Clear aligners have changed how many people think about straightening teeth, yet they are not a universal answer. Invisalign can work well for mild crowding, small gaps, and many bite concerns, but success depends on tooth position, bone support, gum health, and patient follow-through. Before choosing any orthodontic option, a person needs a careful exam, a realistic treatment plan, and clear expectations about daily wear.

A qualified dentist can assess spacing, bite depth, jaw relationship, and tooth rotation before recommending invisalign treatment in Las Vegas as a possible option. This step matters because clear trays move teeth through planned pressure, and some smiles need attachments, refinements, or a different orthodontic method for stable results.

What Invisalign Can Usually Correct

Invisalign is often effective for mild to moderate crowding. Crowding happens when teeth compete for limited space, which can make brushing and flossing harder. Aligners can create controlled movement over time, helping teeth sit in a cleaner, more balanced position.

Small gaps may also respond well. Spaces can appear because of tooth size, gum changes, habits, or natural growth patterns. A digital treatment plan helps show whether closing those spaces will also protect the bite.

Many bite issues can see an improvement with aligners. Overbites, underbites, crossbites, and open bites vary in severity. Some respond predictably, while others need extra planning because jaw position affects more than tooth alignment.

Where Invisalign May Have Limits

Some smiles need more force or control than clear trays can provide alone. Severe rotations, large vertical movements, and major bite changes may be harder to manage. In those cases, braces or combined treatment may offer better control.

Gum and bone health also matter. Teeth move through bone, so active gum disease must be treated first. If support is weak, movement may need to be slower, limited, or avoided.

Restorations can affect planning. Crowns, bridges, implants, and veneers do not move the same way natural teeth do. A dentist must account for those details before approving aligner therapy.

Daily Wear Makes a Major Difference

Clear aligners are removable, which is useful for meals and cleaning. That benefit also creates responsibility. Most plans require trays to stay in for 20 to 22 hours each day. Wearing them less can slow progress or affect the final position.

Consistency matters more than many people expect. Teeth need steady pressure to move predictably. Skipping hours, leaving trays out during social events, or changing sets too early can disrupt the plan.

Cleaning habits are part of the process. Aligners should be removed for food and most drinks other than water. Brushing before reinserting trays helps reduce staining, odor, and plaque buildup.

Age Is Rarely the Main Factor

Adults can often use Invisalign if their gums, teeth, and bone are healthy. While there is no strict upper age limit, the better question is whether the mouth can handle this movement safely.

Teenagers may also be suitable candidates, but discipline matters. A teen who keeps trays in as directed may do well. One who often forgets them may get poor results, even with a good plan.

Younger children usually need a growth and development exam first. Some may require early orthodontic care before aligners become practical later.

Comfort, Speech, and Lifestyle

Most people feel pressure when starting a new set of trays. That sensation usually fades after the teeth begin adapting. Sharp pain, sores, or trays that do not seat properly should be checked.

Speech may sound slightly different at first. A mild lisp can occur while the tongue adjusts to the plastic. Practice and regular wear usually help speech return to normal.

Diet changes are limited because trays come out during meals. Still, frequent snacking can become inconvenient because teeth should be cleaned before aligners go back in.

How Dentists Decide Candidacy

A proper screening includes photographs, digital scans, dental X-rays, bite evaluation, and gum assessment. These records help determine whether aligners can move teeth safely and predictably.

The dentist also reviews goals. A person who wants a small cosmetic change may have a shorter plan. Someone with bite problems may need more stages and refinements.

Cost and timeline should be discussed early. Treatment length often depends on case difficulty, tray wear, and how teeth respond. Clear estimates help patients make informed choices.

Invisalign can be a strong fit for many smiles, but it is not right for every case. The best candidates have healthy gums, realistic goals, and the discipline to wear trays as directed. More complex movement may require another orthodontic approach or added steps. 

A complete dental evaluation is the most reliable way to match the treatment to the smile, protect oral health, and support a stable result.

Every year, thousands of people turn to spinal cord stimulators hoping for relief from pain that has taken over their daily lives, only to face new complications instead. As of July 2025, at least 24 federal lawsuits tied to Boston Scientific’s spinal cord stimulator devices were pending across nine districts nationwide, now centralized under MDL No. 3181 in the Central District of California before Judge Josephine L. Staton. Families in St. Louis, MO, and beyond have reported injuries ranging from lead migration and unexpected shocks to infections, nerve damage, and the need for revision surgery, each carrying its own physical, emotional, and financial toll.

For residents weighing their legal options, understanding how a Boston Scientific spinal cord stimulator lawsuit fits into this growing litigation is crucial. These claims touch on several forms of personal injury, from device malfunction and “failure to warn” to long-term disability and diminished quality of life. As the MDL moves through its early stages, let’s take a closer look at the key issues shaping these cases.

What MDL 3181 Covers

People researching Boston Scientific spinal cord stimulator lawsuits may encounter references to MDL 3181. This federal proceeding concerns product liability allegations involving spinal stimulation systems. On June 5, 2026, the Judicial Panel on Multidistrict Litigation transferred qualifying cases to the Central District of California before Judge Josephine L. Staton. Each action remains separate for damages, settlement, or trial.

Why Centralization Matters

Multidistrict litigation places cases with shared factual questions before one court for pretrial management. That arrangement can limit duplicated discovery and conflicting rulings. Counsel may examine engineering files, warning materials, adverse event reports, and expert opinions through coordinated procedures. Centralization does not create a class action. Every patient keeps an individual claim, personal evidence, and separate damage calculation.

Product Identification Is Essential

A claimant must establish which implanted system was used. Operative notes may identify the pulse generator, leads, model number, serial code, implantation date, or removal date. Hospital records, billing files, physician notes, and patient implant cards can fill missing details. If product identity remains uncertain, proving a connection between the device and injury becomes more difficult.

• Common Device Allegations

Reported problems may include lead migration, fractured components, lost stimulation, unexpected shocks, burning sensations, charging failures, or limited pain relief. Some patients undergo revision surgery, treatment for infection, or explantation after symptoms worsen. Each allegation depends on the device, procedure, and the patient’s medical history. Evidence must connect the claimed harm to a defect, inadequate warning, or recognized legal theory.

The Main Liability Questions

Several questions may shape a product claim. 

• Did a manufacturing error affect the implanted component? 
• Did the design create an unreasonable risk? 
• Were physicians and patients given adequate safety information? 
• Did company records reveal earlier reports of failure? 

Answers may depend on testing data, internal communications, adverse event submissions, physician testimony, and technical evidence.

Medical Proof Can Drive the Case

Medical records should show the patient’s condition before implantation, during treatment, and after symptoms developed. Physicians may need to separate device-related harm from the underlying illness that prompted stimulation therapy. Imaging studies, diagnostic tests, surgical notes, medication changes, and removal records can establish timing. A consistent sequence strengthens causation evidence. Missing records may provide grounds for a defense challenge.

Shared Evidence and Individual Evidence

The coordinated proceeding may address common proof concerning product development, testing, warnings, and reported malfunctions. Individual evidence remains equally important. Patients may have varying symptom severity, surgical history, employment impact, care requirements, and recovery outlook. Hence, two people with similar implants may still face different damages because their health conditions and financial losses are not the same.

Possible Damages

A successful claim may seek compensation for medical bills, future treatment, lost wages, reduced earning capacity, physical pain, emotional distress, and diminished daily activities. Additional surgery or long-term care may increase documented losses. Recovery amounts depend on evidence and applicable state law. No uniform payment applies to every claimant, and the litigation has not established liability or guaranteed compensation.

Steps for Potential Claimants

Patients should preserve implant cards, operative reports, imaging results, billing statements, prescription records, and provider communications. A dated personal timeline can record symptoms, programming changes, emergency visits, failed therapy, and later procedures. Only qualified clinicians should make treatment decisions. Filing periods typically differ by state, injury type, and discovery date, making prompt legal review important when protecting available rights.

Litigation Status

MDL 3181 remains active. The June 2026 transfer order established a federal structure for coordinated pretrial proceedings involving spinal stimulation product claims. The court has not found the manufacturer liable, and allegations remain contested. New filings, court orders, expert disclosures, and settlement discussions may alter future procedures. 

MDL 3181 provides a shared process for examining evidence linked to spinal cord stimulation systems. Each patient must still prove injury, a product connection, a legal basis, and a measurable loss. Complete records can clarify device identity, symptom timing, treatment needs, and financial consequences. Patients considering legal action may benefit from preserving documents and consulting counsel familiar with medical device claims, clinical evidence, and applicable filing deadlines.

Presley Gerber was beautiful. Almost startlingly so. He had the genetics of two models, the face of his famous mother, Cindy Crawford, and an entrance into a world most people spend their lives trying to reach. He was born into money, fame, access and extraordinary privilege. He became a model himself, working for major fashion houses.

Kaia and Presley Walker Gerber

His sister, Kaia Gerber, became one of the most recognizable models of her generation. From the outside, the Gerber family seemed to possess the kind of life our culture continually tells us is the prize.

Rande Gerber, Cindy, Kaia and Presley Gerber

Presley Gerber died Sunday at 27 years old. According to the Los Angeles County Medical Examiner, he died at a rehabilitation facility. His family has confirmed his death and asked for privacy during what their representative described as a “very difficult and painful time.” As of this writing, no cause of death has been determined.

Rande Gerber, Cindy, Kaia and Presley Gerber

That last fact matters. We do not know what killed Presley Gerber, and his death should not become an invitation for strangers to diagnose him after the fact. What we do know is what he chose to tell us while he was alive.Presley had spoken publicly about depression and his struggles with mental health. He created “Mental Health Mondays,” using his social-media platform to discuss those struggles and try to help other people experiencing their own. Years earlier, he tattooed the word “misunderstood” across his face, later explaining that he chose it because that was how he had felt throughout his life.

In December 2025, his disclosures became considerably more troubling. He spoke publicly about panic attacks, loss and the medications he was taking. He also expressed fear about medication withdrawal and frustration that, after seeing numerous psychiatrists, he felt he needed more direction in managing what he had been prescribed. He told followers that he was speaking because he hoped someone listening would realize that they were not alone.

There is something heartbreaking about that now.

We live in a culture that is very good at measuring what somebody has and remarkably bad at understanding what somebody carries. Presley Gerber had beauty. He had famous parents. He had money. He had access. He had opportunities most aspiring models could only dream about. None of those things tells us what it felt like to wake up inside his mind every morning.

That may be the hardest thing for people to understand about suffering. Pain does not conduct a financial background check before entering the room.

Money can buy excellent doctors. It can buy treatment, privacy, beautiful surroundings and opportunities unavailable to millions of other people. Those advantages are real and should not be romanticized away. But money cannot guarantee peace. Beauty cannot guarantee self-worth. Fame cannot guarantee that somebody feels seen. Loving parents cannot climb inside an adult child’s mind and repair everything hurting there. Sometimes the people who appear to have been handed the entire world are fighting battles invisible to everyone looking at them.

Presley’s life also reminds us how little a photograph tells us. We look at beautiful people standing on red carpets and unconsciously complete the rest of the story ourselves. Beautiful means happy. Wealthy means safe. Famous means fulfilled. Successful means whole. None of those equations is reliable.

Perhaps that is why the word Presley once chose to put on his face feels so haunting today: misunderstood. We cannot know everything he meant by it, and we shouldn’t pretend that we do. But we know that a young man surrounded by enormous privilege nevertheless felt misunderstood strongly enough to write the word across the face the world considered so beautiful. There is an uncomfortable lesson in that.

We spend enormous amounts of our lives chasing the things we imagine will finally make us safe from unhappiness. More money. A better body. A beautiful face. Recognition. Connections. The right family. The right address. The right career. We look at people who possess those things and think they have somehow crossed an invisible border into a life where ordinary human suffering cannot reach them. There is no such border.

Presley Gerber was someone’s son. He was someone’s brother. He was a young man who struggled, talked publicly about those struggles and tried to turn some of what he had experienced into something that might help another person. Whatever the medical examiner ultimately determines about how he died, that deserves to be remembered alongside the photographs, the famous surname and the headlines.

Twenty-seven is terribly young. And somewhere tonight, behind all the celebrity attached to this story, there is a mother and father who have lost their son and a sister who has lost her brother. Fame does not protect them from that grief either.

You can be gorgeous. You can be famous. You can be born into money, prestige and opportunity. You can seemingly have the world waiting at your feet. And you can still hurt.

Perhaps Presley Gerber’s life asks us to stop assuming we know who has everything.

Sometimes everything we can see has absolutely nothing to do with what is happening inside.

There are family secrets we inherit, family stories we repeat and family wounds we spend a lifetime trying to understand. In Crazy Mama: A True Story of Love and Madness, playwright Sharon Scott Williams turns her own family history into a theatrical examination of what happens when a child grows up loving someone she cannot save.

Rubicon Theatre Company will bring the Off-Broadway premiere of Williams’ autobiographical play to 59E59 Theaters this fall, with Linda Purl taking on an extraordinary 16 characters under the direction of Anson Williams. Will Huse joins her as The Blues Man.

For television audiences, the director Anson Williams remains instantly associated with Warren “Potsie” Weber on the iconic series Happy Days, but his career behind the camera has been extensive, directing hundreds of hours of television. There is also a delightful bit of Happy Days symmetry in his collaboration with Purl: she played Ashley Pfister, Fonzie’s girlfriend, during the series’ tenth season. Decades later, the two are reunited on considerably darker territory, with Williams directing Purl through a story in which comedy and heartbreak live uncomfortably close together.

The story begins just days after Sharon’s eighth birthday. Racing home from school to beat her teenage brother, Spikey, to the final piece of birthday cake, she walks into the kitchen and finds her mother holding a knife. The sheriff takes her mother away, and a deputy gives the little girl an explanation both brutally simple and wholly inadequate: her mama is “not right in the head.”

What follows is not simply a story about mental illness. It is the story of a daughter who spends decades believing that if she loves fiercely enough, tries hard enough or somehow finds the right answer, she can rescue her mother.

That distinction gives Crazy Mama its emotional center. Mental illness affects the person living with it, but its reach rarely stops there. It changes marriages, childhoods, siblings and entire families. Williams writes from the perspective of someone who knew both the love and the fear inside that experience.

“Mental illness affects one in four people, but all-too-often individuals and families don’t speak of their experience and hide their pain,” Williams says. “I was lucky. I had my family to help me through it, but there were times we were afraid to talk about it. Crazy Mama is a story that helps lift that stigma.”

Rather than treating its subject with unrelenting solemnity, the play is laced with humor as well as pathos. That matters. Families living through extraordinary circumstances still laugh, fight over birthday cake, irritate one another and get through Tuesday. Resilience isn’t always heroic. Sometimes it is simply continuing to love someone when love cannot fix what is wrong.

For Purl, whose career has moved easily between stage, film and television, Crazy Mama presents a formidable theatrical challenge. Sixteen characters pass through a single performer, requiring not merely vocal or physical transformation but the creation of an entire family and world around one woman’s memory.

The production arrives in New York following its world premiere at Rubicon Theatre Company in Ventura, California, in March 2025. Rubicon Producing Artistic Directors Karyl Lynn Burns and Jonathan Drahos now bring the work east for its Off-Broadway debut.

The creative team includes Brian Gale, who provides lighting and projection design, and Lindsay Jones on sound design. Alexandrea Hess Rodriguez serves as production stage manager, with Stephanie Coltrin as associate producer.

At its heart, Crazy Mama asks a difficult question: What happens when the person you desperately want to save is someone you do not have the power to save?

Williams lived that question. Now Linda Purl will become the 16 people who helped her tell the story.

Performances begin September 16, with opening night set for September 22. The limited engagement runs through October 18 in Theater C.

Crazy Mama runs two hours and five minutes, including intermission, with performances Tuesday through Friday at 7:30 p.m., Saturdays at 2:30 and 7:30 p.m., and Sundays at 2:30 p.m. Tickets are $42, including the $2 fee, through 59E59 Theaters, by phone at 646-892-7999, or at the box office at 59 East 59th Street.

There is a question New York seems increasingly afraid to ask because asking it sounds insufficiently compassionate: When did someone else’s mental illness become everybody else’s responsibility to endure?

I am in in Times Square most every day. I take New York City buses. I walk these streets and like millions of New Yorkers, I have found myself trapped in public spaces with people screaming, threatening, striking out at invisible enemies, terrorizing passengers or behaving so erratically that everyone around them begins calculating where the nearest exit is. We have normalized it. Don’t engage. Move away. Change subway cars. Get off the bus. Don’t make eye contact. Give the person space. Why is the burden perpetually placed upon the person who is simply trying to get home or on about their business?

On August 31, Erin Piacenti was doing exactly that. She was 32 years old, a lawyer and vice president at Bank of America, and had just returned to work after five months of maternity leave. She was walking through Times Square after work when Pamela Cisneros, 49, stabbed her in the abdomen in what police described as a random and unprovoked attack. Cisneros had also stabbed 68-year-old Tak Kam, who survived. Piacenti did not. She left behind a husband and a five-month-old daughter.

Almost immediately, much of the story has became about the mental illness of the woman who killed her. Cisneros had suffered from serious mental-health problems for decades, according to her father. In 2019, she reportedly attempted to jump in front of a subway train. Afterward, her father began taking her to monthly hospital appointments where she received injections that he said kept her stable. In April, according to his account, she told him she could handle those appointments herself and stopped allowing him to accompany her. It remains unclear whether she continued receiving treatment.

That history explains something. It does not resurrect Erin Piacenti. That distinction has become dangerously blurred. Mental illness may explain why someone behaves irrationally. It may explain why someone cannot regulate behavior or distinguish reality from delusion. But an explanation does not make the consequences disappear for everybody else.

Erin Piacenti’s daughter will not grow up with her mother. Her husband does not somehow lose less of his wife because the attack was committed by someone with a history of mental illness. Tak Kam was not stabbed less deeply because his attacker was psychiatrically troubled. Their suffering counts too.

Yet increasingly, when something like this happens, our cultural reflex is to move almost immediately toward the suffering of the person who caused the catastrophe. What happened to her? Why wasn’t she receiving treatment? What trauma had she experienced? What diagnosis did she have? Those may be legitimate questions, but there is another question that deserves considerably more attention: Who was responsible for making sure a person known to be dangerously unstable did not reach the point where complete strangers became responsible for surviving her?

That responsibility cannot belong to a woman walking home from work. It cannot belong to a tourist coming out of the subway or passengers trapped on a bus. It cannot perpetually belong to police officers who encounter someone at the very end of a psychiatric collapse and are expected to solve in seconds what families, doctors, hospitals and institutions have failed to solve over years.

Cisneros ultimately approached police carrying two knives, refused repeated commands to drop them and continued toward officers even after Tasers were deployed. Officers shot and killed her. By the time the episode ended, an innocent woman was dead, another innocent person was wounded, Cisneros herself was dead and police officers had been placed in a confrontation that never should have reached that point.

There is also something we have become extraordinarily reluctant to discuss: families have responsibilities. Yes, an adult has rights. Yes, families cannot simply control another adult. Yes, serious psychiatric illness can make treatment extremely difficult, and relatives themselves can become exhausted, frightened and overwhelmed. Family cannot simply disappear from the discussion when someone has a known history of profound instability.

In this case, Cisneros’ father appears to have tried. He accompanied his daughter to treatment and helped make sure she received medication. When she said she could handle those appointments herself, he believed she had turned a corner. That makes this particular case more complicated, but it also exposes the enormous hole in the system. What is a family supposed to do when an adult relative with a history of serious psychiatric instability refuses help? Who follows up when someone receiving treatment that has apparently kept her stable suddenly stops appearing? At what point does somebody have the authority—and the responsibility—to say this person is not capable of simply being left alone?

We have created a remarkable vacuum of responsibility. The individual is mentally ill, therefore her responsibility may be diminished. The family cannot force treatment. Doctors face legal restrictions. Police frequently cannot intervene until particular thresholds are crossed. Everyone else is instructed to avoid confrontation and protect themselves. Responsibility evaporates precisely when it becomes most necessary, and somewhere inside that maze stands an ordinary person who never volunteered to participate in any of it. Sometimes that person ends up dead.

Times Square magnifies the problem because everybody comes through here. Workers, tourists, families, performers, hustlers, homeless people, people struggling with addiction and people experiencing profound psychiatric distress are compressed into a few blocks of public space. Those of us who actually live and work here know the choreography. You notice the person screaming before you reach the corner. You watch someone’s hands. You move farther down the platform. You decide whether to board the subway car. You quietly change seats on the bus. That is not prejudice. It is self-preservation.

We do not owe another human being the surrender of our own safety because that person is ill. We can acknowledge mental illness without making innocent strangers responsible for enduring its consequences.

Erin Piacenti had spent five months at home with her baby. Four days before her death, she wrote publicly about how grateful she was for that time. On her first day back at work, she walked through Times Square and never made it home. Her daughter is now five months old and motherless.

Erin Piacenti did not cause any of this. Neither did Tak Kam. Neither do the millions of New Yorkers who board buses, enter subway cars and walk through Times Square every day.

Mental illness needs treatment there is no denying it, but the public is entitled to something as well, and we have become strangely apologetic about saying it. We have the right to go home alive.