Millions of people suffer from having crooked teeth that they would like to have fixed. Most teeth can be fixed when a person is a teenager or in their early 20s, but adults often have a hard time getting the necessary dental care that they need to fix their crooked teeth. One popular option to correct this problem is Invisalign, which are clear plastic moulds that fit around the teeth and gently push them into the correct alignment.

The most obvious advantage of the treatment is cosmetic: the aligners are completely transparent, therefore far more difficult to detect than traditional wire and bracket braces. This makes the method particularly popular among adults who want to straighten their teeth without the look of traditional metal braces, which are commonly worn by children and adolescents. In addition, the aligners are marketed as being more comfortable than braces. Due to the removable nature of the device, food can be consumed without the encumbrance of metallic braces.

Clinically, aligners avoid many of the side effects of traditional fixed appliances,for example the effects on the gums and supporting tissues. Fixed appliances are known to cause the roots of teeth to shorten for most patients,and demineralisation or tooth decay occurs in up to 50% of patients because they cannot be removed for eating and cleaning, and because they prevent accurate x-rays from being taken. Patients "graduate" to a new set of aligners in their treatment series approximately every two weeks. The aligners give less force per week and less pain than do fixed appliances (traditional metal braces). Fixed appliances are adjusted approximately every six weeks and apply greater forces.

Aligners should be removed to eat, drink, to clean the teeth, or to have them checked by the clinician. Because you remove the aligners, you are not limited to what you eat. (It is acceptable to wear aligners while drinking water.) Computerized treatment planning is compulsory as part of the Invisalign protocol. As with other forms of orthodontic treatments that incorporate a computerised plan, this allows the prospective patient to review the projected smile design, learn how long the treatment is likely to take, compare different plans, and make a more educated decision about whether or not to use Invisalign.

Invisalign treatments have been claimed to be quicker than traditional orthodontics. A large-scale study of 408 patients with traditional appliances in Indiana took an average of 35.92 months with a maximum of 96 months,while Invisalign takes between 12–18 months. In a much smaller study Invisalign was shown to be faster and achieve straighter teeth than alternatives but relapsed to ultimately get similar results to the traditional appliances examined.

The study was considered by the authors, however, to be too small for many conclusions to be statistically significant. Furthermore, this general concept that Invisalign is faster has been challenged by the Invisalign review which points out that there are other brace appliance systems that take half the time, for example by incorporating surgery or temporary implants that insert into the patient's bone, to accelerate the procedure.

What is Invisalign?

Invisalign is ‘fantastic’, ‘revolutionary’ and ‘state-of-the-art’. What else do you need to know? Well, quite a few things actually. In a nutshell, Invisalign is a fast new way to move teeth so that you can close gaps, re-align crooked teeth and cure over- or underbites. In that way, it performs exactly the same function as conventional braces. What makes Invisalign different is the technology behind it. Invisalign is based around a series of clear plastic aligners, rather than the conventional metal track braces. These aligners are each less than one millimetre thick and are also removable. So while you are wearing them, they are very discrete. Perfect of course, if you are a Hollywood celebrity worried about being snapped by the paparazzi!

Are the aligners really invisible?

No, if you look closely you can see them. They are, however, barely noticeable and very comfortable to wear too. So most people find that they still have the confidence to smile, talk and socialise naturally.

How do the Invisalign aligners work?

Using the latest 3-D technology and modelling techniques, your dentist or orthodontist works closely with you and the Invisalign laboratory to render an image of how you want your perfect teeth to look once the treatment has finished. Once this final image has been agreed, a set of aligners are produced that will gradually move your teeth towards the desired position.

Why is Invisalign better than other braces?

Unlike traditional braces, there are no brackets or wires. So it is generally agreed to be a more comfortable, less intrusive and more aesthetically pleasing orthodontic treatment. The other appealing aspect of Invisalign is that the aligners are moulded to suit your teeth and how you want them to look. Conventional braces are constantly being tightened and screwed in again as they lose their shape and tension every few weeks. Invisalign works more effectively and efficiently, exerting the right amount of pressure without the need for tightening. For you, that means fewer visits to the dentist.

Does Invisalign work for everyone?

Invisalign can correct a large number of orthodontic problems. However, not everyone is a suitable patient for this treatment as Invisalign is not always appropriate for more complex problems. The best way to find out is to talk with an Invisalign-certified dentist. Even if Invisalign is not right for you, your dentist will be able to recommend a more suitable form of treatment.

What about teenagers and children?

Invisalign is not suitable for children because it is only appropriate for patients who fully grown teeth. However, there is a version of Invisalign which has been adapted to suit teenagers, called Invisalign Teen. This is a slightly modified version of the Invisalign system that allows for a little bit more of an active, rough-and-tumble lifestyle. For example, it includes replacement aligners in case any are lost or broken and compliance indicators so the dentist can see how much the patient has been wearing the aligners.

How fast does Invisalign work?

Some people who have mild conditions can complete their treatment in 12 months. Others, however, if their problem is more severe, may need to wear their aligners for anything up to three years (similar to conventional braces, just better looking). Because the aligners are removable, people can sometimes extend their treatment time by not wearing them enough. Dentists recommend that they are worn for around 20 hours per day.

For people who require a very minor correction, there is a new type of Invisalign product available – Invisalign Lite. This uses the same type of system but is more suited to milder cases and therefore can sometimes be completed in as little as 6 months. Needless to say, it is worth consulting your dentist initially, as not all people can see a change in their teeth in such short timescales.

What exactly does the Invisalign treatment involve?

The procedure usually involves four clear steps.

In the first step, you will sit down with your dentist and talk about how exactly you want your teeth to look. After this, the dentist takes X-rays and then creates the 3-D model of your teeth. This is one aspect of the procedure that really makes Invisalign stand out. You have the opportunity to see how your teeth could look at the end of the treatment. Invisalign can be an expensive treatment, so it is definitely worth talking to your dentist honestly and giving him or her your opinion clearly. After all, you won’t get a second chance.

The third stage of the process is having the aligners made and fitted. These aligners are designed exactly to suit the shape of your mouth and teeth. So they gradually move your teeth into position, rather than forcing them through a rigid metal structure like conventional braces.

On average, treatment times are probably 12 months, but your dentist will give you a plan with clear timescales. The fourth stage of the procedure simply involves regular trips to your dentist, to ensure that you are looking after your teeth, wearing your aligners regularly and seeing some visible change.

Does it hurt?

Invisalign can cause slight soreness in the gums when you change your aligner, which you should do at fairly regular intervals. But to be quite honest, it’s nothing compared to how uncomfortable conventional braces can be. The aligners are also removable, so it makes life much easier when you want to clean your teeth, eat certain types of food or smile for a photograph.

Similarly, because the Invisalign system works more efficiently and faster than conventional braces, it does not need to exert so much force on your teeth. This also makes the treatment more comfortable.

What sort of food can I eat when in Invisalign treatment?

With the Invisalign system, there should be no restrictions over the kinds of food you can eat. But, of course, you do have to use a bit of common sense. Your aligners are removable, so you can feel free to eat all kinds of foods without worrying about food getting stuck to your braces.

If you do try to eat while wearing your removable braces, you probably won’t enjoy your food very much. Your aligners can make chewing awkward at times, with food becoming stuck around your aligners. It might be okay at home, but it certainly wouldn’t be very pleasant if you were eating in public!

Can you chew gum while wearing Invisalign braces?

Chewing gum is probably one of those habits you might have to break with while you are wearing your braces. It sticks to your aligners and can be difficult to clean off. File alongside bubblegum, toffee and caramel.

Anything else I need to know?

Some patients find that their eating habits change slightly. When they change their aligner, some patients shy away from hard foods that require greater biting pressure – just because their gums can be a little bit sore. Some people can experience slight soreness when reinserting their aligners – so they find themselves eating larger meals, less regularly. Of course, less snacking between meals is hardly a bad thing anyway!

What should I do next?

At this stage, most people start worrying about cost. But initially, the best thing to do is to visit an Invisalign approved dentist for a free consultation. Obviously, the treatment can be expensive. But the consultation is free and if you want to know more about the procedure, it is a good place to start.

Invisalign: the costs
We can’t give you a figure for treatment here – after all, we haven’t seen your teeth! However, if you are interested in Invisalign then you should be able to arrange a free, no obligation consultation with your local Invisalign-approved dentist or orthodontist. Following your consultation they should be able to give you an accurate indication of the projected costs for your individual course of treatment. As a guide, average treatment costs can vary from between £1500 and £5000.

Don't forget to ask your dentist to explain the differences between Anterior Invisalign, Invisalign Lite and Full Invisalign as this will have a bearing on the overall cost.

There are several different types of dental retainers that you and your dentist may choose to utilize for your retention phase.

Which is the best type of dental retainer?

The product also has potential disadvantages: the very fact that the aligners are removable means they are not continually correcting the teeth. Unlike traditional fixed braces, they are largely dependent on a patient's habits and their consistency in wearing the aligners. The success of the Invisalign aligners is based on a patient's commitment to wear the aligners for a minimum of 20–22 hours per day, only removing them when they are eating, drinking, or brushing their teeth.

The system is also somewhat expensive, as conceded by the Align company, and can be more expensive than traditional wire and bracket systems.
The aligners must be removed before eating, an advantage and disadvantage depending upon the person. They and the teeth should be cleaned before re-inserting them afterwards.

Because the aligners are removed for eating, they could be lost. Invisalign recommends that the patient keep the previous aligners in case this happens. However, Invisalign provide two plastic containers to keep the braces in, so they are safe and can't be lost or damaged.

Certain teeth are slightly problematic for Invisalign aligners to rotate. Some lower premolars with their rounded shape can be difficult for the aligners to grasp and apply a rotational force to.

Unlike traditional braces, if a patient grinds or clenches her or his teeth during the day or while sleeping, the aligners can become damaged. In practice, however, this problem is very rare and a new aligner can be ordered. Also, similar to traditional metal braces, aligners may cause a slight lisp at the beginning of treatment. This usually disappears as the patient becomes used to the treatment.

The aligners are constructed of implantable-grade polyurethane, and the Align company has acknowledged that, though extremely rare, there may be cases of allergic and toxic sensitivity reactions to Invisalign. Minor symptoms such as sore throat, cough, and nausea have been reported.
Should the treatment go off track, or patients fail to keep the aligners in for the required length of time, then the next aligner in the series will not fit, and a new set of impressions and aligners will be necessary, adding to the cost.

1. Invisalign is a more attractive choice for many people, because Invisalign is not visible like metal braces. Invisalign uses a series of clear, removable aligners that move teeth over time. You will wear Invisalign at all times except during meals.

2. Potential

1. A 2005 study revealed that while Invisalign braces worked great for closing small spaces and straightening front teeth, they were not as successful at correcting a severe overbite, underbite or correcting back tooth bite problems. Regular orthodontic braces will do a better job for those more serious conditions. One big difference between Fixed braces and Invisalign is that while fixed braces are in position 24 hours a day, Invisalign relies on patient compliance. The aligners only work when the patient is wearing them! Patients are required to wear the aligners for 20 hours a day to achieve the best results.

2. Considerations

1. There have been advances in Invisalign, which involve using rubber bands, to correct bite problems. Your dentist should be able to tell you if your bite problem is one that Invisalign can correct, or if you should use metal or clear braces instead. If wearing metal or clear braces is something you absolutely do not want to do, you can perhaps limit your time in them, at least, by wearing Invisalign for part of the time and then finishing up with traditional braces, according to Shurman.

2. Expert Insight

1. The national average cost for Invisalign is about £3500. This cost varies depending on whether the treatment is Invisalign Anterior, Invisalign Lite or Full Invisalign. Again, your dentist should be able to advise which type of Invisalign would be better for your particular situation. The cost of Invisalign has come down significantly over the last couple of years and is now on a par if not more affordable than traditional fixed braces.