Invisalign

Every single day, I get asked if teeth whitening is safe for children. As an orthodontic specialist, I focus on healthy bites, esthetic alignment, and functional joints, but this is one of the most common questions on the minds of the moms in my office. Why? Because after the ubiquitous question “when will my braces be finished?” my teenage patients want to know how to get their newly aligned teeth white and sparkling. The answer to this question isn’t as simple as you might think. Here are a few important things to consider when your child asks to whiten their teeth:

• Types of treatments: Whitening treatments are divided into two main categories: at-home therapies and in-office. At-home therapies include over-the-counter products like toothpaste and white strips. They also include professional strength products offered by your dentist or orthodontist that you use at home, like custom trays or light-activated therapies, like Glo. In-office procedures use professional strength bleach and are closely monitored by the doctor. 
• Risks: The foremost risk with whitening procedures is the development of tooth sensitivity. This can be short-term or long-term. It’s best for a dental professional to evaluate your child to determine their specific risk. Risk factors for sensitivity include recession, wear of the teeth, and general tolerance to temperature changes. Other risks of whitening include changes to the gum tissue color or sloughing of the tissue. 
• Age of your child: Children under the age of 13 should not whiten their teeth. There are intrinsic risks to whitening, and the benefits do not outweigh the risk for kids this age. Children ages 13-14 can use over-the-counter whitening strips and whitening toothpaste. Children ages 15-18 are old enough to do more intensive whitening treatments like custom trays and at-home system. Although in-office whitening procedures are easy, quick, and can produce amazing results, I do not recommend them for those under the age of 18.
• Gum tissue issues: During orthodontic treatment, it is not uncommon for the gum tissue to become puffy. This is usually a result of poor oral hygiene and/or mouth breathing. Once the braces come off, puffy tissue tends to resolve relatively quickly. It is important to note that whitening treatments should be postponed until the gum tissue is back to normal. Puffy or overgrown tissue can block whitening to parts of the enamel, resulting in a poor whitening result. 
• White stains: Decalcification of the enamel can occur when plaque, which mostly consists of bacteria and their acidic byproducts, sits on the enamel for extended periods of time. (Think: my child hasn’t brushed their teeth in 24 hours.) These white stains are permanent damage to the enamel, may lead to decay, and are not reversible. If your child has developed these stains, it is best not to whiten their teeth with any products until a dental professional has evaluated them. White stains may require more aggressive treatments, like fillings, bondings, or veneers. 

Whitening treatments can be a valuable addition to the esthetic result of orthodontics. I like to think of it as the icing on the cake and I provide lots of options in my office to my patients. The majority of treatments are safe and easy, and can be used by teenagers! Check with your orthodontist or dentist for the best treatment option for your child!

Over the years, braces have become a middle and high school Rite of Passage. After which, the ugly duckling teenager has a “glow-up”- the braces and glasses are shed, contacts go in, and the sparkling straight teeth are revealed. Not to mention the invention of hair straighteners and concealer make-up! It’s the ultimate coming of age transformation!
Recently, however, some pre-teens and teenagers are asking to skip the traditional metal braces, and minimize the dramatic makeover experience. More and more, I see kids asking for Invisalign®, which has traditionally been marketed to adults as the easier, more esthetic alternative to traditional orthodontic braces.
Before you and your teen decide which orthodontic treatment is the right one, take the time to ask these 5 important questions:

1. Does my orthodontist recommend Invisalign® for my child?
   Not all orthodontic problems are suited to Invisalign® treatment. Growth issues of the jaws, extreme crowding or spacing, and other severe problems are typically treated best with traditional braces. Your orthodontist will be able to guide you to what modality is best.
2. Does your teen want to minimize the look of braces?
   If your teenager wants people to know they have braces, or use colors to decorate the braces, Invisalign® is not for them. Some kids love the idea of flashing their silvery grin, with colors to match their mood. Invisalign® is clear and does not show.
3. What is your teen’s responsibility level? Invisalign® works by slow and steady pressure of the clear trays on the teeth. In order for them to work in the prescribed amount of time, the trays must be worn 22-24 hours per day! Removal of the trays are allowed only for eating and brushing. If your teen easily keeps up with their books and phone, and doesn’t have a habit of leaving things behind or losing things, they will likely be able to manage Invisalign® treatment, which takes a great deal of personal commitment.

4. Does my teenager have good oral hygiene?
   One of the major advantages of Invisalign® is the ability to take out the trays in order to brush and floss. Kids who struggle with brushing properly, as well as those with weaker enamel and those who are more cavity prone, may benefit from have a removable appliance versus fixed (glued-on) braces.
5. What about wearing Invisalign® while playing sports?
   Teens who play sports can use Invisalign® since it will act as a type of mouth guard. However, for contact sports like football, that require a special heavy-duty mouthguard, Invisalign® may not be the ideal treatment, since the trays would have to be left out during practice and games, which would prevent efficient movement and lengthen treatment times.