Invisalign
Your ultimate guide to clear aligner treatment
Last updated: 28th June 2022
Written by Dr Zaeem Jafri
Invisalign (clear aligners) is making it easier for people to have orthodontics treatment (moving teeth) without having the hassle or the appearance of braces.
In this guide, we will go over everything that you need to know about Invisalign, clear aligners and orthodontics treatment in general.
Let’s clear some things up first…
Dental jargon makes things confusing for everyone so we just want to clear up some things before you read on below. Invisalign is an extremely popular brand of clear aligners but there are many others that your dentist may use. Just for ease, we will refer to Invisalign specifically throughout this article but the concepts and processes are pretty much the same for any other system of clear aligner treatment.
Orthodontic treatment - Dental treatment that involves moving teeth
Clear aligners - Clear, removable appliances that move teeth
Fixed braces - Brackets and wires fixed to your teeth that can not be removed
Invisalign - A well-known brand of clear aligners
Orthodontist - A dentist that has done a few years of recognised training to become a registered specialist in orthodontic treatment
General dentist - A dentist that can legally provide orthodontic treatment but has not gone through a recognised specialist training pathway
What is Invisalign?
Invisalign is a system that uses clear aligners to move teeth. It’s a great alternative to having braces for people who don’t want to have ‘tram tracks’ visible on their teeth.
As well as looking nicer than braces, Invisalign aligners can also be removed whenever you want which makes it easier to eat food and keep your teeth clean.
There are no age limits to having treatment with Invisalign and in the right hands (see below), Invisalign can be used for almost every case.
How does Invisalign work?
When you start treatment, you will be given several aligners to wear in a particular order. Each aligner will be worn for 1-3 weeks (depending on your treatment plan) and will put a controlled amount of pressure onto your teeth to move them into a new position.
Although the aligners can be removed at will, you need to wear them on your teeth for a minimum of 22 hours a day. This means that you need to wear them all the time except for when you are eating or cleaning your teeth.
How long does Invisalign take?
How long your treatment will take to complete depends on 3 main things:
How much you are planning to move your teeth
What kinds of movements are required
How well you comply with wearing your aligners
Mild movements like this can usually be done in 3-4 months.
More extensive corrections like this will take 9-12 months
Severe movements can take from 12-24 months to correct
In general, if your teeth just require some slight movements to fix that are out of alignment or teeth that have moved since you had braces as a child, expect to spend around 6-9 months of aligners.
If your teeth and very crowded, rotated, completely out of the arch or if you are looking to close big gaps with Invisalign then you are looking at at least 12 months.
How much does Invisalign cost?
This depends on who you decide to see, where you live and the length of time your treatment is going to take. As a rough guide:
£2000 - £4000 for simple cases (6 months)
£3000 - £5000 for more complex cases (12 months)
Seeing a newly trained dentist will usually be cheaper and seeing a highly experienced specialist will be more expensive.
How to find the right dentist for your Invisalign treatment
Choosing the right clinic
Most dental clinics provide Invisalign or some kind of clear aligner treatment. Check the clinic’s website or social media pages to see what they offer.
Examples of some clear aligner brands aside from Invisalign:
Smilelign
Clear correct
Q-Smile
ClearSmile
Choosing the right dentist
The dentist themselves will be the ones responsible for planning and executing your treatment so it is important that you know exactly how skilled they are. Any dentist can legally start providing orthodontic treatment with minimal training.
General dentists (minimal training/experience)
These are normal dentists who have attended a short course on how to provide orthodontic work. Everyone has to start somewhere! If your teeth only require minimal movements that are easy and straightforward then seeing a newly trained dentist is perfectly okay and you may end up saving a lot of money on your treatment as they will usually be offering you treatment at a cheaper price.
Even if your treatment needs are more complex, a newly trained dentist may be working under the close supervision of a more experienced colleague helping them plan your treatment.
General dentists (extensive training/experience)
Some dentists have several years of experience with Invisalign and may have also completed additional training such as a masters degree or other diplomas. Although these dentists are not specialists they may have the excellent clinical skills to take on more complex cases.
Specialists (Orthodontists)
A dentist needs to have completed a specific training pathway (usually 3-years in a hospital) and passed a certain set of exams in order to call themselves a specialist or an orthodontist. Specialists will be highly skilled in planning orthodontic treatments however their training usually contains a lot more work with fixed braces than with clear aligners.
Many orthodontists will have a preference to use fixed braces over aligners as that is where their experience lies, however you can find orthodontists that have also undertaken extensive training with Invisalign as well.
Consultants
A consultant is a specialist that holds a consultant role at a hospital and will usually be referred to by other dentists to handle complex cases
Orthodontic therapists
These are not dentists, but therapists who are trained in many of the clinical procedures involved with Invisalign. Some dentists will work with a team of therapists to carry out routine procedures whilst they plan and supervise the treatment.
I think I’ve found a dentist, how can I tell if they are good?
Here are a few things you should establish before starting treatment with Invisalign
Find out if they are a general dentist or a specialist orthodontist
Ask them how long they have been providing Invisalign and how many cases they have done so far
If they are not very experience ask if they are being supervised or mentored by anyone
Ask to see photographs of previous cases similar to yours. A good dentist should have a portfolio to show you
Once you know all of the facts, you are then free to choose who you decide to see for your treatment.
The Invisalign treatment process
Consultation and assessment
General health
Before you start treatment you need to have a consultation with a dentist, not only to plan your Invisalign but to make sure that your teeth and mouth are healthy enough to have treatment. Your dentist should carry out a full examination and x-rays to determine that:
You don’t have teeth with large holes or decay
Your bone and gum health is good enough for Invisalign
You don’t have any infected, broken or loose teeth
Your jaw joints and muscles are healthy
You don’t have any signs of oral cancer
Cosmetic assessment
once it’s clear you are a suitable candidate for Invisalign your dentist will discuss your concerns with you and find out exactly what it is you would like to achieve with your treatment. They will look at your smile, the positioning of your teeth and discuss what kind of outcomes you can expect and any limitations as well.
Photographs and scans
Your dentist will take a series of photographs to serve as a baseline record and to help plan your treatment. They will also take a digital scan of your teeth using a scanner (digital scanning has replaced the need for taking messy physical impressions, most modern-day dental practices will have a digital scanner available).
Digital Clin-check simulation
This simulation usually takes around 1 week to prepare and your dentist can show you exactly what movements they have planned for your teeth. Things you should discuss at this stage are:
What the final result will look like
Any limitations or compromises in your final result
Which teeth will have attachments placed
Which teeth will require IPR and how much
How long your treatment will take
If you see something in the clin-check that you are unhappy with make sure you ask your dentist about it before proceeding.
Beginning your Invisalign treatment
There are a few key things that happen on your first appointment:
Begining any Interproximal reduction (IPR)
Bonding your attachments (buttons)
Placing elastics if required
Checking the fit of your aligners
Making sure you know how to use your aligners
What is IPR (Interproximal reduction)
If your teeth are crowded, then your dentist may need to make some space in your arch so that your teeth can all fit together neatly. This can be done by either extracting a tooth (in severe cases) or by thinning your teeth slightly which is called IPR.
IPR involved removing up to 0.3mm from each side of your teeth in a safe controlled manner. The process doesn’t create any sensitivity or pain because your dentist will make sure that they only remove the superficial enamel layer of your teeth and don’t go any deeper.
Crowded teeth
Teeth thinned with IPR
Teeth aligned
How is IPR carried out?
Your dentist will use a combination of strips, discs and burs in order to carry out IPR. In most cases, they will perform most of the reduction at the start of the treatment and then do some more at each of your review appointments. Exactly when and how much IPR is done is completely dependant on your individual case.
IPR bur
IPR strip
IPR disc
What are Invisalign attachments?
Attachments are little buttons your dentist will bond to your teeth. They come in different shapes and help the aligners grip your teeth and move them in a specific way. Your dentist will bond them onto your teeth at the start and then drill them off at the end of your treatment. They are pain-free, tooth coloured and don’t cause any damage to your teeth. Attachments may rub against your lips and cheeks whilst eating at the start of your treatment but your mouth will get used to this quickly.
Do I have to have IPR and attachments?
Attachments are almost always necessary for treatment as they help the aligners perform more advanced movements of your teeth. IPR is also almost always needed if your teeth are crowded.
If you really don’t think you can manage to have IPR or attachments for any reason, your dentist may be able to avoid them however you may have to accept some major compromises in your treatment.
If you have big events such as weddings in the middle of your treatment, your dentist may be willing to pause your alignment, remove your attachments and give you some retainers for a short period before re-bonding your attachments and moving on. There will usually be an additional fee for this.
What are Invisalign elastics?
Elastics are used mainly to treat cases with big ‘overjets’ where your front teeth are too far forward than your bottom teeth. They are not as common as IPR and attachments. They essentially act as a small rubber band hooked around a specific part of your aligners.
Instructions for using your Invisalign aligners
General instructions
Make sure you are comfortable with taking your aligners in and out before you leave the dental practice after they have been fitted
You must wear your aligners 24/7, except for when you are eating, drinking or cleaning your teeth
Each aligner will be worn for 1 week (unless your dentist has advised otherwise) before you move onto the next one
At the start of the week, the aligner will feel tight and your teeth may be tender, take some painkillers to manage this
Using chewies will help your aligner seat into place and massage your teeth leading to less pain
At the end of the week, your aligner should be easy to take on/off and any tenderness around your teeth should have worn off. If your aligner is still tight, consider wearing it for a few extra days until it becomes more passive
Clean your aligner using tap water and soap, a spare toothbrush is ideal for this (avoid using toothpaste as it can stain the aligner)
For a deeper clean you can use the cleaning crystals that come with your aligners, soak your aligners in a cup of water with the crystals dissolved for 15 minutes
Eating and drinking with your Invisalign aligners
You must only have plain water with your aligners in
Drinking and eating with your aligners can cause them to stain. But the main issue is that small bits of food will get trapped around your teeth and can lead to your teeth decaying quickly
Before eating or snacking, remove your aligners and place them in their carry case (do not wrap them in tissue, someone will throw them away)
Once you have finished eating, clean your teeth with a brush and place your aligners back in
It’s worth carrying a small toothbrush with you when heading out
Troubleshooting
If you lose or break an aligner contact your dentist to find out if they want you to move onto the next one, move to the previous one or if they want to order a replacement aligner
If an attachment comes off from your teeth, call your dentist and tell them which one straight away, they may need to see you to replace the attachment if it is a vital one at that phase of the treatment
If you have not been wearing your aligners enough, tell your dentist! They wish to move you to longer wear times (2-3 weeks) to make sure your teeth move properly
Retainers
Once your teeth are in the correct position, you must have a retainer to keep them there. This is a lifelong commitment and if you don’t wear a retainer then you risk your teeth moving back to their original position again.
Types of retainers
Fixed retainers
Your dentist may give you the option of having a retainer that is bonded to the back of your teeth. This is always possible on your bottom teeth but only an option for your top teeth if there is enough room in between your bite.
These retainers are not visible and are stuck to your teeth which is convenient but they may require periodic repairs and replacements. They can also make it hard to clean around your teeth so you need to make sure that you are keeping the area clean and seeing a hygienist regularly to remove any build-up of calculus.
Removable (Essix) retainers
Removable retainers can be used on top of fixed ones or on their own. The fact that you can take them out means your teeth are much easier to keep clean but you need to make sure that you wear your retainer and don’t lose it.
Removable retainers can be worn 2-3 nights a week and will typically need to be replaced once a year (depending on how worn down they become).
Free online Invisalign consultations
If you’re interested in Invisalign treatment and would like some 1-1 advice from our online dentists. you can chat to one for free right away. Just click the button below.
We’ll assess your teeth and give you an idea of pricing, timescales and which dentists in your area are the best ones for you to visit.
More articles about Invisalign
The route to a straighter-looking smile doesn’t necessarily have to always be with braces or Invisalign.