When people think about orthodontic treatment, let’s be honest, most of us think metal brackets and wires. If you are a teenager or adult, a “clear alternative” might sound like a better option. Invisalign® continues to grow in popularity as an effective alternative to braces. It is most definitely talked about, but you may be wondering: What exactly is Invisalign and how does it work?

Our team at Igel Orthodontics has put together this easy-to-follow guide to help you understand the ins and outs of Invisalign.

First Things First

Generally speaking, Invisalign can treat almost anything that braces can:

  • Crooked Teeth
  • Overbite
  • Underbite
  • Crossbite
  • Gaps in Teeth
  • Open Bite
  • Crowded Teeth

Invisalign is great at what it does. However, there are certain situations where it may not work as effectively as traditional braces. The determining factor in whether Invisalign is or is not right for you is the severity of your case.

Dr. Igel and Dr. Chartrand believe each case is unique — and a complimentary consultation will help us determine what is right for you.

The Next Steps

Once we determine that you are a good candidate for Invisalign, we’ll take detailed records. These records include:

Dr. Igel and Dr. Chartrand will review each of these with you, discuss your desired orthodontic results and provide a customized corrective treatment plan.

We believe the key to a successful outcome with Invisalign is a is our highly skilled orthodontists creating the right treatment plan for you. When Invisalign is your prescribed treatment, Dr. Igel and Dr. Chartrand will create a complete treatment plan, from the initial position of your teeth to their final desired position, with the use of advanced 3D computer imaging technology. The records taken are sent to the Invisalign lab with detailed instructions on how they want your teeth to be moved. Once Dr. Igel and Dr. Chartrand approve your treatment plan, Invisalign clinicians start to create your custom-made clear aligners, also called trays. Once our office receives the trays, typically in three to four weeks, we’re ready to start the straightening process!

The Specifics

Each set of Invisalign aligners are worn for (usually) one week at a time. Aligners are designed to move your teeth in small increments. Each aligner is designed slightly straighter than your teeth. This puts gentle, constant pressure on your teeth, so that over the course of the week, your teeth move to match the aligner.

As you progress in the series of aligners, your teeth continue to move — little by little, week by week — until they have straightened to their final positions.

You’ll visit Dr. Igel or Dr. Chartrand once every 2 to 3 months to ensure your treatment is progressing as planned. The initial number of aligners worn during treatment can vary and are dependent on your specific case.

The length of treatment should not be confused with the initial number of aligners. For example, If Dr. Igel or Dr. Chartrand mentioned you would need 50 initial aligners during treatment, and you changed your aligners every week, that would mean you will be finished in 50 weeks – which is less than one year! Right? Not exactly.

After completing your initial series of aligners, Dr. Igel or Dr. Chartrand will determine if an additional series of aligners are necessary to perfect your smile. If more aligners are needed, we will take an updated digital scan of your teeth, and Dr. Igel or Dr. Chartrand will submit an updated prescription for additional aligners needed. These additional aligners are a result of “Refinements”. Patients should always expect at least 2 to 3 refinements.

What are Refinements?

Refinements are a natural part of aligner therapy. This means you may have a few more sets of aligners to complete your treatment. For example, you may have 50 initial aligners on your first set that get you close to your result. On your second set you may have 25. Then you may only have 10 on your next set. The number of aligners in successive sets typically is less but not always.

Just like when we prepared for your initial set of aligners, Dr. Igel and Dr. Chartrand spend a lot of time assessing every tooth movement and designing your aligners. Once they are designed and shipped, we will see you for your refinement appointment. At this appointment, you can expect that some attachments will be removed and others will be bonded to your teeth. Careful planning is factored into this appointment in determining the number of attachments that are needed.

While orthodontists are well trained at assessing the types of movements that are required to achieve your ideal results, moving teeth on a computer screen is much different then moving them in the human body. Keeping this in mind, you can imagine that there are several variables that affect the way your body responds to orthodontics. We make every attempt possible to predict and accommodate for this but there will always be a degree of variability.

There is also the compliance factor where the patient’s ability to wear the aligners according to our recommendations affect the results as well. For all of these reasons, we say that you should never expect to be finished after the first set of aligners. While finishing treatment in one set of aligners is possible, it is not likely.

Final Thoughts

With braces, you come in every 8-10 weeks and your wire is changed or an adjustment is made to your wire. When your body does not respond to the desired tooth movements, it is easy to adjust your wire at your next visit and redirect the course of your treatment.

In contrast, with Invisalign, Dr. Igel and Dr. Chartrand try to plan your entire treatment from start to finish when he designs your aligners. When your teeth do not move the way that they move on the computer, then an adjustment needs to be made. Think of your refinements as a wire adjustment.

There are many advantages to aligner therapy. One is that you can go 12 weeks or more without having to see us. The drawback is that when an adjustment is needed, it is more involved and takes a little more time to shift gears when you have aligners than it does with braces. This is not a bad thing. Just understand that refinements are a normal part of aligners.

 Invisalign Benefits

  • You can — and should — take your aligners out any time you eat or drink. This means none of the frustrating food restrictions that come with traditional braces!
  • Aligners are virtually invisible, making it the perfect choice for a more aesthetically pleasing option and for patients who prefer a more subtle treatment option.
  • Brushing and flossing can be difficult with traditional braces, but removable aligners make good dental hygiene a much easier process, helping keep your teeth and gums healthy.
  • You can remove your aligners temporarily for senior photos, sports events or any other special occasion.

Important Considerations With Invisalign

Aligners alone may not move your teeth into alignment …attachments are sometimes a necessary part of Invisalign to help move your teeth.

Attachments enable aligners to move with a little extra force to shift teeth into their proper position. This extra force is used when alignment changes cannot be accomplished on their own because of the size, shape or angle of a specific tooth. Below are some things to know about Invisalign attachments:

  1. The attachments are tiny. Invisalign attachments are little, tooth-colored dots made of composite filling material that are bonded to teeth to help the Invisalign aligners move teeth.
  2. Location matters. The attachments are usually placed around the middle of the tooth, serving as an anchor to make an aligner work more effectively.
  3. Shape can vary. An attachment can be circular, square, rectangular, or triangular. The type of attachment you receive depends on the goal that we are trying to achieve, like tooth rotation, intrusion or extrusion.
  4. Attachments have an important job. Attachments serve as anchors for your aligners, allowing the aligners to fit more snugly over your teeth and move more effectively. When your teeth shift into alignment the way they’re intended, your treatment with Invisalign will proceed smoothly, and you’ll have a beautiful healthy smile before you know it!
  5. Attachments can sometimes be annoying. Because attachments click into the aligners at designated spots (to better secure your aligner tray over your teeth), putting in your aligners takes some precision. You won’t just be clicking Invisalign in and out on a whim. Some patients complain that attachments irritate their mouth when their aligners are out, while others dislike that food builds up around the attachments during meals. (You need to be diligent about cleaning the attachments and your teeth after every meal and before aligners are put back in place.)
  6. Not every tooth needs an attachment. The number of attachments you need will be determined by our orthodontists. If you do require attachments on certain teeth, they may not be necessary for the entirety of your treatment.
  7. Sometimes attachments are obvious, sometimes they’re not. If you need attachments on your front teeth, they’ll be more noticeable than on other teeth. Dr. Igel and Dr. Chartrand will match the shade of the attachments as closely to your natural tooth color as possible so they blend in with your teeth.
  8. Adding attachments is simple. The surface of your tooth is prepped for bonding. Dr. Igel and Dr. Chartrand will use an Invisalign template to mark the locations of the attachments, fill the template, then cure the bonding so the tiny attachments harden and stay in place. When you no longer need the attachments, they will simply be buffed off your tooth.
  9. You may not need any attachments at all. If your treatment plan is straightforward and the Invisalign aligners can do all the alignment work on their own, you may never need attachments on your teeth.
  10. Attachments make Invisalign possible for more patients. If you’ve been told that Invisalign could never work for your complicated alignment problems, don’t give up — schedule an appointment with Dr. Igel or Dr Chartrand to find out for sure. Attachments can help aligners achieve tooth movements that would not otherwise be possible with Invisalign.

If the thought of getting attachments has you changing your mind about Invisalign, don’t let it. Remember, Invisalign aligners and the attachments are difficult to see. They are not nearly as obvious as brackets, wires and elastics. Your attachments will be hidden by your aligners most of the time, and they will make your orthodontic treatment more effective, and therefore, faster.

To find out if you or your teen are a good candidates for Invisalign, schedule an appointment with Dr. Igel or Dr. Chartrand at our Omaha, Nebraska, office today!

Wearing Your Aligners

For the duration of your treatment, you will be expected to wear your aligners for a minimum of 22 hours a day. This will help move your teeth into their final position for that particular set of aligners. If you do not wear your aligners for the prescribed time, your teeth will not move into their anticipated position, and your next set of aligners will not fit correctly. By the time you are multiple trays into your treatment plan, the fit will be noticeably off. In the event your treatment does get off track, Dr. Igel or Dr. Chartrand may have you go back to previous aligners to get your teeth into the position needed to proceed with treatment. It’s important that you keep all your aligners until you have completed your Invisalign treatment. Returning to previously worn aligners will delay your treatment completion time but is sometimes needed to get you back on track.

The best results from your Invisalign treatment are obtained when your teeth fit perfectly in each aligner before you move on to the next. To help ensure your aligners are seated firmly over your teeth, you will be provided with:

    1. Chewies
      You will know your aligners are not fitting well (and are therefore unable to work effectively) when there are air gaps between your teeth and the aligner. If you notice these gaps, we recommend using “chewies,” which are small, cylindrical cushions. By biting up and down on chewies a few times a day, as well as each time you take your aligners out and put them back in, you will help seat the aligner, which means the aligner fits tightly against your teeth. Using chewies regularly will increase the likelihood that you will finish treatment on time. Need more chewies? You can order more on our online store!

 Cleaning Your Aligners

Each morning and night, remove your aligners and brush and floss your teeth. Also, gently brush your aligners with your toothbrush and rinse before putting your aligners back in. This is important because bacteria can build up on the trays overnight and throughout the day.

Prior to putting your aligners back in after eating, you should brush and floss your teeth and rinse your aligners. Putting aligners back in without brushing can trap food particles inside the aligners. This can lead to cavities and other dental issues down the road.

Are Rubber Bands Needed With Invisalign?

Yes, sometimes … Rubber bands are usually recommended when more force is needed to move the teeth into proper alignment, so your upper and lower jaws fit together.

When your top teeth stick out over your bottom teeth, this is called a Class II Malocclusion, better known as an overbite. When your bottom teeth stick out over your top teeth, it is called a Class III occlusion, or an underbite. When your bite fits together properly and evenly, it is called a Class I Malocclusion. The goal in wearing rubber bands with Invisalign aligners is to achieve a Class I occlusion where your teeth come together to form a perfectly aligned bite for effective chewing, as well as improved overall health and well-being.

If rubber bands are recommended, it’s important that they are worn every day as prescribed. Remove them to eat and hook them back up after you brush and place your aligners back in your mouth.

How Are Rubber Bands Worn on Invisalign?

That’s a great question! With braces, you have hooks already on the brackets for wearing rubber bands. Invisalign doesn’t, so Dr. Igel or Dr. Chartrand will place “buttons” (small plastic or metal brackets) on your teeth. Then, the rubber bands are hooked on the buttons. Sometimes, the aligner itself will be one of the anchors for the rubber band. In this case, your aligner will be trimmed into a hook shape for the rubber band to hook on to. The buttons themselves are pre-made from Invisalign and are simply adhered to your teeth.

The rule of thumb when wearing the rubber bands is to change them twice a day so they don’t lose elasticity.

 How Visible Will the Buttons Be?

The buttons are typically made in a color very close to the color of your teeth to make them less visible. They are generally placed close to the gumline to make them less noticeable. While the buttons are less visible, the rubber bands themselves will be visible when you are wearing them.