A Complete Guide to Invisalign

What is Invisalign?

Invisalign is a clear braces teeth alignment system developed by California based medical device manufacturer Align Technology in 1997. Invisalign may be used to treat mild malocclusion of the teeth (e.g. cross-bite, crowding, spacing issues, etc.) and may be used to some effect in more severe misalignment cases.

The system – which may be used to treat alignment issues in both the upper and lower teeth – requires the patient to wear a clear aligner for up to 22 hours per day, removing the clear braces device only for periods of eating, drinking anything that isn’t water, or when desired for reasons of personal preference such as smiling for photographs.

Each aligner is designed to place gentle pressure on the teeth, moving the teeth a fraction of a millimetre over a two-week period. The aligner must be swapped for the next aligner at the end of this two-week period, gradually moving the teeth into a desirable and aesthetically aligned position within the mouth over a period of months. Patients will typically require an average of 18 – 30 sets of aligners in order to treat the most common cases of teeth misalignment (faster treatments are available for less serious cases).

This treatment period is generally considered to be comparable to the time periods involved with completing a course of traditional orthodontic metal braces treatment, although patients should note that the varying levels of complexity involved in each individual case may result in either a comparatively longer course of Invisalign treatment or in a significantly reduced course of Invisalign treatment.

Unlike traditional metal braces, Invisalign clear braces control the amount of force applied to each tooth at each stage of the treatment. This means that, instead of experiencing slight discomfort throughout the whole mouth each time braces are tightened in the traditional fashion, Invisalign delivers efficient force to only certain teeth at each stage of the treatment (reducing the level of slight discomfort felt by the patient as the braces gently apply force to move the teeth into place).

How much does Invisalign cost?

The price for Invisalign braces varies in relation to several important factors relating to the complexity of the individual patient’s needs. To this end, there are many types of Invisalign treatments available. Each different treatment is designed to resolve different kinds of teeth alignment issues. This means that patients wishing to resolve mild teeth alignment issues may require a relatively shorter treatment period of 2 – 3 months, compared to the time required to complete a more complex course of treatment (which can require in the region of 24 months to achieve the desired alignment outcome). For this reason, the price for Invisalign braces varies dramatically across the Invisalign treatment range.

In general, patients with mild to moderate teeth alignment needs can expect to face costs of around €2,500 to €3,500. In terms of Invisalign cost vs. the cost of traditional metal braces, the price most patients can expect to pay is comparably similar between the invisible braces system and the metal braces system (although more complex cases may result in slightly higher costs).

Patients concerned about the cost of the Invisalign process are advised to speak with a trusted family dentist for a better idea of finance options – the dentist may be able to recommend a suitable finance option that will likely involve an initial deposit followed by regular instalments throughout the treatment period.

Can I spread the payments for Invisalign?

The good news for patients who are concerned about running into financial difficulties if asked to pay up front for Invisalign treatment is that financing options are available from many dentists.

This means that patients are typically able to pay an initial deposit and spread the remaining payments out over the course of the treatment. Patients are advised to speak directly with the dental surgery about financing options, as financing rates may be significantly higher or lower between different practices.

Types of Invisalign treatment

Invisalign offers a range of custom teeth alignment treatments. Each treatment is designed to provide optimal results dependant on factors such as the patient’s age and the extent of the patient’s teeth alignment needs.

Based on the results of the orthodontist’s initial investigations (which may involve taking high resolution digital photography and X-rays of the mouth), the orthodontist will make a recommendation on the best fit teeth alignment treatment from the Invisalign product range.

Please see below for a description of the different Invisalign treatments that patients can expect the orthodontist to recommend specific to the patient’s needs and expectations.

  • Invisalign Full

Invisalign Full is the original Invisalign treatment system. Designed to offer a clear braces alternative to traditional metal braces, Invisalign Full is able to correct a broad range of teeth alignment issues – including, in some instances, relatively complicated cases.

In general, patients can expect to complete a course of Invisalign Full treatment in around 12-18 months, changing each Invisalign ‘tray’ at intervals of around every 2 weeks.

The complete course of treatment will include attending regular dental appointments, typically spaced to fall at intervals of around 4 – 8 weeks. The orthodontist will use these appointments both to check the progress of the Invisalign Full treatment and to provide the patient with the next set of trays.

Where opportunities to complete the treatment in a more satisfactory shorter time frame are identified, the orthodontist may recommend the addition of small Invisalign attachments. These attachments serve to provide the clear brace system with extra leverage in certain areas (i.e. through the use of small Invisalign attachments, the orthodontist may be able to assist the patient in realigning particular problematic teeth that require more attention to achieve alignment compared to the patient’s other teeth).

If attachments are added, patients should be advised that although the materials chosen to make the attachments are selected to be in fitting with the visually low profile benefits of the Invisalign system, the attachments do appear slightly more noticeable than the clear braces alone.

  • Invisalign Express

Upon the completion of the orthodontist’s investigations into the best-fit teeth alignment solution available from the Invisalign range of products, the patient’s needs may be deemed relatively mild in comparison to typical issues requiring a course of Invisalign Full treatment.

In this case, the orthodontist may recommend a course of Invisalign Express treatment. There are two main types of Invisalign Express treatment available:

  • Invisalign Express 5 – this involves the use of five aligners over a period of three months.
  • Invisalign Express 10 – this involves the use of ten aligners over a period of six months.

Types of teeth alignment issues that Invisalign express treatments are designed to treat include:

  • Minor misalignment of the front teeth
  • Teeth overcrowding or teeth spacing (up to 2mm)
  • Any early stage relapse issues from previous orthodontic procedures

The benefit of choosing to undergo either the Invisalign Express 5 or Invisalign Express 10 treatment is a reduced treatment time. While this shorter treatment brings lower costs, patients are advised that a limited range of relatively minor teeth alignment issues are suitable for the Express treatment.

This should be taken into consideration as additional treatment tacked onto the back of the Express treatment (i.e. extra treatment that did not form part of the agreed price at the art of the process) is not an option once the planned treatment is complete – meaning the patient would have to consider further complete courses of treatment if the end result of the Express system did not meet with the patient’s expectations.

  • Invisalign i7

Invisalign i7 is a teeth alignment treatment that was developed for use in dental patients requiring only minor teeth alignment treatment. The treatment is offered to patients who present alignment issues that can be resolved over a period of as little as three months using seven aligners.

The Invisalign i7 treatment is therefore ideal for patients wishing to correct any perceived minor flaws in the overall aesthetic appearance of the teeth.

  • Invisalign Lite

Ideal for dental cases that bridge the grey area between mild and moderate alignment issues, Invisalign Lite was designed to offer an alternative to the relatively greater cost – and in the case of the individual patient, the unnecessary complete course – of Invisalign Full.

Invisalign Lite offers a teeth alignment system that can bring mild to moderate issues into alignment over a period of seven months.

  • Invisalign Go

Invisalign Go offers a teeth realignment solution for patients wishing to address alignment issues with the front ten teeth. Although the system may be offered by some specialist general dentists (with the support of other trained professionals), the service is not guaranteed to be available from all dentists and patients are advised to enquire with a dentist as to whether the service is available through that particular dental surgery.

The Invisalign Go system involves the use of up to 20 aligners, used to correct issues in mild to moderate teeth alignment cases.

  • Invisalign Teen

Addressing any teeth alignment issues during the teenage years (as opposed to later in life) is usually preferable to the patient in terms of a relatively shorter treatment time frames. This is because the teeth and jaws are still developing into what will become the final adult mouth shape and teeth position, meaning the teeth are not yet resting in a permanent position within the mouth and may therefore be guided with greater ease.

Taking into account factors such as the heightened risk of teenage patients failing to look the removable Invisalign aligners during treatment, and teenage patients removing the aligner for prolonged periods either on purpose or due to forgetfulness, the Invisalign Teen treatment system comes with additional features as part of the service.

Invisalign Teen treatment includes:

  • Replacement aligners to be issued in the event of loss or damage (note: there is a limit of up to six replacement aligners offered as part of the Invisalign Teen service)
  • Specialist ‘eruption’ considerations may be built into the aligner system to allow for the safe and unhindered emergence of new adult teeth
  • Specialist lower jaw aligners may be offered that serve to encourage the advancement of the lower jaw so as to create better alignment of the teeth

Techniques to measure compliance with treatment advice are also available to dental professionals, meaning the dentist or orthodontist will be able to report back as to whether the patient is wearing the clear brace system for the required 22 hours per day.

Typically, teenage patients are associated with traditional metallic braces. While the cost of Invisalign Teen is potentially greater than the cost of traditional braces, patients may choose to opt for Invisalign Teen treatment as the clear brace system is less noticeable. This can reduce any anxiety that the patient may feel about wearing traditional metal braces as bullying (such as name-calling, for example) can be an issue.

Another benefit of choosing the Invisalign Teen system over traditional metal braces treatments is that the patient is able to remove the braces when taking part in typical teenage hobbies and interests such as sports, social activities, and playing musical instruments.

What type of dental issues can Invisalign fix?

Invisalign treatment may be used to fix a broad range of teeth alignment issues. Below is a description of the common types of malalignment that Invisalign can be used to treat.

  • Crowding
    Displacement or rotation of the teeth can lead to crowding – this condition is typically notable in the lower front teeth of adult patients.
  • Underbite
    Also known as prognathism, underbite occurs where the teeth in the lower jaw overlap – or sit further forwards than – the teeth in the upper jaw.
  • Open Bite
    Open bite occurs where the upper and lower teeth fail to meet each other when the mouth is closed, resulting in a gap through which the tongue can be seen.
  • Cross Bite
    Cross bite occurs where one tooth (or several teeth) in either the upper or lower jaw sit closer to the cheek or tongue than the upper or lower antagonist tooth/teeth.
  • Tooth Gapping
    Tooth gapping can occur naturally (where gum spacing is visible between teeth) or where tooth loss leads to a gap between the teeth.
  • Overbite & Overjet
    Overbite occurs where the upper teeth sit visibly further forwards in comparison to the lower teeth – overjet occurs where the upper teeth both overshoot the lower teeth and points forwards (this can result in the teeth in the front lower jaw making contact with and grinding against the inner surface of the teeth in the upper jaw as part of the natural bite).

Is everyone suitable for Invisalign?

In terms of age range, teenage and adult patients are suitable candidates for Invisalign treatment. Whether the decision is made to go ahead with the Invisalign treatment will however rest with a number of other factors, including whether the patient presents good general health and good oral health. Issues such as severe crowding or spacing may also require specialist attention before a clear braces solution to bring the teeth into alignment can be used to maximum effectiveness. In some cases, severe gapping of the teeth cannot be helped with a clear braces solution and would typically result in a discussion about the possibility of solving any gapping issues with the introduction of a bridge, a dental implant (permanently embedded false tooth) or a partial denture.

Patients who may not be suitable for Invisalign include:

  • Patients who are yet to lose all baby teeth
  • Patients fitted with dentures or other false teeth
  • Patients fitted with a bridge, joining the teeth in an area
  • Patients suffering from periodontal disease or gum disease

Steps must also be taken to ensure that the patient’s medical history does not involve any recent surgery or X-rays of the head and neck prior to X-rays being taken of the patient’s mouth – although the patient is only exposed to a minor dose of radiation during X-rays (such that effects on health are not typically deemed to be an issue when used sparingly), a build-up of radiation following many X-rays can lead to potential health risks, with symptoms in extreme circumstances including vomiting and hair loss.

Patients who are concerned about over exposure to X-rays should speak to the dentist for peace of mind before going forward with any dental treatments.

What are the benefits of Invisalign?

The ongoing and increasing popularity of Invisalign aligners has made the media over recent years – several high-profile celebrities have been spotted wearing the product. Starting out in just North America, and soon spreading to places like Japan and Australia, Invisalign has become synonymous with orthodontic teeth alignment options across 90+ countries in a relatively short space of time. Why? The success of Invisalign is down to the multiple benefits to both adult patients and teen patients.

The benefits of choosing to undergo Invisalign treatment include:

  • Improved dental hygiene – Unlike traditional metal braces, which are not removable and provide ample nooks and crannies in which remnants of food (and all manner of unhealthy bacteria) can gather and fester throughout the day, Invisalign clear braces may be taken out at will. This means that the patient can enjoy the same high level of access to the teeth as was previously experienced prior to opting in to the Invisalign treatment. Patients can remove the aligner to eat a meal (or to drink anything that isn’t water), proceed to brush and floss the teeth as usual, and replace the aligner after each meal – the dentist will also be able to recommend specialist cleaning products that can help the aligner to remain free from harmful bacteria that if left on the retainer can lead to a range of symptoms, including bad breath and gingivitis.
  • Suitable for adults and teenagers – In the case of teenage patients, the Invisalign teeth alignment system presents several major benefits over that of traditional metal braces. For example, teens wishing to take part in sporting activities (and in particular, contact sports such as football, hockey, or even martial arts), may protect the aligner from becoming damaged by removing the tray and making use of the protective case that comes with the system. Also, if the teenage patient currently plays (or wishes to take up) a woodwind musical instrument, the clear braces aligner can be removed prior to lessons or practice. Lastly, teenagers are typically image conscious, and may wish to remove the clear aligner for periods of the day where face to face conversations are necessary, or during parties and other social events where photographs may be taken (Invisalign Teen is a product range that provides the patient with up to six free aligner replacements – this product was made available due to the tendency of teenage patients to lose one or more aligners during the course of the treatment).
  • Easy to monitor progress – Where supporting dental practices have the requisite technology in place, the progress of the Invisalign teeth alignment system can be monitored and relayed to the dentist overseeing the treatment via an app. This not only provides both teenage and adult patients with instant peace of mind that the treatment is progressing both on time and as expected, but the app can also be used to assist in potentially further reducing the number of visits to the dentist that may otherwise be necessary throughout the course of the Invisalign teeth alignment treatment.
  • Near invisible – boost confidence – Unlike other more noticeable braces that may be glued to the front of the teeth, Invisalign is highly difficult to spot to the casual observer. This reduces the self-conscious element for both teenage and adult patients alike, who may not wish to highlight the fact that braces are in place – braces have historically suffered from a social stigma and the use of the Invisalign teeth alignment system can help to reduce the impact on the patient’s confidence.
  • Eat and drink anything – ‘Zero restrictions on the food that can form part of the patient’s diet’. With traditional fixed braces, there is a danger that certain ‘hard’ foods may provoke individual brackets to break free from the orthodontic glue holding them in place. Although this is a rare occurrence that can be avoided by following the precautionary advice from the orthodontist, many patients do not appreciate being told not to eat certain favourite foods. With the Invisalign clear braces system, the patient may remove the braces prior to eating the meal, meaning there are no restrictions on the hardness or on the colouring of the foods permitted.
  • Improved levels of comfort – Patients wearing traditional metal braces report several common issues relating to discomfort. For example, traditional metal braces are known to present the common risk of rubbing against the inside of the mouth, causing discomfort in isolated areas of the cheek lining. There is also the ‘brace tightening’ procedure that traditional metal braces rely upon for effectiveness. This involves tightening the wire that connects the metal brackets glued to the front of the teeth, resulting in a more or less equal distribution of heightened sensitivity and discomfort across each tooth wired into the fixed braces system. Invisalign, on the other hand, provides accurate targeting of individual teeth, resulting is greater overall comfort during the initial bedding-in phase associated with each aligner change (i.e. depending on the patient’s individual needs, the Invisalign teeth alignment system does not necessarily place gentle pressure on all of the teeth at one time in order but can instead promote the movement of targeted teeth, focusing and sensations of pressure in to certain areas).
  • Used to treat a wide range of alignment issues- Invisalign can be used to solve a range of teeth alignment issues, meaning patients with hugely varying needs may all be suitable candidates for undergoing the treatment. For example, Invisalign can be used to treat common issues with mild to moderate cases of malocclusion such as crowding, spacing, and overbites/underbites. Where the individual patient needs exceed the so-called mild to moderate bracket, the dentist may recommend other treatments prior to being eligible for Invisalign.
  • Straight teeth- This is the final and perhaps the most important benefit of using the Invisalign teeth alignment system. Not only will the patient benefit from all of the above-mentioned positive outcomes, but the teeth will achieve a more natural and in-line appearance without compromising on the end result despite not using traditional metal braces.

This means that in comparison to traditional metal braces, patients with the means to opt for the Invisalign clear braces treatment have every reason to make the necessary enquiries.

Other types of invisible braces

The term ‘invisible braces’ is slightly misleading – although very discreet, so-called invisible braces are not actually invisible. So why the popularity? The answer is that, in comparison to traditional metal braces, the various types of invisible braces on the market do provide a much lower visual impact, meaning a lowered chance of any casual observers noticing the braces.

This under-the-radar characteristic of invisible braces is not only an attractive prospect for teens with concerns over bullying or name-calling, but also presents a much more subtle teeth alignment solution for adults who do not want otherwise noticeable metal braces to become a regular talking point in daily life (e.g. at work, when dating, when speaking to friends, etc.)

Several types of invisible braces have been developed in order to give patients multiple teeth alignment options. Patients should note that not all of these treatments may be available at every family dentist, although the dentist will be able to advise the patient on the different types of braces and will also be able to recommend specialist orthodontists where appropriate.

Aside from the various Invisalign treatments available to patients, the different types of invisible braces include:

  • Lingual braces

Although lingual braces cannot claim to be truly ‘invisible’, the lingual braces option does present the patient with the closest type of braces that could be said to be unseen.

Lingual braces function in the same way as traditional metal braces, which is to say that brackets are fixed to the teeth using an orthodontic adhesive and a wire is put in place by the orthodontist that links the brackets and creates a small amount of tension (this tension moves the teeth into alignment over time). Orthodontic bands may also be fitted to the rear teeth, acting as an anchor for the wire.

However, unlike traditional metal braces (which are fitted to the front facing surface of the teeth) lingual braces are fitted to the inside of the teeth (the inner surface of the teeth that faces that tongue is known as the lingual surface of teeth, hence the name lingual braces).

The latest incarnation of lingual braces treatment involves the use of a combination of custom-made brackets and archwires, meaning treatments can be extremely precise. This personalised treatment system, mixed with the fact that lingual braces cannot be removed and therefore cannot be accidentally left by the bathroom sink when getting ready for the day, means that lingual braces present a preferable clear braces option for many patients.

  • Ceramic braces

Ceramic braces operate in the same way as traditional metal braces (in that brackets are fitted to the outer surface of the teeth using orthodontic glue and a wire is fitted in place across the brackets to apply a gentle tension that moves the teeth into alignment over many months).

However, the major difference between ceramic braces and traditional metal braces is that the ceramic used to create the brackets is tooth coloured. This means that the braces are significantly less visible in comparison to traditional metal braces. Tooth coloured wires are also available, further adding to the appeal of this particular type of clear braces treatment.

Ceramic braces are especially favoured by adults wishing to solve crowding in the front teeth. This can usually be achieved through a specialist treatment called Six Month Smiles – patients wishing to take advantage of the ceramic braces option in order to address the issue of crowding in the front teeth are advised to enquire about this service with a family dentist.

The dentist may also be able to recommend a mixed treatment of lingual braces for the upper teeth and ceramic braces for the lower teeth, for example.

Do I need to have teeth removed for Invisalign?

The answer will vary from patient to patient. However, in general terms, patients who do not present issues of severe crowding or tooth decay should not typically expect tooth removal to form a normal procedural step in the Invisalign treatment process. Mild to moderate cases of teeth misalignment, for example, would not usually be associated with the extraction of healthy teeth as a necessity.

Patients who wish to undergo Invisalign treatment to improve teeth alignment but who are concerned about the potential for tooth extraction to be recommended as part of the procedure are advised to seek professional advice for peace of mind.

Invisalign vs metallic braces – what are the key differences?

Invisalign treatments present patients with a range of benefits. Aesthetically speaking, the obvious advantage of Invisalign clear braces over traditional metallic braces is that Invisalign aligners are much less noticeable – both teenage and adult patients therefore benefit from the reduced visual impact of braces on personal interactions in school life, professional work life, and while socialising.

Benefits of Invisalign compared to traditional metal braces include:

  • Invisalign aligners are hard to see and reduce feelings of self-consciousness.
  • Invisalign aligners are removable – patients may remove the aligners for the purposes of eating, drinking, or when smiling for photographs, for example (note: the orthodontist will advise the patient on the correct number of hours per day for which the aligners should be worn, although as a general guide patients should expect to be instructed to wear the Invisalign clear braces for 22 hours per day).
  • Unlike traditional metal braces that come with certain food restrictions, Invisalign aligners may be removed before consuming food or drink, meaning there are no restrictions on the types of food that the patient is able to enjoy whilst undergoing treatment.
  • Invisalign aligners are easily maintained, presenting a considerably more hygienic option in comparison to traditional metal braces (a common issue in relation to fixed metal braces is that food may become stuck in or around the brackets or wiring, resulting in poor day to day oral hygiene).
  • Once the Invisalign aligner is removed, patients may brush and floss teeth as normal (flossing in particular is not generally considered a possibility for patients fitted with traditional metal braces).
  • Patients are given a supply of several Invisalign aligners, to be changed every two weeks. This means that, unlike patients fitted with traditional metal braces who must visit the orthodontist for each upper or lower brace to be tightened at regular intervals, patients are able to change the aligner at home without the need to visit the dental surgery (reducing the number of visits required throughout the treatment).

There are also several potential ‘downside’ considerations that patients are advised to take into account before committing to the Invisalign treatment process, for example:

  • Where the patient loses a custom-made aligner, the replacement costs can be expensive (remember, the aligners are patient-specific, meaning the individual aligner must be remade to fit the patient and therefore cannot be replaced by a ‘stock’ or ‘unneeded spare’ aligner).
  • The aligners are not designed to withstand the effects of chewing food – patients must remove and replace the aligner around every meal or snack, which some patients may find to be something of an awkward practice in public places such as school lunch rooms, office break rooms, and restaurants.
  • Patients are advised to brush thoroughly after each meal or snack (i.e. before replacing the aligner) – again this comes with certain considerations when planning to eat in a public place.
  • Patients who ‘skip’ days by failing to wear the Invisalign aligner for a full period of 24 hours will not benefit in full from the treatment – such behaviour will typically lead to a prolonged treatment period, which means an ongoing associated discomfort with the mild ‘strained’ feelings each time an aligner is changed that could have been ended much sooner had the patient followed the guidelines.

How can I make the most of my Invisalign treatment?

Part of the convenience associated with choosing to align the teeth using the Invisalign treatment system is that the patient is equipped with several aligners upon each visit to the dental surgery. This is convenient because the patient is able to change the aligner at home without the need to revisit the dental surgery each time (thus reducing the number of visits required to complete a successful course of treatment in comparison to the number of visits required to complete a course of traditional metal braces treatment).

Given that the patient is empowered to take daily ownership of Invisalign’s effectiveness, there are many tips available on how to make the most of Invisalign teeth alignment system, such as:

  • Use the Invisalign storage case provided. The Invisalign system is intended to be removed (so that the patient can eat and drink or smile for photographs) and replaced several times per day. This means that as a natural part of the treatment, the aligner must be safely stored for short periods of time. Patients are provided with a purpose designed aligner case that is both discreet and robust, offering a superb level of protection against knocks and bumps whilst also taking up very little space. Patients who are tempted to simply wrap an aligner in a hanky or place the aligner in a pocket or bag are reminded that the cost of replacing damaged aligners can be expensive (each aligner is custom-made and cannot be easily replaced without considerable effort, time, and money).
  • Take the time to follow the cleaning instructions as advised by the dentist. Where patients do not take thorough care of each and every Invisalign aligner, there is a possibility that unhealthy bacteria may accumulate in the aligner. Where this happens, the aligner will in turn transfer the potentially harmful bacteria to the teeth and gums, which can result in poor oral hygiene. The dentist will be able to recommend methods of maintaining the clear aligner – this may include the use of Invisalign cleaning crystals.
  • Use the ‘chewies’ provided. The dentist will likely recommend the use of chewies as a means of helping the braces to fit neatly onto the teeth each time the aligner is replaced. A chewie is a small plastic/foam-like finger of spongy material used by Invisalign patients. The idea is that once the aligner has been placed onto the teeth, the chewie is used as a cushion on which the patient can bite down, edging the aligner into perfect position. Patients are advised to bite on the chewies for a minute or two after inserting the aligner for best results.

What does the Invisalign process involve?

In order to begin the process of aligning the teeth using the Invisalign teeth alignment system, patients must first make dental appointment to discuss all of the relevant factors, including suitability, expectations, and fees. This is the patient’s opportunity to voice any concerns over the Invisalign procedure and to evaluate whether the investment in Invisalign sounds like a suitable teeth alignment solution.

During the initial consultation, the dentist will take the opportunity to make all necessary enquiries about the patient’s general medical history. The dentist will also inspect the patient’s teeth and make a judgement over potential issues that may require attention prior to beginning the Invisalign process (for example, this could include issues surrounding any significant crowding, gapping, or insufficient levels of oral health).

The dentist will listen to the patient’s expectations and advise on the kind of results that may be possible using the Invisalign teeth alignment system. At this stage, the patient may be offered the opportunity to undergo a separate treatment called Digital Smile Design (DSD). This involves the use of digital intraoral scanning equipment to produce a series of digital representations of the patient’s smile following completion of different available treatments. DSD comes at a separate cost to the Invisalign treatment system – patients interested in viewing a digital representation of the outcomes that may be available following different kinds of treatment are advised to enquire about the service during the consultation stage.

Where the decision is made that the patient is a suitable candidate for the Invisalign teeth alignment system, the process may begin.

The dentist will take a series of digital photographs, dental impressions, and X-rays. This will allow for careful analysis of the current position of the patient’s teeth, including an analysis of the patient’s facial structure and midline of the pallet (this is the line of symmetry that runs from the centre of the front teeth to the rear of the mouth).

Once the custom-made Invisalign trays have been manufactured, the patient will receive the first instalment of aligners. These must be worn for up to 22 hours per day, removing the aligners only to eat or drink anything that isn’t water (for when choosing to do so briefly for personal reasons such as smiling for photographs). The patient must remember to change the current aligner for the next aligner in the treatment series every two weeks.

Treatment time will vary depending on the needs of the patient. In general, patients can expect treatment to take approximately 6 – 24 months, which is considerably a much shorter time period than some patients can expect from traditional metal braces – in adult patients, traditional metal braces may require up to around 30 months to achieve the desired teeth alignment outcome.

Does Invisalign cause pain?

Any orthodontic treatment to align the teeth gradually over time will naturally involve placing a gentle pressure on the teeth in order to achieve the desired movement. This pressure is most noticeable in the early stages of each new aligner being introduced to the teeth – any discomfort or sensitivity commonly manifests as a dull ache that fades over a period of a day or two.

Where the patient reports an above average level of tenderness in the teeth and gums following the introduction of a new aligner, the dentist may prescribe a course of pain relief medication.

Each Invisalign aligner is custom-made to fit the patient’s mouth. This means that the tray is manufactured to meet the patient’s gum line, giving a full coverage of each tooth. Should the patient experience any rubbing of the tray on the surface of the gum, dental wax may be used to help reduce friction in the area. Alternatively, patients who feel that more needs to be done to reduce the friction felt at the gum line are encouraged to speak to the orthodontist overseeing the treatment – the orthodontist may be able to file the edges of the Invisalign aligner on the patient’s behalf, creating a more natural fit that does not irritate the gum.

Does Invisalign affect speech?

Prospective Invisalign patients are advised that there may be a period of adjustment involving speech in relation to wearing the clear braces for the first time. When the aligner is placed in the mouth, the patient may notice a slight audible lisp when attempting to pronounce certain letters or words. For example, when patients who are new to the Invisalign system first begin to wear the aligners, the patient may experience and initial difficulty in clearly pronouncing “s” sounds – commonly, this sound instead sounds like “sh”. However, as the patient begins to acclimate to the presence of the aligner, the tongue and cheeks will naturally make the necessary adjustments to enable clearer speech.

Invisalign patients who pursue careers that depend on speaking to people on a regular basis (such as call centre operatives or front of house staff) are advised to practice reading aloud at home in order to achieve faster results in easily forming words when the aligners are in place.

Generally, patients who report encountering issues with speech only report minor and short-lived issues. Patients who are still concerned over the potential affect that Invisalign may have on speech are advised to speak to the family dentist/orthodontist for further information on techniques to reduce further any speech impediments that may arise from wearing the clear braces aligners.

Will any existing aesthetic issues prevent me from undergoing Invisalign treatment?

As with any purpose designed product, there are certain complex teeth alignment needs that may rule certain patients out from suitability for the treatment. For example, while Invisalign can be used to great effect in solving a broad range of aesthetic issues, conditions such as a sever overbite or overjet may require different treatments before Invisalign could be considered an option. Likewise, severely rotated teeth would benefit from receiving targeted orthodontic work in order to achieve greater alignment – remember, the Invisalign system is designed to provide movement of a few millimetres and should not be considered a cure-all for some more complex alignment issues.

What food and drink can I consume whilst having Invasalign treament?

Another consideration relates to the food and drink aspect of the Invisalign product. While the removable Invisalign system does indeed mean that patients can eat and drink anything they like during the course of clear braces treatment, the aligners are intended to be functional for up to 22 hours per day – perhaps not all Invisalign patients are fully mindful of what this entails in relation to eating a drinking. For example, patients who enjoy a morning coffee are instructed to remove the aligner, drink the coffee and brush the teeth to prevent staining the aligner, before eventually quickly cleaning and replacing the aligner. The same considerations must be made when thinking about drinking alcoholic beverages in the evening. All of this removing and replacing may sound easy enough, but given that the aligner must be in place for 22 hours per day, patients are advised to take care over the amount of time given to removing the aligners for non-essential meals (especially if the wearer wishes to save time for not wearing the braces while attending a social event, for example). On the flip side of this advice, patients consequently report eating fewer snacks, with the inevitable outcome of accidental weight loss – a welcome bonus for some patients.

How should I care for my teeth during treament?

This is a good opportunity to hammer home the message that Invisalign patients are expected to take superb care of the teeth during treatment – meaning that patients are advised to brush and floss after every meal before replacing the aligner. Removing food debris trapped between the teeth is of vital importance for several reasons. First, the aligner system will not fit against the teeth in the proper fashion where obstacles get in the way of an air-tight seal. This may sound dramatic, but foods such a sweetcorn and some meats are well known for leaving behind a significant amount of undesirable leftover food between the teeth. As a knock-on effect of this debris not being cleaned away in a timely manner, poor oral health may begin to develop, potentially leading to a swelling in the gums that could push against the aligner system and cause discomfort. Of course, the main concern here is that poor oral health must be addressed, but where gum disease does lead to swelling and therefore an inability to wear the aligners comfortably, the treatment may have to be postponed while the necessary treatments to resolve any oral health issues are carried out (meaning the patient will have to wait longer for results).

How should I clean my aligners?

Aligners must not be cleaned with off-the-shelf standard toothpaste. Although the temptation exists to use a damp toothbrush while brushing the teeth to gently brush away any debris that may have accumulated in the tooth indents inside the aligner, this kind of activity is ill advised. Standard toothpaste contains a mild abrasive that can scratch the aligners, creating the ideal breeding grounds for bacteria. Not only will this potentially cause the aligner to smell, but the bacteria may ultimately transfer to the teeth and gums, resulting in poor oral hygiene that may require professional intervention. Instead, aligners should be cleaned using the products recommended by the dentist (soaps and mild detergents are examples of acceptable cleaning products suitable for use on aligner trays).

A point also worth mentioning here is that prospective Invisalign patients who have not witnessed the product up close will not necessarily appreciate just how very close to invisible the aligner system appears in the mouth. Although the uninitiated may be tempted to think of the aligner system as resembling something close to the fake vampire teeth children are seen wearing towards the end of October each year, this would not be remotely close to an accurate portrayal of how real Invisalign aligners look when worn correctly. The custom-made thin aligners are designed to sit flush against the teeth, with the ‘base’ of aligner extending all the way to the gum line. This means that people looking right at an aligner being worn by a patient will not see the aligner straight away and may take some prompting to look a little closer before noticing anything out of the ordinary.

How much of a difference will Invisalign make?

Patients are also advised to approach the Invisalign teeth alignment treatment program with realistic expectations. While the system does typically offer an excellent return on investment for the vast majority of patients presenting with mild to moderate alignment issues, factors such as the patient’s existing facial structure, mouth shape, and any missing teeth could mean that the ideal results desired by the patient may not be entirely possible through the use of Invisalign alone. The dentist will discuss expectations with the patient. Where necessary, the dentist will make recommendations on a combination of treatments if the desired results may be achieved only through such means.

What is a “finishing aligner”?

If needed, some Invisalign patients may require a ‘finishing aligner’, which should be worn overnight. The recommended use of such a finishing aligner may come as a surprise to some patients, but this is in no way an indication that the treatment has not been successful – merely that the orthodontist has deemed that one more aligner must be used before the permanent realignment of the teeth can be considered a success. The use of finishing aligners is not always required, however, and such orthodontic appliances will be considered for use on a patient by patient basis.

Finally, the Invisalign system works best when overseen by experienced professionals – there is an element of orthodontic artistry involved in producing the best possible results, meaning patients should always seek out experienced staff and established orthodontic practices (avoiding any cheaper offers from newer practices advertising from foreign locations, for example).

Does Invisalign always work?

The ultimate success of a complete course of Invisalign treatment will depend on two main principles. First, the skill of the dentist/orthodontist directing the treatment is paramount to the effective design and direction of the treatment. Second, positive measurable results will depend upon whether the patient adheres to the ‘22-hour per day’ guidelines for wearing the clear braces system. Where the Invisalign treatment plan is designed and overseen by a highly trained specialist orthodontist, and where the patient takes care to follow the guidelines over wearing the aligner for the requisite number of hours per day, the Invisalign treatment system is expected to function without any issues.

FAQ’s

What is a Malocclusion?

The word malocclusion translates as “bad bite”. Specifically, a malocclusion occurs where the teeth in the upper jaw are misaligned to the opposing teeth in the lower jaw. Invisalign treatment can be used to correct both minor to intermediate cases of malocclusion – in some instances, a skilled orthodontist may be able to correct extreme cases of malocclusion using the Invisalign treatment system.

Malocclusion is commonly inherited, characterised by spacing problems and irregularities with the size and shape of the jaw bones and facial bones. However, the condition may also result from instances of acquired injuries or from medical conditions such as dental disease (or from other related medical conditions such as enlarged tonsils, which can lead to the patient developing an open mouthed breathing habit that consequently acts as a barrier to the natural coming together of the teeth, preventing the closed bite from developing). 

In terms of symptoms relating to a malocclusion, the patient may experience a sensation of stress or strain in certain areas of the jaw and mouth when biting (pain is also reported in some patients). This can lead to problems with achieving a comfortable chewing motion and can even lead to tooth decay in certain areas of specific teeth that the patient relies upon for the easiest chewing experience (thus leading to overuse of those teeth when chewing).

In cases of malocclusion relating to overcrowding, the decision may be taken to remove one tooth or several teeth prior to further treatments (such as braces) being administered. The decision may also be taken to add a space maintainer where an adult tooth is yet to ‘erupt’, ensuring that the requisite amount of space is saved for the future development of the tooth and in doing so avoiding any future issues with crowding in that area. Invisalign can help to gradually move the teeth into a more comfortable position in the mouth, reducing and eliminating the malocclusion to restore a comfortable bite and create a much more aesthetically pleasing smile.

Can Invisalign fix crooked teeth?

Yes. Depending on the extent of patient’s malocclusion (where the teeth in the upper jaw do not align with the opposite teeth in the lower jaw), a relatively shorter or longer term Invisalign plan will be required to resolve the issue.

In extreme cases of severely crooked teeth, the dentist/orthodontist overseeing the treatment must be equipped with an advanced skill set in order to complete the Invisalign treatment without the need for other treatments such as metal braces.

Is Invisalign invisible?

Bespoke Invisalign clear aligners are made from a specially developed medical grade thermoplastic designed to be very thin and virtually invisible. The clear aligner sits flush to the teeth, offering an ultra-low visual profile. This means that casual observers are unlikely to notice the aligner unless the wearer points out that the clear braces system is in place.

What are the benefits of Invisalign treatment from a specialist orthodontist?

Some general dentists (also known as family dentists) are able to offer certain Invisalign treatments to patients. However, because these general dentists have not undergone additional specialist orthodontic training, the range of treatments available is limited. The benefit of receiving Invisalign treatment from a specialist orthodontist is that the treatment will be holistic – orthodontists are able to treat the entire spectrum of teeth alignment issues, meaning the bespoke treatment can be directed to suit the exact needs of the patient.

How long does Invisalign treatment take?

In most cases of mild to moderate occlusion (misalignment of the teeth), the Invisalign treatment process can be planned, carried out, and completed in around 12 to 18 months. Given that patients are required to change each aligner for the next in the series of custom-made aligners around once every two weeks, an average of up to 30 aligners will typically be required in order to complete a full course of Invisalign clear braces treatment.

Patients should note that although treatment times do extend into several months, results will be visible within weeks.

Can I swap my braces for Invisalign?

The answer to this question is that switching from a course of traditional braces to a course of Invisalign clear aligners is possible mid-treatment, the orthodontist in charge of carrying out the treatment is best placed to listen to the patient’s concerns and desires and to help the patient to make smart decisions (both in terms of the potential financial costs of switching treatments, and in terms of potentially making the switch for little reason if the traditional braces treatment is nearing its end in any case).

My teeth have moved after braces, can Invisalign help?

Yes. Upon completing a course of traditional braces, the teeth will experience a natural settling in period – use of a retainer during this time can help the teeth to remain in the desired position. However, where patients did not follow the follow up advice from the orthodontist regarding after care during this settling in period, the patient may notice a slight movement in the teeth away from the initial completed position. Invisalign is an ideal solution to this scenario, with specially designed short-term course of Invisalign treatment available for this very purpose.

Is Invisalign suitable if I have crowns, veneers, or bridge work?

This is a grey area in which a definitive answer may only be gained by seeking professional advice. In the specific case of bridge work, for example, the use of clear aligners may not be as effective as would be typically expected from cases where bridge work is not present. This is because the Invisalign clear braces system is designed to move individual teeth. Where the system is asked to move conjoined teeth, the slight pressure exerted by the clear brace may not be sufficient to achieve the desired result. Likewise with any other permanent previous dental work that is present in the mouth, the dentist must consider whether the pressure exerted by the clear aligner will be sufficient to move teeth that may be partially missing (meaning a significant amount of tooth root is connected to a very small portion of healthy tooth above the gum line, giving the aligner a considerably smaller platform onto which pressure may be applied in order to achieve the desired movement).

How long do I wait between changing aligners?

Patients undergoing Invisalign treatment will be advised by the dentist overseeing the treatment to change the current aligner for the next in the series of custom designed aligners around once every two weeks. This not only gives the current aligner time to apply a sufficient amount of gentle pressure to the targeted teeth, but also avoids a situation in which the teeth are moved too quickly. Where the teeth are encouraged to move too great a distance over too short a time frame, the tooth roots can be affected. In turn, this can result in weakened tooth roots that can affect the tooth’s ability to settle in place following the completion of treatment and can ultimately pose a long-term increased risk of tooth loss. 

Is tooth removal an expected part of the Invisalign process?

No. Extraction based orthodontics is normally associated with traditional metal braces (tooth extraction treatment linked to Invisalign treatment is not common). 

Specialist Invisalign practitioners with an advanced skill set can help to devise custom Invisalign treatments that avoid extraction in many cases. Patients who are concerned about potential tooth extraction due to overcrowding (either in the upper or lower jaw) are advised to make a dental appointment to discuss the possibility of using Invisalign to resolve complex overcrowding issues. 

Tooth reshaping – will I require interproximal reduction?

Interproximal reduction sounds a lot more severe than the actual process itself. Also known as interproximal stripping, the procedure involves the skilled removal of a small portion of tooth enamel. Only a fraction of a millimetre of enamel is removed during the quick and pain free process. The purpose of undergoing interproximal reduction is to create vital extra space into which adjacent teeth can move. This means that if only a small amount of extra space is required, healthy teeth do not need to be extracted in order to make room. 

What are Invisalign attachments?

Invisalign attachments are a common auxiliary feature of Invisalign treatment. When fixed in place, the tooth coloured attachments resemble a small and almost unnoticeable ‘lump’ on the surface of the tooth. The purpose of fitting patients with Invisalign attachments is to introduce a raised area that will make a better connection with the Invisalign clear braces – in essence, the attachment allows for the aligner to gain a much better grip in problem areas. Such problem areas could include teeth that sit slightly further back from other teeth, or teeth to require specific gentle pressure to be applied to a particular area of the tooth (e.g. the upper portion of a tooth). 

Attachments consist of a dental composite material formed to blend seamlessly with the natural colour of the tooth. This means that although the attachments are slightly more noticeable in comparison to an Invisalign aligner worn without any attachments, the patient will still benefit from an ultra-low level of clear braces visibility throughout the treatment process. 

The process of fixing the attachments in place is quick and painless. The attachments are fixed in place using a special orthodontic equipment – when the treatment is complete, the attachment is polished off the surface of the tooth. The whole process leaves no lasting evidence that the attachments were ever in place and there is absolutely no damage caused to the tooth enamel. 

Can I eat or chew gum while wearing Invisalign aligners?

Invisalign patients are instructed to remove the clear aligner from the mouth before eating any food, chewing gum, or drinking anything that isn’t water. Although the aligners fit to the teeth with a comfortable slimline accuracy that renders the clear braces virtually invisible to the casual observer and close to unnoticeable to the wearer, patients must remember that the braces are in place and that chewing gum or eating food is not recommended. Improper use of the aligners can cause scratches to the surface of the aligner, which not only increases the visual impact of the clear braces system, but also presents an opportunity for bacteria to gather and multiply. This can cause staining, bad breath, and if not rectified may ultimately lead to poor oral health issues such as inflammation of the gums, bleeding gums, tooth decay, and tooth loss. 

Will Invisalign cause bad breath?

There are multiple causes of bad breath that most Invisalign patients do not realise can be exacerbated through the use of either clear plastic aligners (or, for that matter, from the use of traditional metal braces or through the use of any other kind of orthodontic appliance). 

The reason that braces may encourage a greater degree of bad breath is simply that by increasing the number of surfaces within the mouth, the patient presents a greater number of opportunities for bacteria to gather and proliferate. Therefore, due care and attention is required at all times when undergoing the Invisalign teeth alignment process so as to minimise the risk of bad breath from becoming a noticeable issue. Below is a list of some of the more common considerations concerning bad breath.

Can Invisalign cause dry mouth?

The mouth does a fantastic job of producing saliva for the purpose of naturally ‘flushing’ the mouth throughout the day, helping to reduce the build-up of any bacteria that may lead to bad breath. However, patients fitted with Invisalign aligners may find that the comparatively heightened sensitivity felt in the teeth and jaw during the early ‘acclimatising’ stages of the treatment may lead to leaving the mouth open (because closing the mouth and touching the teeth together may cause discomfort). This is normal, but patients are advised that this can lead to increased chances of bad breath – closing the mouth wherever possible is advised. 

How does smoking impact upon Invisalign treatment?

Not all symptoms of bad breath are due to the temporary or accidental opportunities given to bacteria to build-up in the mouth. Among other more immediate severe health risks, smoking is a conscious action that causes instant and lasting bad breath. Where an Invisalign patient chooses to replace an aligner after smoking without first attempting to clean the teeth and mouth, the clear braces will provide an additional surface onto which the smell of the cigarette will be transferred, giving the wearer additional surfaces that must be cleaned of the smell before the symptoms of bad breath begin to fade. Smokers should also be aware that smoking affects the smoker’s own sense of smell – this means that although the smoker may believe themselves to be of sufficiently pleasant smelling breath, the likely story is that in fact the smoker’s breath smells far worse than the smoker is capable of perceiving. 

Do I need tongue scraper? 

Many people do not appreciate that the tongue itself presents a huge surface area within the mouth. Simply cleaning the teeth after every meal may not provide a sufficient means of cancelling out bad breath where the tongue has not been cleaned. Again, patients of the Invisalign teeth alignment system are reminded that the aligner presents a clean surface to bacteria, which when in the mouth is made warm and moist (ideal for the bacteria to spread). Along with taking proper care of the teeth so as to avoid bad breath during Invisalign treatment, patients are advised to invest in a tongue scraper. These relatively inexpensive and simple devices consist of a thin handle (similar to the handles found on men’s and women’s razors) connected to a flat and thin piece of plastic that can be pulled across the tongue to gently remove any build-up of bad bacteria that if left may result in bad breath. As a general rule, the tongue should be pink – if the patient notices that the tongue has developed a white-ish or brown-ish coating, this is a strong indicator that the patient would benefit from cleaning the tongue to help avoid bad breath. 

Are Invisalign aligners made from plastic?

Invisalign aligners resemble clear plastic. However, there is a major difference between the plastic available on the high street and the materials used to make Invisalign aligners. 

Invisalign aligners are made using a purpose designed medical-grade thermoplastic. This robust material is patented and has gained FDA approval. Patients are reassured that the material does not contain any BPA, BPS, gluten, or latex. 

Although the material is designed to withstand expected levels of stress and strain that come with sitting in the mouth on a daily basis, patients are advised that the material is not indestructible – the Invisalign treatment system comes with a protective case that should be used to store the aligner when eating, when drinking anything that isn’t water, or when storing the aligner for a prolonged period of time such as when attending a party or social function.

Retention after Invisalign – will I need a retainer?

Each Invisalign treatment is specific to the patient. Where relatively simple cases of teeth misalignment can be resolved with minor corrections, a shorter course of Invisalign treatment that does not require a retainer may be prescribed. However, where the orthodontist is confident that further action is required to hold the teeth in place following a complete course of Invisalign treatment, several options are available. For example, in some cases, patients may require a discrete retainer fixed to the rear of the teeth and an impression will be taken for a removable retainer (which will only need to be worn at night). 

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