Invilalign, Cosmetic Bonding, Veneers, and Frenectomies

Discussion in 'Trumpet Discussion' started by Jcoffey, Mar 7, 2010.

  1. Jcoffey

    Jcoffey New Friend

    Aug 20, 2007
    Atlanta, GA
    So, I have developed this gnarly gap in my teeth, which has really started to bother me when I play. Part of my lip often slips in between my front teeth, making it more difficult to buzz. There is a local dentist who is also a very accomplished trumpet player and he told me about the following options:
    1. Do nothing
    2. Invisalign: he told me I was a minor case which would cost about $2400... really expensive, but also very effective and permanent.
    3. Veneers: about the same price as invisalign, possibly more. But it's reversible.
    4. Cosmetic Bonding: basically, they take some goop and sculpt along the sides of my front teeth to make them slightly wider and close the gap. It's relatively cheap, $500, but apparently it may have to be redone every 18-24 months.

    He also told me that my gap was caused by my frenulum, the flap of muscle that connects your gum to your upper lip. He talked about a frenectomy (warning:graphic pics on that link), or the removal of said flap. He wasn't sure if it would have a long-term effect on my playing.

    SO! Aaaanyways, I wanted to pick yall's brains to see what you know about these options in reference to playing. :play:
    Any input would be just superb!
  2. flugelgirl

    flugelgirl Forte User

    Jan 20, 2008
    Seattle, WA
    A friend of mine got invisalign, but had problems with it at first. They put attachments on the front of your teeth that hold the thing in, and he couldn't play over the attachment on his front teeth. After getting really bruised, he had to have the dentist move them. It would probably work all right as long as the dentist knew in the beginning not to put the attachments where they would be a problem for you to play on.
  3. Jarrett

    Jarrett Piano User

    Nov 11, 2003
    Richland, MO
    If he's both a dentist and an accomplished player, I'd just do whatever he thought was best. He has background in both areas and is probably better equipped to make an informed decision than most of us.
  4. s.coomer

    s.coomer Forte User

    Mar 25, 2005
    Indianapolis, In
    I have to agree with the last poster. Considering your dentist plays and if he can set things up so you can continue to play why not? Seems like a no-brainer to me.
  5. Ric232

    Ric232 Pianissimo User

    Apr 30, 2009
    Coastal GA
    I had a frenectomy (and a big gap) when I was 13, right before getting braces. There will be a short healing (and adjustment) period, but I don't think this will bother you long term. I cannot speak from experience on the the 3 treatment alternatives he offered, but if I was in your shoes, I would look at it this way:

    Veneers and cosmetic bonding: Both offer an immediate correction to the gap (pro) but this means you have to adjust your trumpet playing to a more dramatic change in your teeth (con). I think this could have a major (and perhaps permanent) negative impact on your trumpet playing.

    Invisalign: This will fix your teeth permanently (pro), but I'm assuming the process takes a while (con), but the fact that it takes a while means you can SLOWLY adjust your trumpet playing (probably imperceptibly) while your teeth SLOWLY move. Honestly, I bet you'll never know the difference, unless the process is much quicker than I'm thinking. (I'm assuming you can remove the fittings while you play trumpet.) EDIT: I just noticed the post by flugelgirl about the "attachments." Definitely follow her advice on that.

    I know you may be thinking the veneers are a good idea because they are reversible, but think about it. If you go with the Invisilign route, you know early in the process if it's going to cause a problem for you in the long term, and you can stop the process. It's not as if you'll be fine until the very last stage of the treatment when your gap is completely closed and then all of the sudden you realize you cannot play and you're stuck without a gap in your teeth.

    You're fortunate to have a dentist who's a trumpeter. Go with his advice, but consider discussing my thoughts from above with him. This is a great question!! Let us know what you decide.
    Last edited: Mar 7, 2010
  6. EricMGB1974

    EricMGB1974 Pianissimo User

    Nov 12, 2009
    Elmira, NY
    As a dentist myself, and with the caveat of not having seen your particular case myself, here are my thoughts.

    The first thing to consider is the size of the diastema (gap). If the diastema is very wide or your teeth are short or square shaped then the veneers or bonding may cause the front teeth to look abnormal. For the purposes of this discussion, I'll assume that this is not the case.

    The downside of the veneers or bonding is that the shade match to your existing teeth may not be perfect depending on what your natural teeth look like and either the abilities of the lab that the dentist uses to make the veneers or the composite system employed by the dentist for the bonding. In addition, if you ever decided to have you teeth whitened in the future the veneers or bonding cannot be bleached and would have to be redone. The advantage to the veneers or bonding would be time. The veneers could be done in two visits and the bonding in one.

    The Invisalign option will take longer but it's advantage is that there is no modification of your natural teeth and no concerns over altering the esthetics of the front teeth. If the position of the "attachments" (actually positioning guides for the lab to use in making the trays) is a concern to you, you could always ask your dentist to place them first but not go any further with the case until you have a chance to practice with them in for say a week or two to ensure they won't interfere with your playing. At that point he could take the impressions to sent to the lab for the trays to be made. If it turned out that you couldn't play with the guides in place at least the dentist hasn't already had to pay the lab for the trays and you shouldn't be on the hook for the full fee for an appliance you couldn't use.

    Regardless of which option you choose, the frenectomy is probably a good idea. If the frenum really is causing the problem then anything else you do will only be treating the symptom rather than the problem. In the case of the Invisalign, the diastema will definitely recur if the underlying problem with the frenum is not addressed either with a frenectomy or a retainer (either fixed or removable) to prevent relapse. The problem with the retainer is that the fixed kind, assuming there is room for it to be placed, splints your teeth together making hygiene difficult. The removable retainer needs to be worn nightly, indefinitely. In either case the frenectomy is a much more permanent and elegant solution. I would think the two biggest risks to your playing from a frenectomy would be either an infection or scar formation. Assuming a good surgeon, adequate post operative hygiene on your part and no underlying medical problems like diabetes or other immune related disorders I wouldn't be overly worried about infection. Scar formation can be a little less predictable, but again with good surgical technique and post-op care can be minimized.

    In an ideal world, on a generic patient, I would say the Invisalign with a frenectomy is the preferred treatment plan, but in the end your dentist is the one who has actually seen your case, so let him be your guide. Hope this was some help. If all I did was repeat what your dentist already told you, which I suspect has been the case, then at least you have a concurring second opinion.
    Last edited: Mar 8, 2010
  7. Pedal C

    Pedal C Mezzo Forte User

    Jan 24, 2005
    This is only my experience, so your mileage may vary...

    I had a frenectomy in middle school, also because of a gap in my teeth (a large gap in fact...). I couldn't play for a week or two, but other than that I didn't have any trouble. I wasn't too good at the trumpet at the time, so who knows if it affected my trumpet playing, but I've done fine since.

    I also used Invisalign (just a few years ago) to correct a tooth problem that was affecting my trumpet playing. I didn't have any sort of "attachments" in my mouth, so I don't know what that even means. The only thing I used was a clear plastic tray that fit over my teeth. It moves the teeth slowly so there's no sudden shock to the system as your teeth evolve. I took the trays out to play. It was a definite win for me.

    Before the Invisalign, I tried to correct my problem with a little bonding stuff. Actually, my dentist was also a trumpet player too. Anyway, it felt bad to play on and I had it taken off and did the Invisalign thing.
  8. Herbie van Tetering

    Herbie van Tetering New Friend

    Aug 7, 2010
    Depends on how one develops, but one should always evade health problems and stick within the comfort zone and use zero pressure playing. Usually the good dentist knows best; with broken teeth it's sometimes difficult to get them repaired correctly and be able to play as well.
    Last edited: Nov 6, 2011
  9. rowuk

    rowuk Moderator Staff Member

    Jun 18, 2006
    what a great post! Thank you!
  10. Herbie van Tetering

    Herbie van Tetering New Friend

    Aug 7, 2010
    You're welcome.
    Last edited: Dec 5, 2010

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