check on his wearing, cleaning, brushing, and flossing for 18-24 months.  He also suffers somewhat from absent-mindedness, though that has been getting better.  I wish we could push this off until he is older, but the ortho says it has to be done now.

He definitely has the ability to comply as he should, but motivation is such a huge factor.  He is promising over and over to do everything involved with Invisalign.  He has a positive expectation of what living with it will be like.  If he finds the treatment to be uncomfortable, too much work, eating restrictions too inconvenient... something negative that shatters his expectations, his motivation will probably disappear.  Likewise, he would be upset about getting conventional braces, leading to compliance issues either for lack of motivation or a backlash against us for "punishing him."  I know that braces look like a very long-lasting, over-the-top punishment to him for being dishonest in the past.  To me, it's the option more likely to keep a major investment from being wasted.  Honestly, I wonder how many 14-year-olds can really keep up with all that Invisalign demands.

I welcome any advice, or testimonials about the work involved with Invisalign that I could read to him, or commiseration re: teens and dental treatments...

[Lecka]

How often will he go to the dentist?  When I had braces I went fairly often and if I hadn’t done a good job the dentist would talk to me and I would take it to heart.

I think if he might be motivated that way then the accountability with the dentist might go a long way?  

 

[Night Elf]

My first thought is to write out a contract that has clear details of expectations and consequences. I'd have all of you sign in and post it where it can be seen so there's a constant reminder of compliance or consequences. Braces are too expensive to not follow the directions. If he doesn't wear them, his teeth won't improve and your money will go to waste. I have no idea what I'd say in the contract or what consequences may be. Maybe someone else has an idea if they think the contract idea is a good one. Two of my children had Damon braces in their late teens. My youngest wasn't happy at all and cried but she got over it thank goodness. 

[edelweiss]

My older daughter had Invisalign when she was 13.  She did very well with it.  She never had any problems with it at all.

My younger daughter wanted Invisalign, but she ended up with regular braces because her orthodontist said that in her specific case, he could not guarantee that Invisalign would be able to do all of the fine-tuning she needed done to have perfect teeth.  He said that there was a chance that she would have to wear regular braces for 3-4 months once she had completed Invisalign.  Plus, even if that did not end up happening, Invisalign was going to take 6-8 months longer than the traditional braces.  So, she opted to do traditional braces with clear brackets on the front.  She ended up wearing them for even less time than predicted because the orthodontist was convinced that she would be extremely compliant when wearing her retainer (which she is).

I do know that in both of my children's cases, the orthodontist made it very clear that he would only consider Invisalign for those patients who he was certain would be compliant.  He said that he only offers it to a small portion of his younger patients.  

I can see your dilemma.  He might be more compliant because he is getting what he wants, and he might want to show you that he can handle it.  But if he doesn't take responsibility and do it, it will be a very expensive mistake.  I do not have boys and my daughters are super-compliant, so I am not sure what to advise. 

 

[catz]

I’d just go with traditional braces.   They can do finer tuning with those anyway.   Our ortho strongly encourages traditional for minors.   You might even consider waiting a little bit.  My son got traditional braces at 16.   It has been no big deal and his hygiene is better now than it was.  My son had a freind who had Invisalign at 15 and he kept los8ng and forgetting his trays and the fix hasn’t been that good.  Some boys this age are still working on executive function.   That’s not a character issue, it’s just an immature brain issue.  Make it easier.  

[gingersmom]

I would consider waiting till he is older. 

I regret getting my daughter braces when she was 13/14. She was non-compliant, things took longer because of this. Then she rarely wore her retainer and her botton teeth shifted. I paid in full, no dental insurance. I admit to getting annoyed all over again everytime I notice her teeth and have been known to remind her how much money I wasted.

My son on the other hand did everything he should, wore his retainer and years later still has perfectly straight teeth.

[Katy]

It sounds like you've already decided he needs traditional braces, you just need some parental backup to tell him no because he has such a strong opinion about this. Consider yourself backed up.

If that's not true and you've actually neutral, then call the orthodontist and explain your hesitation.  If the ortho agrees with you that compliance is the most important thing, then the ortho can certainly decide that he is a better fit for traditional braces after all.  Then it's on the ortho, not you.

An alternative is (and this is only if the kid has enough in savings to cover this) if he's not compliant ONE time (that's his fault, not an unavoidable circumstance) then he'll be forced to switch from invisalign to traditional braces, and he would pay the difference in the price, thereby delaying buying a car or whatever it is that he's saving for. Obviously this wouldn't work with every orthodontist, it probably depends on how they lay out their fee schedule. If you'd have to pay the full amount again I would start with traditional braces no matter what.  Does the dentist have ceramic options?  Those are less visible while still giving good results.

[Jean in Newcastle]

My teens have chosen not to have braces. But they were not absolutely medically necessary.  So it was their choice because it is their teeth and it does require compliance - esp. in the case of my Aspie. 

[Terabith]

My daughter is very compliant, but I wouldn't have been comfortable with Invisalign, even with her being very compliant.  Too easy for absent mindedness to become a huge factor.  Too hard for me to check up on it.  Too much expense.  They really were medically necessary for her.  I'd go with traditional braces.

[SKL]

Given the expensive price and the fact that he is requesting this, you could set some milestones of accountability with real consequences.  If a dentist appointment indicates he isn't complying enough, then he loses something of importance to him for an extended time period.  Something he will notice every day.  Another thought is to babysit his tooth brushing if he fails to do it.  I know 14 is old for that, but if he really wants this then he has to buy into it.

Another idea is to have him start saving his own $$ toward braces in case invisalign doesn't work.  If he complies and the braces are not needed, then he gets the $$ to spend or save as he pleases.

 

[Guest]

My DD had Invisalign and she did comply with everything necessary - and, to be sure, it is not a tiny matter. She was in a B&M school, so she had to remove them for lunch, then brush, floss and reinsert them before lunch was over. She could drink only water while they were in. She soaked them in denture-cleaning water every...night? Weekend? Can’t remember that exactly. And the biggest “compliance” issue is that, after she started college, she wore the final retainer-tray sporadically and her teeth have shifted enough that she can’t put the retainer in anymore. So, really, she should have a new one made and should wear it every night but she hasn’t done so and I’m past caring. Any further correction will be on her dollar, though her teeth look spectacular, so I doubt any correction will be necessary. 

The thing about standard braces, though, is that compliance is still necessary for optimal results. He cannot ignore his dental care simply because the braces are fixed. So I don’t know that average teen hard-headedness would be enough to make me “make” a kid get fixed metal braces while they are pleading for Invisalign. I would just brow-beat him over the priviledge we are giving him by getting clear braces and emphasize that you are placing trust in him to care for them properly, even when it’s not enjoyable (leave the lunch table to go brush and reinsert, etc.) 

One final tip: DD could NOT unhook the tray from the clear tooth catch that holds them on until the hygienist mentioned the back-of-spoon trick - using a spoon wedged in to pop the tray off the catch. I thought we would not be able to use Invisalign afterall, because she was in tears trying to take them off, but the spoon trick saved it. She kept the spoon with her toothcare case everywhere she went. 

[livetoread]

My absent minded daughter had them at age 15, and she ended up doing really well with them. She only lost one set, and her hygiene was good enough. I was surprised, honestly.

I have them too, and they are taking longer than traditional braces would have, but it’s worth it to me. Something to point out to him as you consider all of this is his teeth will probably have attachments permanently adhered, so even when his trays are out, his teeth won’t look normal. With trays in, the attachments attract even more attention. They are still better than wires since they are tooth colored, but not invisible. People vary on how many attachments they need.

Editing to add that they are really painful the first week or so, especially as you are learning how to get the trays out. After the first week or so though, everything was fine. I had traditional braces as a teen and much prefer Invisalign.

[kitten18]

My daughter has had Invisalign for a few weeks. It’s going well for her but she’s very compliant. Her regular dentist recommended them for her because she tends to have sensitive gums and he didn’t want her gums neglected with regular braces. Hers are really just cosmetic, she had her bite fixed years ago with a palate expander and a small set of braces. The first week of Invisalign was rough(pain) but it’s been much better since then.

As far as time, my dd’s treatment is only 32 weeks, shorter than regular braces. She got 32 sets and she is changing them every week. Then she will wear the last one as a retainer. Hers really are completely invisible, I can barely tell when she has them in (even with several attachments). 

[penguin8079]

For what it's worth . . . my mom forced me to get traditional braces over my strenuous objections while I was in high school. I urged her to spend the money on herself as I was not concerned about having crooked teeth and told her I had no intention of wearing a retainer. She proceeded and things went just as I said. Total waste of money. If compliance is a potential issue and there is any possible way to hold off, you might want to wait for more buy-in from him. 

[solascriptura]

Our ortho has a policy that if the child isn't doing well with Invisalign, they will put on traditional braces at no additional cost.  My dd is extremely responsible so I've informed her of the policy and said that I would have them put the traditional ones on at the first piece lost or if I see that she skipped a day.  

[Cecropia]

1 hour ago, penguin8079 said:

For what it's worth . . . my mom forced me to get traditional braces over my strenuous objections while I was in high school. I urged her to spend the money on herself as I was not concerned about having crooked teeth and told her I had no intention of wearing a retainer. She proceeded and things went just as I said. Total waste of money. If compliance is a potential issue and there is any possible way to hold off, you might want to wait for more buy-in from him. 

Yes, I think that is part of the issue.  His teeth are pretty well aligned, and he has no self-consciousness about their appearance when he talks and smiles.  It's his overbite that is supposedly causing significant wear to his tooth enamel -- so this is more of a medical problem than cosmetic, but he doesn't have symptoms/functional problems that prompt him to want to fix it.  I don't know if waiting is really a viable option.  The ortho is saying we should start treatment soon; it's easier to correct in adolescents than adults, etc.

[catz]

58 minutes ago, Cecropia said:

Yes, I think that is part of the issue.  His teeth are pretty well aligned, and he has no self-consciousness about their appearance when he talks and smiles.  It's his overbite that is supposedly causing significant wear to his tooth enamel -- so this is more of a medical problem than cosmetic, but he doesn't have symptoms/functional problems that prompt him to want to fix it.  I don't know if waiting is really a viable option.  The ortho is saying we should start treatment soon; it's easier to correct in adolescents than adults, etc.

You know my kid that started treatment at 16 is also being treated for overbite.  I listened to a couple years of alarmist garbage from our old dentist (I did eventually switch) before making a move on getting braces.  In the meantime, a friend in her 50's got braces for an overbite for the first time.  Believe me, they are more than happy to treat adults and do successfully all the time.  If you want to wait, it is likely you could without major repercussions.  My son's traditional braces are taking 18-20 months starting at 16.  That was the EXACT estimate we got several years earlier.  He is in the home stretch now.  He is awesome with hygiene and is invested in the process now.  

[dirty ethel rackham]

I would do traditional braces.  We did invisalign with one of my kids and she refused to wear the tray because it "hurt."  When it hurts through a tightening of regular braces, you just push through it.  It is too easy to say "I'll put them in tomorrow" and then it still hurts.  It was a huge waste.  

Since the issue is wearing away tooth enamel, waiting really isn't a good option.  With my other dd, we did end up going with clear braces because she was not happy about getting them on her sophomore year in high school.  Despite nearly perfect compliance, her teeth have not moved nearly as fast as expected and she may end up going to college in braces.  She is not happy.  If we had known that her teeth would move so much between 8th grade and sophomore year, we would have put them on earlier.  We thought we had dodged the braces bullet until her teeth were no longer find and her bite was affected.

[Another Lynn]

Definitely traditional.  I am finishing up invisalign treatment myself and I sometimes wish I had gone traditional.  Even wanting the treatment, even being motivated to do it, it is a real pain to keep them in as much as they are needed.  It took much longer to complete the treatment.  (Several of our kids' orthodnonitia treatments have taken longer than originally estimated, but this was much, much longer.)  

[cuckoomamma]

Our dd recently got braces and she's shocked us all with how conscientious she is.  We were really concerned going into it, and she's more than risen to the occasion.  Just wanted to through out a positive experience for you!