“Kissing While Wearing Invisalign Trays?” (And 6-Other Top Orthodontic Questions)


I would say most of my Invisalign patients are relapsed patients who have had braces in the past, but they but never wore their retainer and the teeth shifted back.Their ages range from teens to 70’s. All of them have the same traumatic memories of wire braces, brackets and food getting trapped in embarrassing situations!

I completely understand the hesitation to jump back in to the orthodontic boat and would love to address some common patient questions I get from people considering Invisalign treatment:

 Can I wear them out on dates? Yes! I would suggest taking out the trays before your date gets there and putting them back in after the meal (of course after you’ve brushed and flossed or rinsed out well and chewed some sugar free gum).

Will Invisalign trays show in selfies? Shockingly not! While it’s nice when you have the control to sort through and choose the photos that will be publically posted of you, this is not always an option! Patients of mine have found that overall their Invisalign trays do not show up in photos. If you have a big event and are feeling nervous you can take them out for photos, but of course try to limit the time with the trays out.

Can I kiss someone wearing Invisalign trays? The consensus is yes! No one notices. The feed back I got form patients dating or in new relationships it wasn’t an issue. I found patients would take them out in the beginig of treatment but by the end were more secure that no one would notice.

Will Invisalign trays affect my speech?  It may! But usually just for the first day or two. Sometimes not at all! Occasionally patients will lisp every now and then throughout treatment though this is uncommon.

My job requires public speaking, can I wear Invisalign trays at work? Yes! I found that patients may take out their trays for high pressure large public speaking situations but less so as they progress through their Invisalign. Some patients will  leave them in at work in general but take them out for big high pressure meetings.

I feel self-conscience about my appearance and will wearing Invisalign make it all worse?

The feedback  I have received from patients is that they tend to start feeling better about themselves a couple weeks into Invisalign! Most patients tend to lose some weight as snacking and drinking become a bit more of a shlep. My patients hygiene tends to improve too with the added brushing and flossing.

So tell me doc, what’s the deal with Invisalign what are the cons?

Of course there are and I like to be quite clear. Invisalign only works for a compliant patient. You need to wear them 22 hours a day for them to work predictably.  They need to come out at meals. You will inevitably have to remove them in public at times. You need to brush and floss 3-4 times a day! Hygiene is super important so you don’t damage your gums and teeth.

The attachments seem to be the main dread of patients! They are tooth colored composite that is placed on the teeth for the duration of treatment and removed at the end.  They can be pretty spiky and large. They tend to dull with time. I find as freaked out as any patient is, I always offer to remove them  after a week or two if they still bother you and no one ever comes back. Meaning you get used to them and no one notices them.

The long and short is, I love doing Invisalign because I believe it leaves my patients feeling good and sets them up for success. It can decrease chances of gum disease, calculus build up, staining, uneven wear (which can be ugly and hard to fix)and it’s relativity non invasive and I find patients LOVE It.

Do you have any questions I didn’t get to?

Please let me know and I’d be happy to answer.


Can Stress Really Cause Tooth Loss

Dr. Samantha Rawdin discusses the link between stress and tooth loss.

This past week, The Tonight Show with Jimmy Fallon hosted actress Demi Moore. As an avid Tonight Show watcher, I (not-so-shamefully) pride myself on having deciphered the interview sequence they take with their guests:

Guest sits down. Jimmy welcomes guest. Jimmy brings up interesting, obscure detail about guest. Guest tells funny story having to do with interesting, obscure detail.

But this time, the story particularly caught my attention since they started talking about how said guest lost her two front teeth! Due to stress!

If you happened to watch the interview, and saw the part where Jimmy and Demi start praising modern dentistry, I know what you’re thinking. I should be thanking Jimmy for calling me a genius.THANKS JIMMY! Really appreciate the shout out. (Yea, yea. I know. He called all dentists geniuses. But a girl can dream, no?)

So yes. Modern dentistry is awesome. We can do really amazing things to replace teeth and make them look natural and beautiful. (Hence why I love my job.) BUT they didn’t really get to the core issue here. Demi Moore’s teeth fell out due to STRESS. As New Yorkers, it seems we’re always stressed. Should you be worried that one day you’ll just be walking down the street, all of a sudden you feel something fall out of your mouth, and when you look down you’re surprised to see it’s your tooth? In short, no. That’s really not how it happens.

Stress can manifest itself in the oral cavity in a few ways. The most common is bruxing, clenching or grinding your teeth. (Collectively, we call these parafunctions.) This habit can happen either at night while you sleep or during the day– especially while working out or dealing with an aggravating situation. If you continue with this habit for long enough, it will start to wear down your teeth. This does kind of sound like what Demi was saying in that she “sheared off” her teeth… but if you’re guilty of any of these habits, you typically see wear distributed on most, of not all of your teeth.

Interesting that the rest of Demi’s smile appears to be intact, no? Well I have another theory. My guess is that Demi suffers from a super common condition called periodontal disease. Periodontal disease occurs when bacteria that is not removed by regular dental cleanings travels down the root surface of the tooth, causing the gums and bone to be resorbed and thus reducing the stability of the teeth. Periodontal health is intimately linked to overall health. Stress, and all of the other systemic conditions that it is associated with, such as cardiovascular issues, nervous system issues and GI problems, can all exacerbate periodontal disease. This loss of support of the teeth in combination with stress and parafunctional habits can, in fact, cause your teeth to literally fall out of your head.

But, this isn’t something to freak out about. These changes occur over a long period of time. Bottom line? Make sure you see your dentist for regular check ups. Tracking these changes over time is the best way to diagnose early and treat any issues you might have before you start dropping teeth like coconuts falling from a tree.

I give Demi a ton of credit. In an industry where you’re supposed to be flawless all of the time, it must not be easy to plaster a photo of yourself all over the internet, sans one front tooth. It would be a very vulnerable state for anyone, let alone a movie star. Kudos to Demi for bringing the dental consequences of stress to the forefront of pop culture at her own expense.

New Evidence Reconfirms Link Between Periodontal Disease And Heart Disease

A new study from The Netherlands finds that people with chronic gum disease have a significantly higher rate of heart disease and

stroke http://www.reuters.com/article/us-health-gums-heart-idUSKCN10Y238. This adds to a growing body of research

linking gum, (periodontal), disease to heart disease and strokes. It is significant because it reviewed the health records of over 60,000 patients.


While researchers are not completely sure of how to account for this link, the working

theory is that the body reacts to inflammation by elevating certain chemicals in the blood.

In the short run, these factors fight inflammation but in the long run can damage vessels in

the heart and other organs. The chronic inflammation of gum disease may contribute to

these inflammatory factors being constantly elevated.


So while the evidence may not be 100% conclusive, it seems that keeping the teeth and

gums clean and healthy, not only improves dental health but general health as well.