Which is better, Invisalign or traditional braces?

I get this question a lot. Invisalign and braces are just tools that your orthodontist uses, each applies force to teeth. The difference is the orthodontist providing the treatment. Most every orthodontist is very comfortable using braces. It's what we have been using since the first day of residency. Invisalign experience, however, can vary greatly from one doctor to the next as there is a huge learning curve is using this appliance. Some doctors may say you aren't a "candidate" for Invisalign, and in their hands that may be the case so it's a true and honest answer. Another doctor may say you're perfect for Invisalign due to their experience using the appliance so you can get two opposite, yet truthful answers. 99% of the time, I can get the same result whether using braces or Invisalign because I treat hundreds of people with Invisalign every year. Think of Invisalign like learning to play a guitar. You have beginners, and you have Eddie Van Halen. Another analogy I use is Invisalign treatment isn't like buying a Suburban from a Chevy dealership where you can find the same exact car anywhere, and the only difference is price. Invisalign treatment pricing is going to vary vastly as well as the results Researching doctor experience is critical to getting an end result that you want especially in the more difficult treatments where bite alignment is needed or there is lots of crowding.

I've heard of people having issues with Invisalign after treatment is over and developing TMJ symptoms or messing with their bite.

That hasn't been my experience using Invisalign. I'd make sure that those people weren't using a certain aligner company that you see on TV and social media all the time where they never see a doctor in person. The term "Invisalign" is many times used interchangeably for any clear aligner like Kleenex is for tissue. I have heard of these problems occurring many times and have already seen three of those patients show up in my office with bite problems. I've found the opposite in the patients I've treated with Invisalign. Many times it acts like a "poor man's nightguard" because the plastic covers your teeth giving nightguard-like effects during treatment. Again, realize your doctor is the one designing your treatment. Invisalign only manufactures the plastic aligners we use as our tool.

I also have a friend who had Invisalign and wears her retainer every night, but her teeth still seem to shift. I just want a SUPER PERMANENT solution.

Teeth naturally want to shift throughout your life whether you use braces or Invisalign. Orthodontists used to think that after removing your wisdom teeth and wearing your retainer a certain number of years that "stability" was achieved. We now know that isn't true. Wisdom teeth aren't the devil as we once thought. Forces on your teeth cause teeth to shift such as: clenching, grinding, jaw growth, or a poor bite. Getting straight teeth is only part of the answer. If you don't have a stable bite to go with it, your alignment will start to tank. It's hard to know exactly what your friend's situation is, but night time wear works for 99% of my patients. The only super permanent solution is either permanent retainers or retainers at night for life.

YES!!!! That is what a brow lift does. As we age, two things happen in the upper eye region. With loss of collagen and elastin, the brows start their downward descent. This by itself can cause fullness in the upper eye area. However, in some patients, excess upper eyelid skin can also appear causing the sagginess of the upper eyelid area.

A brow lift can correct the shape of the brows and actually reduce the amount of upper eyelid skin. There are different types of brow lifts. In patients with the aerly signs of aging, brow shape can be fixed without surgery! Examples of this kind of brow lift include Botox, thread lifting, and Exilis (noninvasive radiofrequency and ultrasound) treatments. Patients with moderate to advanced falling of the brows most likely need a surgical brow lift. This is normally done in the operating room.

Botox chemical brow lifts normally last about 3 months. Surgical brow lifts normally have a lifespan of over 20 years prior to needing other procedures

Good luck and remember…”the eyes are the window to the soul…”

Raghu Athré, MD FACS

Hi Michelle, Thank you so much for asking a valuable question. Melanoma can be very deadly if untreated. However, if caught early it can be easily cured. Early signs of melanoma can be subtle and require a skin exam by a board certified dermatologist who has additional training in skin cancer care. The cost of a skin exam is typically around 100 dollars but may be less or more if a biopsy needs to be performed. I highly recommend that you have your husband checked. My youngest melanoma patient was only 18 years old! Thank you, Tarek Tarek M Fakhouri, MD, FAAD, ACMS Mohs Surgeon

Yes. If your husband has hip arthritis, a hip replacement would definitely improve his situation. Pain in the hip, limping, and stiffness are the most common complaints. Usually arthritis can be diagnosed with just a simple X-ray taken in the office. An orthopedist is definitely the right physician to diagnose and treat this condition.

Insulin resistance can be difficult at first but it is not a life-long sentence. There are several things we can do to help correct it. First however I would need to get more information and do some tests - including a genetic panel. Eating only protein can be hard on your kidneys. We take a more balanced approach. Please give our office to make an appointment. I would love to help you out!

Sara thanks for asking. You are a perfect candidate. It’s best to solve problems early on before irreversible problems develop. You are young. It’s better to avoid years of sleep apnea, hypertension, diabetes, wear and tear on knees and the back, and it’s nice in many other ways. This is a solution that works. We, different than my colleagues, focus after surgery on helping patients change their day to day eating habits.

It’s important to know what your height and weight is to calculate your BMI. If your BMI is greater than 35, especially if you have developed medical conditions, than surgery is an excellent option. You’re not to young to be considered a surgical candidate. If your BMI is below 35, than there are nonsurgical options such as a gastric balloon and medications. I would recommend setting up a consultation to discuss your needs and what possible options are available. Regards, Dr. St. Laurent

Numbness in the feet is a difficult problem. Yes, many diabetics can have numbness but so can a lot of the other population. We recommend all that do have numbness to be evaluated by a podiatrist or foot/ankle specialist. In many instances we can mitigate the pain associated with the numbness but more importantly prevent long term issues. However, it is important to to know that there is no cure for the numbness rather it is a condition we have to decrease the chance for issues to occur secondarily to the numbness or neuropathy.

Dr. Patrick Briggs

Bariatric surgery is very common procedure these days and is consider very safe when performed by an experienced surgeon with a good follow-up program. Long term studies have shown it to be safer than most orthopedic and heart surgeries and as safe as having your gallbladder removed. Losing weight with bariatric surgery will universally improve your diabetes. In patients who have developed diabetes as they have gained weight, they can often times see their diabetes resolve. Family history will also play a significant role, but you should see your diabetes improve. Weight loss typically will occur over a short period of time (1-2 years), which is rapid compared to the amount of time that it takes most patients to gain their weight. It should not put your body into shock, but there are guidelines that the patient must follow and supplementation that is necessary in order to help one lose weight in a healthy fashion. One important concept to understand about bariatric surgery is that it is not a cure for obesity but rather a tool to help one lose weight. Unfortunately there are no guarantees to weight loss as surgery does not make you or force you to lose weight, it simply helps patients lose their excess weight. This is similar to a shovel helping a person dig hole but not digging the hole for you. It is necessary for patients to make lifestyle changes and to make some change in their eating habits. Your best next step is to set up a consultation with a bariatric surgeon to discuss your specific medical issues and to discuss potential surgical and nonsurgical options. Take time to research bariatric surgeons in your area and to find a quality practice that can help you.

Regards,
Dr. St. Laurent

Insurance does not typically cover bio-identical hormone replacement therapy (BHRT). How often you come in depends on the method of replacing the hormones that you choose. Typically it is 2-4 times per year. The cost again depends on the method you choose along with your health issues.

If you would like more information I am offering a free dinner seminar. Please call our office at 281-710-3380 to get scheduled.