Comprehensive Guide to Invisalign

WHAT TO EXPECT DURING YOUR APPOINTMENTS:​

RECORDS APPOINTMENT – 60 minutes

You will have detailed impressions or scans of your teeth and photographs taken. If you do not have a current full mouth X-ray on file, we will need to take a new one. Your next appointment will be in approximately 5-6 weeks. We will wait to schedule this appointment once we know when your case will be delivered back to our office.

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FIRST APPOINTMENT – 60-90 minutes

You will receive the final instructions about the wear and care of your aligners. At this appointment, we will place tooth-colored attachments on your teeth and begin to perform any IPR (inter-proximal reduction). We will then place your first set of aligners and teach you how to insert and remove them. 

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MONITORING VISITS – 20-40 minutes

We will have you come in periodically to receive your next set of aligners. You need to come with the current aligner set in your mouth. We will make sure your teeth are tracking or moving, as they should in the aligners. Any necessary IPR will be done and new aligners will be placed.

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The number of monitoring appointments depends on the number of aligner sets that have been prescribed. Visits will continue until you have successfully completed all of your treatment. Following your final set, an evaluation is scheduled to determine if retainers can be ordered or if further refining is needed.

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TREATMENT PROGRESS

The most important variable for success of your Invisalign treatment is your compliance to wear the aligners as instructed.  Aligners need to be worn at minimum of 22 hours per day, without exception. Invisalign aligners ONLY work when you are wearing them. The only time the aligners should be out of your mouth is when you are eating and drinking, brushing and flossing, or cleaning the aligners. Wear each aligner for a minimum of 7 days or as directed by the doctor.

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If you miss some days for any reason, pick up where you left off and wear the aligners for a full 7 days and please call the office and let us know.

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TREATMENT INSTRUCTIONS:​

INSERTION

• Each aligner is stamped with a letter and a number (U for upper and L for lower, indicated on each aligner). The number corresponds to the number of the aligners in the sequence.

• Make sure you have the proper aligner in the proper number sequence as marked on each aligner.

• When inserting, gently push the aligners over your front teeth using your hands. Then, apply finger pressure to the tops of the left and right molars until they snap into place. Do not bite your aligners into place.

• Make sure each aligner is fully seated. You should not see any space between the edge of the tooth and the edge of the aligner. You can bite on your “chewy” to ensure that your aligner is fully seated. If the aligner is not fully in place, the teeth will not move properly and the next aligner will be even further off. This can waste many weeks of treatment and even cause starting over with possible extra fees.

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REMOVAL

• To remove the aligners, pull off equally on both sides of the back teeth first, and then gently lift off of the front teeth.

• Always rinse the aligners in cold water and store in the proper container. To prevent damage, avoid unnecessary removal.  

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CARE OF ALIGNERS

• Clean your aligners prior to each insertion. You can use toothpaste and a toothbrush or mild soap. Rinse under running water and brush until clean. Never use denture cleaner or soak in alcohol or bleach, as the aligners will be damaged, become cloudy and very visible when you wear them again. Never place aligners in boiling or hot water to clean them, as they will become distorted and not fit.

• Oral Hygiene: Brush and floss normally with the aligners out. Try to brush after eating and before re-inserting the aligners. Large food particles may prevent proper insertion.

• Eating: There are no food restrictions with Invisalign. However, aligners must always be removed when eating.  Do not chew gum or smoke while wearing aligners.

• Drinking: Except for cold or room temperature water, always remove aligners when drinking anything. Any fluid will get inside the aligners and be held against your teeth, possibly for hours, causing staining or damage to the teeth and aligners. Do not drink hot liquids when wearing aligners.

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STORING ALIGNERS

• Always place the aligners in the cases provided. Never place aligners in napkins or any other case as they can be easily thrown away or lost accidentally.  

• Keep all previous aligners in a bag at home. If you accidentally lose an aligner, call us right away and wear the previous aligner if available. It is imperative that you are always wearing an aligner even if the current one becomes lost. There will be a charge for damaged, lost, or discarded aligners.

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REFINEMENT

• Refinement is expected in most cases in order to “fine tune” how the bite fits together. In most cases, the appearance of your smile will be satisfactory at this point. However, in order for it to last, it needs to function correctly.

• The process includes sending new impressions and new photographs to Invisalign. These will be used to create more sets of aligners in order to achieve the desired results.

• Part of the refining process may involve an equilibration of your bite. Equilibration is the process of making small adjustments to the shapes of your back teeth in order to help them fit together better. This procedure may be completed prior to making your retainers or after the retainers are in place. Minor adjustments to the bite are expected and part of treatment.

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RETAINERS

• Once treatment is complete, we will order retainers. You will wear your retainers full time, like your Invisalign aligners, for 6 weeks. After this time the retainers are then worn at night only – forever, or as long as you want your teeth to remain straight. Unfortunately, without retainer use it is possible for your teeth to move out of place again.

• Your retainers will eventually wear out, which will result in them losing their ability to function properly, allowing your teeth to shift. You will need to replace your retainers when this occurs. Your first set of retainers is included with your Invisalign fee. We recommend you bring your retainers with you at each cleaning appointment for us to evaluate and clean them at no charge. If you feel your teeth are changing their position, call us so we can evaluate. New retainers can be made when necessary.

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TREATMENT COSTS ​

YOUR INVISALIGN TREATMENT COSTS INCLUDE THE FOLLOWING:

• Your prescribed number of aligners

• All routine monitoring visits

• Additional fine-tuning aligners up to 180 days after last originally planned aligner

• Minor bite equilibration or adjustment

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THE FOLLOWING THE FOLLOWING ITEMS WILL REQUIRE AN ADDITIONAL FEE  

    (AND POTENTIAL REFERRAL TO A SPECIALIST):

• Extra aligners ordered from Invisalign due to tearing or loss of aligners

• Scans or impressions taken for temporary aligners

• Refinement needed 180+ days after Invisalign completion date

• Mid-course correction – usually due to noncompliance

• Retainers

• Change in original course of treatment – examples:

  • TMJ issues

  • Any final restorative treatment to teeth

  • Unexpected urgent/emergent dental needs that arise (chipped, broken, fractured, aching teeth, etc.)

  • Significant adjustments to the bite with extra trays or reshaping the teeth

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NONCOMPLIANCE

If you habitually do not follow the treatment course given to you, the end result cannot be guaranteed. Examples of noncompliance include:

• Continual loss of aligners

• Continual tearing/breaking of aligners

• Not wearing your aligners for the specified amount of time (22 hours a day, 7 days a week)

• Not showing up for your appointments

• Repeatedly canceling appointments

• Wearing the wrong set of aligners

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FREQUENTLY ASKED QUESTIONS

How many hours a day do I wear my aligners?
They should be worn minimally 22 hours a day. You should only remove them to eat, drink, and clean your teeth. All other times of the day and night they should be worn.

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How long is each aligner worn?

In order for the aligners to work properly, each set needs to be worn for 22 hours/day for the number of days prescribed (usually 7 days). You may need to wear your aligners longer if your teeth are not tracking or if a movement associated with the aligner is anticipated to be more complicated or unpredictable.

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How do I clean my aligners?

Each time you brush your teeth, take out the aligners and thoroughly brush the inside and outside of them with
cool water. A small amount of toothpaste or mild soap can be used. For most patients this is all that is needed to keep them clean. If you prefer an extra level of clean, Invisalign does offer cleaning crystals which you can soak your aligners in. You can order these directly from Invisalign. It is important to keep your aligners clean because failure to do so can result in decay, gum problems, and/or bad breath.

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Can I eat or chew gum while wearing my aligners?

No, you should remove your aligners to eat anything and avoid chewing gum. Eating in your aligners may cause them to tear or break.

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Can I drink while wearing my aligners?

It is recommended that you only drink clear cool liquids or water while wearing your aligners. Dark beverages (coffee, tea, red wine) may stain your aligners. Sugary and acidic beverages (Soda, Gatorade, Red Bull, orange juice etc.) should not be consumed while wearing aligners due to risk of erosion and/or causing cavities.

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Is it normal for my teeth to hurt when I change aligners? What can I do?

Yes, it is normal for you to have some discomfort on certain teeth. You may feel some discomfort for 1-2 days with each new aligner. Taking some over the counter pain medication (Ibuprofen, Advil, Tylenol, Aleve) as needed will minimize this discomfort.

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What time of day should I begin wearing my next set of aligners?

After wearing your current set of aligners for the specified time, the most ideal time to switch to your next set is shortly after your evening meal and before bed. Brush, floss and rinse your mouth, then place the next set of aligners and then do not remove them until you are ready to eat or brush your teeth the next morning.

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Can my aligners break or tear?

Yes, aligners can break or tear. You need to be careful removing them from your mouth and refrain from eating with them in. Both actions can cause your aligners to tear or break. We will instruct you on the proper way to remove the aligners from your mouth.

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What do I do if my aligner breaks, tears or is lost?

If you lose or break your aligners during the course of treatment, please call our office. We will decide if you can move to the next set of aligners or if we need to reorder the set you lost. It may be necessary to have you back up to your previous aligner and wear it until a replacement aligner can be ordered. If it is determined that you cannot move to the next aligner, one will be ordered for you for a fee of $75. Your previous aligner should be kept.

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What is interproximal reduction (IPR)?

IPR is a safe and effective way of creating the necessary space between crowded teeth in order to align them. Using a series of polishing instruments we can remove very small pre-determined amounts of enamel between your teeth (where floss goes) so that the teeth have room to move into proper alignment. There is minimal discomfort with this process and is usually completed with only topical gel anesthetic placed on the gum.

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What is the purpose of the attachments?

Attachments are designed to retain aligners as well as aid in the specific type of movement needed to properly align your teeth. Attachments are bonded onto the outside of your teeth, are tooth-colored and no anesthetic is needed to place them. At the end of your treatment they will be removed and the teeth smoothed and polished prior to having your retainers made. Because the attachments are temporarily bonded to the tooth, they can occasionally come off the tooth. If an attachment comes off, please call our office.  

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What happens if I don’t wear my aligners 22 hours a day for the number of days specified?
Your treatment cannot work as set up if you do not commit to wearing your aligners as you are directed. The aligners need 150-300 hours each to move and settle your teeth (depending on the amount of the tooth movement) before the next set is worn. If you deviate from the treatment course, there may be an additional fee to complete the treatment.

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Can I use an at-home whitening trays while in aligners?

No, due to the attachments on your teeth, at-home systems will not fully whiten your teeth. If you are interested in tooth whitening, please let us know and we can provide approved whitening systems for use with your aligners.