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Orthodontic Blog


The Pros and Cons of Invisalign Treatment for Adults and Teens

By Orthodontics 10 Comments

Dr. Richard Chan has perfected a lot of smiles with Invisalign in Bothell, Monroe and Mill Creek, Washington as well as at his Juneau, Alaska orthodontic offices (yup, he’s an orthodontist on the move!). Considering how dedicated he is to technology, it’s no wonder he’s a proponent of the innovative treatment. However, it’s important to know that orthodontics isn’t one-size-fits-all and understanding the advantages and disadvantages of Invisalign, as well as keeping in mind your own unique needs and diagnosis, will be the key to making an informed decision about your care. This guide will help if you’re trying to determine if you should opt for braces or Invisalign.

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swollen gums with braces and smiling

Why Do I Have Swollen Gums With Braces?

By Orthodontics No Comments

You’re in braces treatment, you check out your smile in the mirror, and you notice your gums look red, inflamed, and swollen. Is it par for the course during orthodontic treatment or is it a sign of an oral health issue that needs to be addressed? To give you peace of mind and help you determine what’s normal and what isn’t, our Juneau, AK, Bothell, Monroe, Mill Creek, and Everett, WA orthodontist is sharing everything you need to know about braces and your gums. 

In this post, we’ll cover:

  • The causes of red, irritated, and/or swollen gums with braces
  • Ways to deal with irritated gums from braces
  • General tips for how to get healthy gums with braces
  • A note on braces and periodontal health 

Why Do I Have Red, Irritated, and/or Swollen Gums With Braces?

There are a number of culprits that could be behind irritated, swollen, big gums with braces, including:

Lack of stimulation

One of the main culprits of swollen gums during braces has to do with food. What does food have to do with swollen gums during braces? Well, imagine eating without braces.  Every time you chew on food, the food naturally rubs against the outside of the teeth, as well as the gums. This gently massages your gums, stimulating them and keeping them from getting swollen. Once you are in braces, however, the braces and wires stop any food from getting near the gums, and this natural stimulation is gone. If you are not stimulating the gums with your toothbrush during your orthodontic treatment, they will swell up automatically.

To prevent this from happening, use your toothbrush and gently massage the gums, as well as the part of the teeth between the gums and the braces. This will keep your gums from getting swollen and also help prevent cavities from happening between the braces and the gums, which is the most common area for them to occur.

Braces Irritation

The hardware from braces can irritate your cheeks and sometimes your gums. At the start of your treatment, your mouth isn’t used to having brackets and wires in it and the different parts of your braces may rub against the soft tissues of your mouth, leading to discomfort. 

These soft tissues will “toughen up” once you get acclimated to your appliance. This means gum irritation from braces is short-lived and generally resolves itself within a few weeks. If the problem does disappear once you’re used to your braces, then irritated, swollen gums are not a sign of a more serious issue. 

Food Particles Stuck in Your Braces 

Your braces brackets and wires are prone to trapping pieces of food. If you get food caught around your braces, between your teeth, or under the gumline, it can result in swollen, inflamed gums (popcorn kernels are a notorious offender!). Once the food is dislodged, any redness, swelling, or irritation should subside. 

Gum Disease

Not only do braces trap food particles, they also give bacteria and plaque more places to hide. Practicing excellent oral hygiene is the key to eliminating plaque and keeping your gums healthy with braces. If you have poor oral hygiene during your treatment and you don’t consistently remove plaque from around your gumline, it increases your risk for gum disease. 

What is Gum Disease?

What is gum disease? Gum disease, technically called periodontal disease, is when the toxins produced by plaque cause inflammation and infection in the periodontal tissues around the teeth. 

In its earliest stages, periodontal disease is known as gingivitis. Gingivitis is reversible with proper treatment and homecare. If not addressed, gingivitis can advance into periodontitis, the more severe form of gum disease. Periodontitis, which causes bone loss and, in extreme cases, tooth loss, can’t be cured but it can be managed.

Signs of Gum Disease

If you persistently have inflamed, swollen gums with braces or experience bleeding gums when brushing and flossing, it’s probably not simply from lack of stimulation of the gums, and could be gingivitis. Other signs of gingivitis include bad breath and loose teeth. 

Causes of Gingivitis

While poor oral hygiene is the leading cause of gingivitis-related red, swollen, big gums with braces, the following can also make you more susceptible to gingivitis:

  • Pregnancy hormones
  • Diabetes
  • Using tobacco products
  • Broken restorations or missing fillings
  • Certain medications 

Gingival Enlargement

Occasionally, if you suddenly seem to have big gums with braces or it looks like your gums are growing over your braces, it could be due to gingival enlargement, also known as gingival hyperplasia or hypertrophy. Gingival enlargement is an abnormal overgrowth of gum tissue that can be caused by certain medications, medical conditions, a rare hereditary condition, or inflammation from plaque build-up. 

If you do suspect you have large, inflamed gums with braces due to gingival enlargement, schedule a visit with your general dentist. They’ll be able to determine the reason for the problem and recommend the ideal course of action. 

How to Get Rid of Swollen Gums With Braces

As for how to get rid of swollen gums with braces, there are a number of things you can do right off the bat to deal with acute inflammation, irritation and swelling, such as:

  • Gently brush and massage the inflamed gum tissue, right along the border of the gums and teeth. If you imagine the middle of the bristles of your toothbrush, keep the middle of the toothbrush right on the border of your gums and teeth.
  • Gently floss and then brush your teeth. If a food particle is stuck and causing inflamed gums with braces, freeing it should do the trick.
  • Create a saltwater rinse by mixing ½ teaspoon of salt with eight ounces of warm water. Swish the solution around in your mouth and then spit it out. You can do this several times a day until inflammation goes down. 
  • For lip, tongue or gum irritation from braces that are rubbing against the soft tissues of your mouth, first, gently dry the parts of your appliance that are bothering you. Then, break off a small piece of orthodontic relief wax, roll it in between your fingers to warm it up, and place it on your braces.
  • Ask Dr. Chan which of the different types of mouthwash you can use to alleviate discomfort, fight plaque, and keep your gums healthy. For many patients, an antibacterial mouthwash like Colgate® Peroxyl® will quickly eliminate pain, infection, and irritation. Swish with the mouthwash for one minute and then spit it out after brushing your teeth. You can use it several times a day. 
  • Take an over-the-counter pain reliever (whatever you’d normally take for a headache) if needed. 

General Tips for How to Get Healthy Gums with Braces

We know everyone wants to know how to get healthy gums with braces fast. While the above tips are ideal for dealing with acute discomfort and swelling, the following are the steps you’ll want to take for long-term oral health:

  • Floss with braces once daily using an orthodontic flosser or regular dental floss and a floss threader. 
  • Brush your teeth and gums with a soft-bristled toothbrush and fluoride toothpaste in the morning, after meals and snacks, and before bed.
  • If you forget your toothbrush and you’re not at home, rinse your mouth out really well with water after eating.
  • Consider a waterpik for braces. While using a waterpik, or water flosser, doesn’t take the place of regular flossing and is an extra step in your oral hygiene routine, when it comes to how to get healthy gums with braces fast, it’s an excellent solution. Breaking out your water flosser once a day will banish any lingering plaque, stimulate the gums, and dislodge food. 
  • Use an interdental brush (proxy brush) to clean around your brackets and get into tight spaces. The more effectively you remove plaque, the less likely you’ll be to develop gingivitis.
  • Use mouthwash after brushing. As we said above, there are different types of mouthwash that can benefit braces patients. An antibacterial mouthwash will zap bacteria and keep gums healthy, while a fluoride mouthwash is ideal for strengthening enamel and preventing cavities. Regardless of the type of mouthwash you choose, the act of swishing it around will help remove any plaque and food you may have missed when brushing and flossing.
  • Eat a well-rounded diet filled with foods that strengthen the teeth and gums. Enjoy simple starches and sugary drinks and treats in moderation, as the bacteria in the mouth feed on sugars and starches. Instead, opt for plenty of fruits and vegetables, lean protein, low-fat dairy products (or foods high in calcium if you don’t eat dairy), healthy fats, and complex carbohydrates. 
  • Continue visiting your general dentist once every six months, or as often as they recommend, for exams and cleanings throughout your braces treatment. Your dentist will make sure your gums are healthy and be able to catch issues early on while they’re easier to treat. 

A Note on Braces and Periodontal Health

Most causes of irritated, swollen gums with braces are temporary. In fact, in the long run, braces treatment will improve the health of your gums. Straight teeth are easier to effectively brush and floss, which reduces your risk of gum disease. Additionally, when teeth are properly aligned and your bite is strong and stable, it prevents undue pressure on the bone and gum tissue, bolstering periodontal health. 

Can braces help gum recession? While braces can’t cure or treat gum recession, braces can help gum recession on a cosmetic level and play a part in stopping it from getting worse. Bringing the teeth into alignment with braces will make recession appear less visible and, when combined with a solid oral hygiene routine, will give you the amazing oral health you deserve. 

We’re Here to Help!

If you’re concerned about swollen gums with braces, give us a call or talk with Dr. Chan at your next appointment. He can evaluate your gums and let you know what steps to take to reduce swelling and improve your periodontal health. 

If you haven’t started treatment and you’re interested in braces or Invisalign® in Everett, Bothell, Monroe or Mill Creek, WA or Juneau, AK, schedule a complimentary consultation at Richard Chan Orthodontics today!


How To Floss With Braces

By Orthodontics No Comments

The Ultimate Guite To Floss With Braces

When our Alaska, Bothell, Monroe and Mill Creek braces patients first kick-off treatment, we always teach them exactly how to take care of their braces and their smile. Of course, knowing what to do and actually learning new techniques are two different things. For most people, figuring out how to floss with braces takes the most getting used to. To help give you a better idea, we’ll be sharing everything you need to know about flossing with your hardware. 

While our Invisalign® patients should floss their teeth too, one of the benefits of Invisalign vs. braces is the aligners are removable, so you can floss your teeth with regular old dental floss just as you normally would. For that reason, this information is geared towards those with braces. 

In this post, we’ll cover:

Why is Flossing With Braces So Important?

Whether you have braces or not, flossing your teeth every day is crucial to maintaining your oral health. Flossing gets rid of plaque and food debris between the teeth and along the gumline that your toothbrush can’t reach. In fact, flossing is responsible for about 40% of plaque removal. Together, brushing and flossing lower your risk of tooth decay and gum disease. 

When you have braces on your teeth, there are more places for plaque, bacteria and food to hide. If you don’t practice good oral hygiene with braces, you are more likely to get cavities or experience gum inflammation. In extreme cases, you could have to have your braces removed to have your dental problems treated, which would extend your braces treatment time. Additionally, teeth move most effectively in a healthy oral environment. So, diligent brushing and flossing will help you get the best braces results and finish your treatment on schedule. 

How Often Do You Need to Floss Your Teeth With Braces? 

We recommend flossing at least once a day when you have braces. You can break out your dental floss or orthodontic flosser whenever you have time and there are no hard and fast rules about what time of day to floss. However, flossing at night is a good way to eliminate the plaque, bacteria and food particles that have accumulated throughout the day.

Should You Floss or Brush First?

Now, should you floss or brush first? A 2018 study published in the Journal of Periodontology on the efficacy of flossing before or after brushing found flossing before brushing removed significantly more plaque from in between the teeth and in the mouth overall. Subjects who flossed before brushing also had a higher concentration of fluoride from their toothpaste. The fluoride helps to further zap plaque and strengthen enamel. So, our advice is to floss first and then brush if possible. 

What is the Best Floss for Braces?

It is a good idea to use a waxed dental floss because your brackets and wires can shred unwaxed floss. Unwaxed floss is also more likely to get stuck in your braces. Other than that, the best floss for braces is really a personal preference. 

Some patients do like traditional dental floss, but using a floss threader will get the job done much quicker. An orthodontic flosser (like a Platypus flosser) is the fastest option of them all and will really cut down on the time you spend flossing with braces

While you can absolutely use a Waterpik, technically called a water flosser, when you have braces, and we would recommend adding it to your oral hygiene routine, a Waterpik does not replace regular flossing with dental floss or an orthodontic flosser. It’s something you’ll do in addition to your daily flossing, but most patients find it’s well worth it, because it helps get their teeth and gums feeling squeaky clean. 

How to Floss With Braces Using Traditional Dental Floss

As we said, flossing with traditional dental floss will take longer when you have braces than it will if you use a floss threader or orthodontic flosser. However, if you have your heart set on using regular floss to floss with braces, it’s possible.

Here’s how:

  • Break off a length of waxed dental floss about 18 inches long.
  • Using one hand, carefully thread one end of the floss between your arch wire and your teeth. With your other hand, grasp the end of the floss as it makes its way through. 
  • Wrap the ends of the dental floss around your index fingers. You can also wrap it around your middle fingers, leaving only a few inches to use between your teeth, and hold the floss tight with your thumbs and index fingers. 
  • Position the floss between any two teeth. 
  • Glide the floss up and down the side of one tooth, making a C-shape at the base of the tooth when you reach the gums to gently floss the area between your gums and tooth. Then, floss up and down the side of the other tooth, repeating the C-shape to get just under the gum line. 
  • Remove the floss and unthread it behind your archwire. 
  • Repeat the process on the next set of teeth using a clean section of floss until you’ve flossed all of your teeth, including behind your back molars. 

How to Floss With Braces Using a Floss Threader

A floss threader will make flossing with braces just a bit easier. It’s a piece of flexible plastic with a loop on the end that transforms regular floss into floss for braces or restorations like fixed bridgework. There are also versions like Super Floss that have a stiffened end.

As for how to use a floss threader to floss with braces, follow these steps:

  • Break off a piece of waxed dental floss about 18 inches long. 
  • Direct one end of your floss through the eye of the floss threader and pull about five inches of the floss through the loop. 
  • Carefully direct the pointed end of your floss threader under your archwire. If you’re using Super Floss, guide the stiffened end of the floss under your wire. Pull the floss through so you can grip it with both hands. 
  • Wrap the floss around your index fingers, leaving a few inches to floss between your teeth with. 
  • Position the floss between any two teeth. 
  • Slide the floss up and down the side of one tooth, making a C-shape at the base of the tooth when you reach the gums to gently floss the area between your gums and tooth. Then, floss up and down the side of the other tooth, getting just under the gumline again. 
  • Gently pull the floss out from behind your archwire. 
  • Use your floss threader again to floss in between your next set of teeth. Repeat the process until you’ve flossed all of your teeth, including around your back molars. 

How to Floss Using an Orthodontic Flosser

An orthodontic flosser is the easiest, quickest way to floss with braces. However, it is more expensive than regular dental floss. 

Here’s how to floss with an orthodontic flosser if you go that route:

  • Slide the rounded end of your orthodontic flosser under your archwire so the floss is positioned between two teeth. 
  • Glide the floss up and down the side of one tooth, making sure to floss slightly under the gumline. Do the same on the other tooth. 
  • Pull the orthodontic flosser out gently and place it in between the next set of teeth. Repeat the process until you’ve flossed all of your teeth, including behind the back molars. 

How to Use a Waterpik With Braces

You can use a Waterpik for braces in addition to your once-daily flossing in order to dislodge food particles and get your teeth and gums extra clean. A lot of water flosser brands actually have orthodontic tips that are designed to be used with braces. 

Here’s how to use a Waterpik for braces:

  • Fill the reservoir of your water flosser with lukewarm water. Then, insert the flosser tip.
  • Use the lowest pressure setting to start. Place the tip in your mouth while you lean over the sink. 
  • Turn your Waterpik on and close your lips to prevent splashing. Allow the water to run out of your mouth straight into the sink. 
  • Begin with your back teeth. Aim your flosser tip at your gumline and gently brush along the gumline, in between the teeth and around your braces brackets. 
  • Repeat the process on the rest of your teeth until you’ve done your whole mouth. 

Don’t Skip Your Dental Check-Ups!

In addition to brushing and flossing with braces, you’ll also want to be sure you continue to see your general dentist during your orthodontic treatment for regular check-ups and cleanings. Your dentist will evaluate the health of your teeth and gums, let you know if your brushing and flossing technique could use some improvement, and help you prevent cavities and gum disease. Additionally, during a professional cleaning, the hygienist will use special tools to banish hardened plaque (tartar) that you can’t eliminate on your own with a regular toothbrush and dental floss, ensuring the best possible oral health. 

If you still have questions about how to floss with braces, ask us! We’ll be more than happy to demonstrate for you, which can be extremely helpful, especially if you just got your braces put on. Not in treatment yet? If you’re interested in learning more about your options for braces and Invisalign in Bothell, Monroe or Mill Creek, Washington or Juneau, Alaska, schedule a complimentary consultation at Richard Chan Orthodontics today!

The Process and Benefits of 3D Printed Dental Retainers

By Orthodontics No Comments

While 3D printing in orthodontics really began in earnest over two decades ago with the advent of Invisalign®, it has become more commonplace in recent years. In fact, at Richard Chan Orthodontics, we have a 3D printer in our office that we use to customize 3D printed retainers for our patients using advanced, thermoplastic material. 

While there are several types of orthodontic retainers, including permanent retainers that are bonded to the teeth and Hawley retainers that consist of acrylic and wire, 3D-printed, clear retainers are the most popular option among our Monroe, Mill Creek, Bothell and Everett, WA Invisalign and braces patients. In this post, we’ll be covering how the process of getting a 3D-printed retainer works and what the benefits are. 

The Conventional Dental Retainer Process

The conventional way of creating retainers leaves a lot to be desired. The orthodontist fills a tray with a putty-like substance and you have to bite down on it and wait for the impression materials to set, which can sometimes take several minutes. They then use your dental impressions to create a custom retainer. A lot of patients gag during the process of getting traditional dental impressions and it’s not very comfortable. Thankfully, we use 3D technology at our practice so there are no goopy, messy molds! 

New and Improved: The Process for 3D-Printed Retainers

3d-printer-in-the-process-of-printing-retainersHow is getting a 3D-printed retainer different? Well, after your braces or Invisalign treatment is complete, we take digital impressions using our iTero® scanner. The 3D teeth scanning process with iTero is quick, comfortable and painless. You can breathe normally throughout it, it only takes a few minutes and there is no gagging. A Richard Chan Orthodontics team member simply waves the small, handheld wand across your teeth and gums and it snaps images in motion. 

The iTero scans are uploaded to a computer and converted into a super precise, 3D CAD model of your mouth, which is sent to our 3D printer. Dr. Chan and his team will then print and fabricate your custom, clear, plastic retainer. 

You’ll wear your clear retainer, which is technically called an Essix retainer and sometimes referred to as an Invisalign retainer by patients, according to Dr. Chan’s instructions. It will hold your teeth in their new places so that they don’t shift after your braces or Invisalign treatment. 

The Benefits of 3D-Printed Retainers

3D printing dental retainers has made helping patients maintain their smiles much more streamlined. Here are some of the benefits:


When dental impressions are sent to a third-party lab so they can create a custom retainer, it can take three weeks or so for you to receive the retainer. Then, if you lose your retainer, getting a replacement will also take time. With a 3D-printed retainer, we’re able to design, fabricate and print the retainer right in our office, allowing us to get you your retainer sooner. If you need a replacement, that will be quick and easy as well, ensuring your teeth don’t shift while you wait for your appliance. 


The removable, clear retainers are similar to Invisalign aligners. They’re made from smooth plastic, are designed especially for your mouth and they slip over your teeth. There’s no irritation and patients find them to be extremely comfortable. Yet, it’s not just the clear, plastic retainers themselves that are comfortable; the process is comfortable and clean too. As we said, we use our iTero scanner to take quick digital impressions and you don’t have to bite into a goopy mold and hold it in your mouth while trying not to gag. 


The digital impressions from the iTero scanner are high-definition and precise. Digital scanning creates a real-time, virtual rendering of your mouth. When we use the scans for 3D printing dental retainers or other appliances, you get a truly custom fit for the best possible results and comfort. 


It’s quick and easy to take digital impressions and you’ll receive your 3D-printed retainer in less time. Additionally, we keep your digital dental model. So, if you lose your retainer and need a replacement, you won’t have to come in for new scans. We can make you a new one immediately from your previous scan. We’ll tell you when it’s ready and you can either come to the office to pick it up or we can mail it to you. 


3D-printed retainers are more affordable than other options. This is because creating them takes significantly less time and when they’re printed in the office, there is no outside lab involved. We pass these savings on to our patients. 


While eventually you’ll only wear your retainer at night, if you do have to wear it full-time at first, a clear retainer is less noticeable than a Hawley retainer, which has a wire that wraps around your teeth. The plastic is clear and smooth and the retainer fits like an Invisalign aligner. Most people won’t even notice you’re wearing it. 

Better Oral Health

With removable retainers, like a clear retainer or Hawley retainer, you can brush and floss as you normally do. This allows you to maintain excellent oral hygiene, which, of course, is key if you just invested in braces or Invisalign treatment to get your dream smile. While most of our Alaska and Washington orthodontic patients are amazing at keeping their permanent retainers clean, the wire does create more areas for food and plaque to hide, which can increase your risk of tooth decay

To learn more about our high-tech options for creating confident, beautiful smiles, including 3D-printed retainers, schedule a complimentary consultation at Richard Chan Orthodontics in Mill Creek, Monroe or Bothell, WA or Juneau, AK. 


Can You Drink Soda With Braces or Invisalign?

By Orthodontics No Comments

Can you drink coffee with clear braces? Can you drink with Invisalign aligners in your mouth? Why is soda bad for braces? These are some of the questions we get from our Everett, Bothell, Monroe and Mill Creek Invisalign and braces patients. While most people have a pretty good idea of the ins and outs of eating with orthodontic appliances, not everyone is as well versed when it comes to beverages. To help give you a better idea of what you should know about drinking with Invisalign or braces, we’re covering some of the most common beverage-related questions. 

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Do You Know These Common Braces Myths?

By Uncategorized No Comments

When it comes to dental braces, there are myths abound. Some of the common braces myths are rooted in people’s experience with the braces of decades past (today’s braces are a big upgrade and a lot of the challenges no longer exist) and others, well, we’re not exactly sure where they come from. To help dispel any misconceptions, we’re countering some popular braces myths with braces facts!

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Common Teeth Problems an Orthodontist Can Fix

By Orthodontics No Comments

Can I get braces for an anterior crossbite? Can Invisalign fix an overbite? We get a lot of questions like these from our Alaska, Bothell, Monroe, Mill Creek and Everett, WA Invisalign and braces patients before they start treatment. As a certified specialist in orthodontics, Dr. Richard Chan specializes in diagnosing, preventing and treating malocclusions, or problems with the size, positioning and alignment of the teeth and jaws. Of course, orthodontic treatment is focused on straightening the teeth and creating a beautiful smile for every patient, but we also want to design the most functional bite (how the upper and lower teeth fit together). While each patient is unique and you could even have a combination of problems, these are the most common bite issues we address. 

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Eat Local: Top Bothell, Monroe and Mill Creek Restaurants With Braces-Friendly Food

By Community, Orthodontics No Comments

Now, more than ever, it’s so important to support local businesses since many were hard hit by the coronavirus shutdown, particularly restaurants. A delicious and simple way to help if it’s within your means is to order a meal for takeout or delivery. To give you some ideas of where to eat, we’re sharing some of our favorite local restaurants. Of course, since we want our Bothell, Monroe, Mill Creek and Everett braces patients to be able to enjoy some delicious food too, we’re highlighting establishments with braces-friendly food. We can’t mention every restaurant, so we would encourage you to patronize your personal favorites as well.

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What are the Different Types of Retainers After Braces or Invisalign?

By Orthodontics No Comments

When you get your braces removed or take out your final Invisalign tray, it’s a big moment! As our Alaska, Monroe, Mill Creek, Bothell and Everett, WA Invisalign and braces patients will tell you, it’s exciting to see your final results. While it might seem like your orthodontic treatment is complete, there’s actually one more step and that’s wearing a retainer (or retainers). We promise, the outcome will be totally worth it. To help give you a better idea of what to expect, we’ll be covering why wearing a retainer is important and what the different types of retainers are.

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The Dos and Don’ts of Wearing Invisalign

By Orthodontics One Comment

Invisalign is a convenient, comfortable way to get your dream smile. Yet, there are still things you’ll have to do (and avoid) to get the best possible results. As an Alaska, Bothell, Monroe, Mill Creek and Everett orthodontist, I’ll fill you in on everything you need to know about Invisalign when you start treatment. By following the instructions and keeping your aligners and smile in tip-top shape, you’ll breeze through the process using best way to clean dental retainers. Here are some of the key dos and don’ts of wearing Invisalign and best way to clean dental retainers. Read More