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Orthodontics' New Teen Spirit


by Joanna N. Farber

Orthodontists learn early on that they are usually going to have two clients per case: the patient and the patient's parent. They also learn quickly that these two clients are often going to have quite different treatment priorities. Teen patients, for example, are concerned with appearance and comfort; their parents are concerned with efficacy, compliance, and cost.

Orthodontists also have their own list of key concerns; treatment success is the highest priority, of course, and that success is affected by a unique set of challenges. "Treating today's teens is a very different challenge than it once was," says orthodontist Dr. Mark Lowe, of Fresno, California. "Years ago, we only had one treatment option: wires and brackets. While very reliable, they have inherent drawbacks – comfort (or lack thereof ), appearance and impaired hygiene."

Lowe was an early adopter of Invisalign aligners after they were introduced in 1997. Over the years, he has successfully treated several of his teenage patients with Invisalign Full and has been pleased with the results. So when he heard that Invisalign was introducing a product specifically for teens, he was very interested.



"Treating today's teens
is a very different challenge than it
once was."
  — Dr. Mark Lowe
Orthodontist
Fresno, California
"I was excited about Invisalign Teen because of its new features," says Lowe. "Compliance indicators, eruption tabs, and Power Ridges for lingual root control deal specifically with the challenges of treating teens." Lowe says another big plus for Invisalign Teen is that it offers free replacement aligners – which appeals to parents who are worried about their children's tendency to misplace things. On the other hand, it should be noted that of the cases Lowe now has in treatment, not a single patient has lost an aligner.

This points out another important factor for success with Invisalign Teen – patient compliance. "Overall, my patients are very enthusiastic about this product," says Lowe. "It works for them, their friends can't see it, and it is relatively pain free. Therefore, they do their part and wear the aligners as many hours a day as they possibly can. They also take good care of them, meaning that they aren't misplacing or losing them. Still, their parents appreciate the fact that if an aligner is lost, it's easy to replace quickly by simply calling my office. It's one less thing they have to worry about."

Lowe's priorities for teen treatment are mirrored by others in his field. Orthodontists participating in a 2007 nationwide survey commissioned by Align Technology identified challenges common in teen treatment that held them back from using Invisalign on more of their younger patients – namely, patient compliance and the ongoing development of permanent dentition. Invisalign Teen was specifically designed with the non-adult comprehensive market in mind, and it addresses the special needs of patients who have shed all of their primary teeth and whose second molars have begun erupting.

"During the initial product launch (in early 2008), we were one of the pilot offices asked to use Invisalign Teen," says Lowe. "We had six cases at that time. Since then, we have added 14. Though none of the initial six cases are completely done yet, everything is going really well. And of the 20, we are very pleased with the way things are progressing."
Orthodontists learn early on that they are usually going to have two clients per case: the patient and the patient's parent. They also learn quickly that these two clients are often going to have quite different treatment priorities. Teen patients, for example, are concerned with appearance and comfort; their parents are concerned with efficacy, compliance, and cost.

Orthodontists also have their own list of key concerns; treatment success is the highest priority, of course, and that success is affected by a unique set of challenges. "Treating today's teens is a very different challenge than it once was," says orthodontist Dr. Mark Lowe, of Fresno, California. "Years ago, we only had one treatment option: wires and brackets. While very reliable, they have inherent drawbacks – comfort (or lack thereof ), appearance and impaired hygiene."

Lowe was an early adopter of Invisalign aligners after they were introduced in 1997. Over the years, he has successfully treated several of his teenage patients with Invisalign Full and has been pleased with the results. So when he heard that Invisalign was introducing a product specifically for teens, he was very interested.

Invisalign Teen: This Teen's First Choice
One particular patient, 15-year-old Carolyn Rinehart, visited Lowe for a consultation to discuss treatment options. With a diagnosis of Class I malocclusion with mild crowding and narrow arches with good periodontal health, Lowe could have put Carolyn in either traditional braces or Invisalign. But Carolyn was enthusiastic about Invisalign, and Lowe thought, clinically, her's would be an excellent case for Invisalign Teen.


"I had seen Invisalign advertised. When I went in for my consultation with Dr. Lowe, I told him that I wanted Invisalign. I was sure I wanted it because I hate the look of braces – braces are the last thing I want at my age!"

– Carolyn Rinehart
15-year-old patient
with Class I malocclusion

Carolyn's treatment plan included non-extraction treatment with expansion using Invisalign Teen to resolve the crowding and broaden her smile. Her chief concern was a narrow smile.

"I had seen Invisalign advertised," says Carolyn. "I had always wondered what it was, so I looked into it. When I went in for my consultation with Dr. Lowe, I told him that I wanted Invisalign. I was sure I wanted it because I hate the look of braces – braces are the last thing I want at my age!" says Carolyn.

After Lowe explained the difference between Invisalign and Invisalign Teen to Carolyn, she was even more enthusiastic.

"I told my mom that I didn't want braces and that I only wanted Invisalign Teen," says Carolyn. She pushed for the product, and her mother, Sheri Rinehart, got on board with it once Lowe assured her that it would be an effective treatment.

"When we went into Dr. Lowe's office, the doctor and the treatment coordinator explained the process to us in great detail and answered all of our questions," says Sheri. "It sounded simple, and it seemed to be a perfect match for my daughter and her lifestyle. Carolyn has a lot of friends with perfectly straight teeth, so she was motivated to get her own teeth into picture-perfect condition. Therefore, it was an easy decision."

"Beyond the fact that the doctor told us it would work, what appealed to us most about Invisalign Teen is how it is undetectable; you really can't tell that she has it on," says Sheri. "Teenagers are constantly taking pictures and going to events. It's great that now Carolyn will be able to have photographs to treasure for the rest of her life, without braces showing.

Even though the product sounded very appealing, there was one final issue: its cost. Cost is a key concern for all parents – more so for some than others. Sheri was a case in point. "I'm a single mom, so I wasn't sure I could afford Invisalign Teen or any other orthodontic treatment for that matter," she says. "But once I found out that my dental insurance would cover half of the cost, that helped with the decision." Chances are, if a customer's dental insurance covers orthodontic treatment, it will cover Invisalign Teen at the same rate.

"Something old, something new…"
"There are many teens for whom traditional metal braces are the best choice," says Lowe. "There are other teens out there who actually want braces. Sometimes it can be a status thing among their peers, or they want the colors. Other teens are cosmetically conscious, though, and don't want people to know they are in treatment. Regardless of what they choose, it's nice that I can give many of them a choice. Invisalign Teen is obviously an attractive alternative for treating the kids who don't want metal braces. There are a certain number of kids who, no matter what their smile or teeth look like, are going to refuse to have braces. Invisalign Teen is a great way to help resolve that problem," says Lowe.

"There is one thing I've noticed when older children go through treatment with conventional fixed appliances," says Lowe. "Even when they have a nice result, they're often disappointed when the braces are removed and they see the decalcifications on their teeth. With Invisalign Teen, we can be assured they are much less likely to have that issue," says Lowe.

Unique Features
Compliance indicators are an appealing feature for parents who are considering Invisalign Teen treatment for their children. The indicators, located on the back of every aligner, fade from blue to clear over a two-week time period to gauge approximate patient wear. "If parents are worried about their children not following through with the treatment, the compliance indicators can help reassure them that they can monitor their child's wear to help them achieve the desired result," says Lowe.

Lowe reports that the eruption tabs have also worked out really well. "Because of these, we are able to start treatment a little earlier than we normally would because we don't need to wait for full eruption of the second molars or second bicuspids," he says. "Of the 20 cases we have started, only one patient had a tough time with tissue irritation. This happened with the first tray, so we just trimmed it. By her second aligner, she was fine," says Lowe.

The Power Ridges address lingual root torque and are automatically placed on the aligner when lingual root torque is detected. They provide additional reinforcement that helps deliver proper moment-to-force ratio without attachments.

"This technology is probably the only one I don't have a full judgment on yet because I haven't fully evaluated the cases," says Lowe. "However, it is a great concept that could probably also be applied to Invisalign Full. In Carolyn's case, only one of her teeth is rotated greater than 30 degrees, and even that tooth is moving as prescribed."

"Oftentimes, with fixed appliances, we find that patients will often miss their appointments," says Lowe. "The teen will ‘forget' to go to a checkup because he or she is not that excited about their treatment, and would rather not see their orthodontist at all. But missed appointments just add to the length of their treatment time. With Invisalign Teen, we've found missed appointments almost never happen."


"I am very happy
with Invisalign Teen.
Dr. Lowe is a great doctor, and we are seeing great results."

– Sherri Rinehart
patient's mother
Clearly Enthusiastic
Carolyn might be even more enthusiastic than Dr. Lowe is. "Invisalign Teen has been a great experience for me," she says. "I'm on my 14th tray, which is about halfway through treatment. So far, the time is flying by; I feel like I have only had them for like a month. For the most part I have had no problems, and love them! They are really easy to use, and no one even notices them. You are able to take them out for pictures or anything else that you wish you didn't have appliances in your mouth for. I think that they are a great product for teens my age."

"If a teenager asked me, I would recommend Invisalign Teen," Carolyn says. "But to make it work, there are a few things that you have to do. For starters, you need to be very responsible and you can't lose things easily. You also need to be disciplined to always wear the aligners; otherwise the treatment won't work. If your doctor says you are a candidate, then I would definitely say, ‘Do it!'"

Mom Sheri is in agreement. "I am very happy with Invisalign Teen," she says. "Dr. Lowe is a great doctor, and we are seeing great results. It was a very good choice for us. Carolyn is motivated to have the product work for her, and she knows that if she keeps them in, the process will get done quicker and we'll be successful."

Lowe mirrors his clients' enthusiasm. "Teens are now starting to ask for this product by name," he says. "They see the advertising, and they (and their parents) are getting a lot of the information about it on the Internet. So it's not like I really have to ‘sell' Invisalign Teen. I'm very happy to provide it for my patients. We think it's going to be an outstanding product for our practice. The more I work with Invisalign Teen, the more confident I feel about using it. So confident, in fact, that I'm adding three or four cases this week alone!"
Author's Bio

Joanna N. Farber has been in the publishing field since graduating with a B.A. in journalism and public relations more than 10 years ago. She has held editor positions for dental/orthodontic newspapers, and has also worked as a freelance writer. Currently, she freelance writes for Align Technology. Joanna lives in New Jersey with her husband, Golan, and their son, David.
Orthotown Magazine
September 2025
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