Invisalign for the nervous patient

The following is a case of a young 19 year old female who as a needle phobic had avoided dental injections and had even had bit her last dentist on the finger.

She presented with her mom in desperate need of orthodontic treatment.

Naturally she had not accepted dental extractions and fixed orthodontics as a teenager but was now keen to be able to smile.

After careful consideration of her dislike of dentistry I examined her and found her suitable for Invisalign treatment.

smile transition through the procedure
  • The patient was a mild class 2 dental and on a class 1 skeletal base
  • Centrelines were acceptable
  • Oral hygiene needed improving
  • I wanted to reduce the amount of dental procedures for her so I decided:
  • No extractions
  • No interproximal reduction
  • Attachments were delayed for 6 months
  • Upper arch space was created by distalising the molars
  • Lower arch space was created by arch expansion
  • There were 35 upper and 17 lower aligners
itero impression of crowding teeth

I saw the patient every 6-8 weeks with no problems or tantrums.

At the end of the treatment of 18 months I was so happy that we agreed to remove the attachments and then take impressions for retainers.

Unfortunately the dental phobic had spent the last year on Google and had become obsessed with her teeth. She wanted them even straighter and had asked for a second opinion.


So I was surprised by her change of heart as I had thought that she would be happy just having them straighter. But I was wrong as she wanted the straightest.

I agreed to do Invisalign Lite (14 aligners) and she agreed to pay for new retainers.

The upside was that she did refer her mother for Invisalign as well.

The refinements were 7 aligners in total and again no IPR.
She then did not attend for over 15 months and decided to treat herself with the aligners.

After 45 minutes of deliberation and mediation with her mother she agreed to retainers and only after I had contoured the incisal edges of at least 8 anterior teeth.

smile transition through the procedure

Invisalign when used to its full potential allows the dentist and patient to benefit from full space creation and minimal stripping or tooth extractions.

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