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Invisalign straightens teeth with a series of clear, removable aligners, each one moving the teeth a little further than the last. The trays are nearly invisible, they come out to eat and to brush, and most adults and teenagers find them easier to live with than braces. They suit crowding, spacing, relapse after earlier braces and many bite problems; some movements and some bites are more predictable with braces. At Vizcaya Dental Arts the diagnosis and the plan come from Dr. Patricia Hong, a board-certified orthodontist, and the consultation is complimentary.
What Invisalign is
An aligner is a thin, clear tray molded to your teeth, with the position of a few teeth changed slightly from where they are now. Worn for most of the day, it pushes those teeth toward the new position. After a week or two you move to the next tray in the series, and the next, until the teeth have arrived. Small tooth-colored attachments bonded to some teeth give the aligners something to grip for the harder movements; they come off at the end. Elastics are sometimes added to correct the bite.
Because the trays are removable, you eat whatever you like, brush and floss as normal, and nobody has to know you are in treatment unless you tell them.
Who aligners suit
Aligners are a good tool for:
- Crowding and spacing
- Teeth that have relapsed after earlier braces
- Many bite problems, in adults, teenagers and selected children
They are not the best tool for everything:
- Some movements, such as bringing a badly rotated tooth around or moving a tooth a long way vertically, are more predictable with braces.
- Some complex bites are better treated with braces or with a combination.
- Growing children sometimes need appliances that aligners cannot replace.
It depends on your teeth, and the consultation shows which. Gums and teeth have to be healthy before anything moves. Patients with untreated gum disease, or dental work that is due, see Dr. Kottar first, and the two plan together.
Planned by a specialist
Orthodontic treatment can be provided by any licensed dentist. An orthodontist has completed two to three further years of full-time specialty training after dental school, and board certification goes a step beyond that. Dr. Hong trained at Columbia University College of Dental Medicine and completed her orthodontic specialty training at the University of Pennsylvania, and she is certified by the American Board of Orthodontics. She practices orthodontics only.
The plan starts with records: photographs, a digital scan of the teeth, and X-rays. From those, a digital treatment plan is built that shows the teeth moving stage by stage to the planned result, and you see it before anything starts.
What treatment involves
- Step 1 of 6 A complimentary consultation
Dr. Hong examines your teeth and bite, tells you whether aligners suit your case or braces would serve better, and gives you a realistic idea of time and cost.
- Step 2 of 6 Records and the plan
Photographs, a digital scan and X-rays. A digital plan is built and reviewed with you before the aligners are made.
- Step 3 of 6 Delivery
Any attachments are bonded to the teeth, the first aligners are fitted, and you learn how to insert, remove and clean them. If the plan calls for small adjustments between the teeth to make room, Dr. Hong does those herself.
- Step 4 of 6 Check visits
Every several weeks, to confirm the teeth are tracking with the plan and to hand over the next sets. Visits are short.
- Step 5 of 6 Refinement
Near the end, the teeth are scanned again. If some have not quite arrived, a short series of refinement aligners finishes the job. Whether refinements are included is set out in your estimate.
- Step 6 of 6 Retention
Teeth move back if nothing holds them. Retainers follow every case; our retainers page explains the choices and the wearing schedule.
Your part
Aligners work only when they are in.
- The standard guidance is twenty to twenty-two hours a day, out only to eat, to drink anything other than water, and to brush.
- Take them out for meals and put them back as soon as you have brushed; hot drinks and anything with sugar or color go through the trays and sit against the teeth otherwise.
- Clean the trays with a soft brush and lukewarm water, never hot.
- Keep them in their case when they are out; most lost aligners are lost in a napkin.
- If a tray is lost or cracked, call us the same day. Depending on where you are in the series, you may move to the next tray or go back to the previous one until a replacement arrives.
Our articles on cleaning Invisalign trays and on eating and drinking with Invisalign go into the detail.
Teens and children
Invisalign Teen is designed for growing mouths, with room for erupting teeth and small wear indicators on the trays that fade with use, so parents and Dr. Hong can see whether they are being worn. The cost is similar to braces. Whether a teenager should have aligners or braces depends on the case and on the teenager: braces cannot be left in a drawer. Dr. Hong talks that through with the family. Younger children are seen from around six or seven for an evaluation, and our children and teens page explains how that works.
Invisalign alongside cosmetic dentistry
Many adults come to orthodontics on the way to something else: a smile they want to change. Our approach, shared by both doctors, is that alignment comes before veneers or bonding when the position of the teeth is the problem, because moving the teeth is minimally invasive and adding porcelain to crooked teeth is not. Whitening follows alignment, and any bonding or veneers come last, matched to the final shade. Spaces that open at the gum line after adult alignment can be closed with bonding. The cosmetic dentistry page sets out the order, and the two doctors plan those cases together.
After treatment
Teeth drift at any age, and a retainer worn at night, for the long term, keeps them where the aligners put them. Retention is part of every case. Our retainers page covers removable and fixed retainers, how long they are worn and what to do if teeth shift.
Frequently asked questions
Is Invisalign as good as braces?
For many cases, yes, and for some, no. Aligners handle crowding, spacing and many bite problems well. Certain movements, and some complex bites, are more predictable with braces or a combination. Dr. Hong tells you which applies to your teeth at the consultation, before you choose.
How many hours a day do I wear them?
The standard guidance is twenty to twenty-two hours a day, taken out only to eat, drink anything other than water, and brush. Teeth move on schedule when the aligners are in; the plan slips when they are out.
How long does treatment take?
It depends on how far the teeth have to move and how consistently the aligners are worn. Simple cases can take a few months; comprehensive treatment often takes a year or more. You get a realistic range at the consultation, not a promise.
Does it hurt?
Each new aligner feels tight for a day or two, which is the pressure that moves the teeth, and the edges can rub at first. Most people describe it as soreness rather than pain, and it fades. Braces tend to cause more irritation of the lips and cheeks than aligners do.
Can teenagers and children have Invisalign?
Yes. Invisalign Teen is designed for growing mouths, with features that accommodate erupting teeth and wear indicators that show whether the trays are being worn. Dr. Hong decides case by case whether aligners or braces are the better tool for a particular teenager.
What about aligners by mail?
The aligners themselves are not the treatment; the diagnosis and the supervision are. Mail-order kits move teeth without an examination, X-rays or anyone checking the gums and bite as things change, and they cannot adjust the plan when teeth do not follow it. We see the results of that. A specialist costs more than a kit and is a different thing.
Is the consultation free?
Yes. Orthodontic consultations with Dr. Hong are complimentary, and you leave with a clear picture of whether aligners suit you, what treatment would involve and what it would cost.
Sources
Professional guidelines and peer-reviewed reviews this page draws on.
- Papadimitriou A, Mousoulea S, Gkantidis N, Kloukos D. Clinical effectiveness of Invisalign orthodontic treatment: a systematic review. Progress in Orthodontics. 2018;19(1):37. DOI
- American Association of Orthodontists. Consumer alert: questions to ask before choosing direct-to-consumer orthodontic treatment. 2018. AAO
