It starts with what you want changed
The first appointment is a conversation. Tell us what bothers you when you look in the mirror: a crowded front tooth, a gap, a tooth that has drifted, or teeth that have moved since braces years ago. We look at your teeth, gums and bite, and tell you plainly whether aligners are a good fit for what you want. Adults and teenagers bring different questions, which Invisalign for adults and Invisalign for teens answer.
Aligners move teeth. They do not fix a tooth that needs a filling, and they do not work on gums that need treating, so those come first. Some bites are better handled with braces, and when that is the case we will say so and refer you to an orthodontist rather than start something that will not finish well. Invisalign compared with braces sets out that choice.
The iTero scan replaces impression putty
Instead of a tray of impression putty, we scan your teeth with an iTero wand. It is a small camera on a stick that is moved around your teeth, it takes a few minutes, and there is no putty to hold in your mouth while it sets. You can pause whenever you need to.
The scan becomes a three-dimensional model of your teeth on the screen, and everything that follows is planned from it. If X-rays are needed as well, they show the roots and bone that the scan cannot, and they are digital, which takes a fraction of the exposure that film did.
You see the plan before you commit
From the scan, a plan is built showing how each tooth is meant to move, stage by stage, and where it is meant to finish. You look at it with us before you agree to anything. If the finish is not what you hoped for, that is the moment to say so, before a single aligner has been made.
The plan is also where honest estimates come from. How long treatment takes depends on how far your teeth have to travel and on how consistently the aligners are worn, so we estimate it from your plan rather than quote a figure beforehand. The fee is quoted from the plan too, in writing, before you start. There is more on that in what Invisalign costs.
Wearing the aligners, about 22 hours a day
The aligners come as a series. You wear each one for a set period, then change to the next, and each is shaped to move your teeth a little further along the plan. A new aligner feels tight for a day or so. That pressure is the teeth moving, and it eases.
They are worn about 22 hours a day: out to eat, out to brush, and in the rest of the time, including while you sleep. This is the single thing that decides whether Invisalign works. Teeth move only while the aligner is pressing on them, so an aligner left in its case does nothing, and a plan built on 22 hours a day falls behind when the hours slip.
Attachments, check-ups and refinements
Some teeth need something for the aligner to push against. For those, we bond small tooth-colored attachments to the tooth, little shaped bumps that give the aligner a grip. They blend in with the tooth, and they are polished off at the end.
You come in for check-ups along the way, so we can see that the teeth are following the plan and the aligners still fit as they should.
Toward the end, a tooth or two may not have quite reached its planned position. When that happens, we take a new scan and have a few extra aligners made, called refinements, to finish the job. That is a normal part of treatment, not a sign that something has gone wrong.
What happens after Invisalign?
When the last aligner is done, you move to a retainer. Teeth tend to drift back toward where they started, and the retainer is what holds them in their new place. A lot of the adults who ask us about aligners had braces as teenagers and a retainer that ended up in a drawer, which is usually how their teeth moved again.
Plan on the retainer being part of your routine for the long term. We will tell you how often to wear it, and check it at your regular cleanings and exams along with the rest of your mouth.
Questions patients ask
Does Invisalign hurt?
Most people describe pressure rather than pain. Each new aligner feels tight for a day or so while the teeth start to move, and then it eases. An over-the-counter pain reliever, taken as the label directs, is usually enough for the first day or two.
How long does Invisalign take?
It depends on how far your teeth have to travel and on how consistently you wear the aligners. We can give you an estimate once your scan and plan are done. Anybody who quotes you a number before looking at your teeth is guessing.
What is the iTero scan like?
It is a small camera moved around your teeth for a few minutes. There is no impression putty to hold in your mouth, and you can pause whenever you need to.
Do I need a retainer after Invisalign?
Yes. Teeth tend to drift back toward where they started, and a retainer holds them in their new place. We will tell you how often to wear it, and it is worth treating as a long-term habit.