How does the Invisalign treatment work?

The Invisalign aligners are transparent and discreet.  Advantages of the Invisalign technique include advanced comfort and faster results compared to traditional orthodontic treatment. Depending on individual, the desired results can be achieved as quickly as within six months of the start of treatment.

Invisalign treatment is carried out using computer imaging instead of the traditional plaster moulds. A patient’s teeth are first digitally imaged using an oral camera, and based on these images, the software generates an individual treatment plan and custom-made aligners that fit the patient’s teeth perfectly.

Digital 3D modelling is also used to accurately predict the results of the treatment. During the treatment, the aligners are replaced with more tightly-fitting aligners once every two weeks until the desired result is achieved.

Invisalign aligners versus traditional braces

During your treatment, you can visit a dental hygienist to have your teeth professionally cleaned. It is recommended that any whitening treatments are taken only after the alignment is complete.

Frequently asked questions on the Invisalign treatment

Treatment process

What will happen during my first appointment?

During your first treatment appointment, your teeth and occlusion will be digitally 3D imaged or replicated using the iTero scanner and your facial features photographed. Based on these images, a treatment plan will be devised and sent to you for assessment.

What will happen during my fitting appointment?

The purpose of the fitting appointment is to put in the transparent, plastic attachments as shown in your treatment plan and to test the fit of the first pair of aligners. The attachments ensure the desired realignment of teeth. During the fitting appointment, you will also receive instructions on the use of the aligners and the cost of the treatment will be discussed. You will also be given written instructions. Patients will leave their fitting appointment with the first pair of aligners on their teeth, which they will then switch for a new pair in approximately two weeks.

What are the attachments?

The location of the attachments is marked in red in the individual treatment plan. The attachments are small anchoring devices made of tooth-coloured plastic on the surface of the teeth. With the attachments, the aligners gain better grip on the teeth and, therefore, the planned realignment of teeth is better ensured. Teeth such as the long-rooted canines and lower incisors coming to a narrow end in particular may need attachments in case the rotation of the teeth is required. The attachments also help the aligners stay in place when the objective is for an adjacent tooth to be pushed down.

Are the attachments absolutely necessary?

In certain cases, attachments help achieve the desired results faster. Incisors can be left without attachments, but in this case the desired results may not be fully achieved.

What are the lumps behind the top incisors visible in the treatment plan?

To fix malocclusion, an occlusion plate may be added to an aligner to help push the lower incisors down.

What are the turquoise lines in the treatment plan?

Instead of attachment locations, turquoise lines in the treatment plan indicate pressure points in the aligner that help shift the roots of teeth into a better position.

How often will I have to change the aligners?

Early on in the treatment, one pair of aligners is usually worn for approximately two weeks. Once the teeth have started shifting, new aligners can usually be put in as soon as the old ones have felt slightly loose for a few days. If the new aligners feel very tight, the old ones can be worn for a few more days.

What if the new aligners don’t fit?

Wear the previous pair of aligners for 1–2 more days and try putting in the new ones again. If the aligners still don’t fit, try the next pair in the set. If this pair seems to fit, wear it for a few days longer than the usual two weeks. If for some reason an aligner has bent at a single tooth, the bent part can simply be straightened out.

Why are rubber bands necessary? Does everybody need them?

Rubber bands are used to adjust the occlusion, as in most cases the upper jaw is set slightly forward relative to the lower jaw. The masticatory muscles function better when the occlusion is well-balanced. Straight teeth remain straight better after the treatment when the occlusion is properly balanced. The rubber bands are changed 2–3 times per day. It is recommended that the rubber bands are taken out before eating and brushing your teeth. If necessary, it is possible to eat with the rubber bands in, but in this case the rubber bands can easily become dislodged. If you run out of rubber bands, call our practice and we will send you more.

What is Chewies and what is it for?

Chewies is a silicone tube that should be chewed between your teeth for a total of approx. 10 minutes every day. This daily chewing encourages blood flow in the teeth and promotes their realignment. Chewies also helps ensure that the aligners remain snugly in place. Using Chewies can also speed up the progression of the treatment and help ensure the desired realignment of teeth.

Is the Invisalign treatment painful?

The shifting of teeth may cause some pain. The pain is individual and is most often present upon the changing of the aligners. It does appear that the Invisalign system causes less pain than traditional orthodontic treatment.

Control appointments

What will happen during my first control appointment?

During the first control appointment, the progression of treatment and the fit of the aligners is checked and the instructions reviewed. If any two teeth are pushed too tightly together, the contacting tooth surfaces are polished so that the teeth can shift more easily. In some cases, the occlusion is adjusted using rubber bands. In this case, small anchoring devices are attached to two teeth and instructions given for the use of the rubber bands.

How often do I need to come in for control appointments and what happens on them?

Control appointments take place every 6–9 weeks. Control appointments are necessary for following up on the progress of the treatment and for monitoring the occlusion. During control appointments, the contacting surfaces of adjacent teeth are polished using polishing floss so that the teeth can better shift in the desired way. Straightening teeth is not very difficult, but balancing the occlusion can be more demanding and time-consuming. However, a balanced occlusion is crucial for the functioning of the temporomandibular joint and to ensure the results of the treatment are permanent.

Everyday life with the aligners

How are the aligners cleaned?

A children’s toothbrush and water are the best tools for cleaning the aligners. Using toothpaste is not recommended, as it can scratch the surface of the aligners. In addition to brushing, cleaning tablets for braces available at pharmacies are a good option for cleaning the aligners.

Can I eat with the aligners in? What about sugary drinks and alcohol?

It is OK to eat with the aligners in, but hot or sugary foods and drinks are not recommended. Sugar feeds the bacteria in your mouth, and the aligners increase the risk of cavities forming. Eating with the aligners can also be slightly uncomfortable. It is recommended that the aligners are taken out before eating, but it is definitely OK to eat with them in and to later take them out, rinse with water or to brush them.

Can I chew gum with the aligners in?

This may be difficult, as the gum will stick to the aligners. Xylitol pastilles are recommended over chewing gum.

Do I have to brush my teeth every time after eating?

No, you don’t. Rinsing your mouth with water and removing any remainders of food with a toothpick is a good option.

Can I wear the aligners while exercising or in a sauna?

Yes, you can.

The aligners cause my teeth to stain, why is this?

Flossing can easily be neglected during the treatment. With the aligners in, the tooth enamel has a higher risk of staining. Staining can easily be removed during an appointment at the practice with whitening paste or soda. For example, you can book a slightly longer appointment for the follow-up imaging of your teeth and have the staining cleared up at the same time. Soda cleaning is not included in the estimated cost of the orthodontic treatment. Staining can also be exacerbated by the decreased contact of the tongue and the mucous layer of the cheek with the surface of the teeth.

Can I trim the sharp edges of the aligners myself?

Yes, you can. You can file down the sharp edges using e.g. a nail file. If the aligner presses on your gums, you can use scissors to trim 1 mm off the edge where it is uncomfortable. Vary rarely, individual aligners may have manufacturing flaws, and if an aligner clearly does not fit or otherwise differs from the rest of the set, you can simply move on to the next aligner and wear this for a few days longer than usual. If an aligner is missing the openings for rubber bands, you can cut notches in the aligner yourself. If an aligner is too long or presses down on your gums, you can trim the edge of the aligner slightly.

For how long can I go without the aligners, e.g. due to an important occasion?

A maximum of 12 hours, and preferably not more often than once a week. The longer you have the aligners out, the easier it is for the teeth to reset and putting the aligners back in will become more difficult. Having the aligners out for extended periods of time may also cause pain in the teeth. If you need to have the aligners out for several hours a week, you must wear the aligners for 2–7 days longer than usual.

The surfaces of my back teeth do not connect, why is this?

As the aligners are placed between your teeth, if you bite down in your sleep, the thickness of the aligners may result in a temporary open occlusion of the back teeth. If necessary, an orthodontics specialist will cut out the section of the aligners covering the back teeth so that the occlusion can quickly rebalance itself. In some cases, rubber bands are applied on the back teeth to help close the occlusion. After the treatment is finished, the occlusion will also naturally become more balanced.

My teeth feel loose – is this normal?

Yes. With orthodontic treatment, the teeth are first loosened up so that they can move. After the treatment, in the retention phase, the new positions of the teeth are stabilised and the sensation of looseness will disappear in a few weeks. In a few months’ time, the bone material will become slightly harder than prior to the treatment.

Maintaining a balanced occlusion

Why do my teeth want to reset?

The hardening of bone material takes a few years, and during this time the teeth will want to return to their original positions due to the pressure of the lips and tongue. The teeth are attached to the jawbone with periodontal ligaments. These ligaments are made of connective tissue, and are gradually renewed every 7 years or so. As the ligaments renew, their pull on the teeth relative to their original position decreases.

How are the achieved treatment results maintained? Can my teeth move back to their original position?

All our teeth will want to shift and settle according to muscular pressure and the wearing down of teeth during our lifetime, so that the occlusion of the teeth remains balanced. After orthodontic treatment, retentive support is always required.

What is retention?

Retention is a support to ensure that teeth will move as little as possible after treatment is finished. Retentive supports include retention aligners, retention plates and retention wires. A retention wire attached to the inside of the lower incisors is preferably permanent. A retention wire behind the upper incisors can remain in place for several years. The use of a detachable retention device (aligner or plate) is decreased over time so that the occlusion can settle.

What is a Vivera retainer?

After Invisalign treatment, a Vivera retainer can be used to support the occlusion. Three separate pieces are usually made. These can last for several years and, if necessary, new ones can also be made. Keep your last Invisalign aligner so that, if necessary, it can also be used as a retainer.

Why do my teeth keep moving after the orthodontic treatment?

Teeth are supposed to keep shifting over a person’s lifetime, so that as the teeth naturally wear down, the occlusion can remain balanced without a potential overbite or gaps forming between the teeth. Teeth will shift according to the pressure of the cheeks and tongue, and will also constantly push out of the jawbone, pulled by the periodontal ligaments. If the teeth are in a position where they support each other, their pushing out of the jawbone will be inhibited as they come into contact with teeth on the opposing jaw. If the opposing pressure is lacking or at an incorrect angle, teeth may push out too far. If the pressure of the lip is stronger than that of the tongue, this may result in the teeth becoming crowded together. Opposite pressure can cause gaps to form between teeth.

Teeth hold up to short-term high pressure very well, but constant, light pressure in the same direction will make them shift. Orthodontics are based on the application of constant, light pressure, which will result in the teeth shifting to the desired position. Teeth will only shift within their biological limits. The teeth of adolescents will shift more and faster than those of adults.

If considerable shifting is required to achieve a balanced occlusion, oral surgery where the jawbone is shifted into a better position may be necessary in addition to the orthodontic treatment. With surgical treatment, an orthodontic appliance is used to even out the dental arches, after which the surgery is carried out and the alignment finished with orthodontic treatment.