“Too bad the whole treatment wasn’t with one of these.”  That’s what 27-year-old- Zia Chisti thought when his orthodontist (finally!) took off his metal braces and showed his retainer to him. Zia found himself thinking about this every time he handled that retainer. What if, he wondered, you could straighten teeth, beginning to end, with a removable, inconspicuous appliance? This was the birth of Invisalign. Zia, at that time, was taking an MBA degree at Stanford University. He began to flesh out his idea in his dormitory room there. He founded Align Technology in 1997, the same year he graduated. The company’s orthodontic device won FDA approval 3 years later. The Invisalign advantage would soon be available everywhere.

The first patient was treated in 2000.  That was 18 years ago. Since then, more than 5 million patients in 90+ countries have been treated by over 100,000 Invisalign-trained orthodontists. Invisalign is recognized as an appealing alternative to traditional metal braces. The Invisalign cosmetic advantage makes it the only acceptable option for some people.

WHAT IS INVISALIGN?

Zia Chisti and his team developed his basic concept into the clear aligner treatment that’s the industry leader. About 27 competitors have emerged since Invisalign pioneered this approach to orthodonture.  No metal braces are involved.  Rather,  movement of teeth is achieved with precision, custom-fabricated, removable clear plastic “trays”, or aligners. They’re thin, soft, and snooth. Patients apply these aligners to their teeth and remove them at will.  The orthodontist fabricates new aligners every few weeks to keep up the pressure as the teeth shift. The aligners, as the trade name suggests, are nearly invisible to others.   

INVISALIGN ADVANTAGE: APPEARANCE!

To the degree that appearances matter,  there’s no question about it. This is Invisalign’s main reason for being.  Invisalign trays are, indeed, invisible to anybody who’s not trying to spot them. Moreover, when an Invisalign patient wants total invisibility – he or she simply takes out the aligner. When the big meeting (or first date) is over – back in they go.

INVISALIGN ADVANTAGE: HYGIENE!

Appearance isn’t the only advantage Invisalign offers. There are oral hygiene benefits, too. Metal braces are hard to keep clean. They’ve got nooks and crannies that catch hold of food bits and don’t want to let go. Metal braces are pretty good at defeating toothbrushes. Trapped food bits, even tiny ones, are like resort hotels for bacteria. The bacteria that cause plaque, tooth decay, and gum disease. Patients with metal braces are at risk for weakened tooth enamel around their brackets.  In contrast, Invisalign trays come out before a patient eats. The patient has the opportunity to brush and floss as usual, and to clean trays before replacing them. All told, Invisalign is much less prone to increasing oral health risks than are metal braces.

NO BLOOD

Anybody who’s had metal braces knows that they can cut your tongue, lips, and inner cheeks. This is especially so when, for example, a wire works loose and becomes a barb. Invisalign trays are soft plastic, no sharp protrusions at all.  Furthermore, the pressures applied to teeth by Invisalign are far milder than those by braces. There’s less risk, in general, of damage to patients’ teeth.

Finally, most patients find the experience of Invisalign treatment more comfortable and less trouble than the traditional options. Less social stress, fewer complications, and shorter treatment times than with metal. Align Technology’s data shows the current average treatment duration is about 12 months.

SO WHAT’S THE CATCH??

At this point, you’re probably wondering why an orthodontic patient would think of choosing anything besides Invisalign.  And yet, you look around yourself and see that some do. Successful Invisalign treatment does, in fact, ask for some patient participation to achieve the best results. It’s not much of a catch, especially when a patient knows going in what to expect.

LIFE WITH ALIGNERS

Patients will have to wear their Invisalign trays 20 -22 hours out of each 24, as a rule. You should always remove them before eating. You should also remove them before drinking any liquid besides water. Beverages with pigment, like red wine, tend to stain the plastic. Sugars in drinks – including dry white wine- can seep in between aligners and teeth, promoting decay.  Hot liquids are another problem.

After eating, it’s essential to brush and floss before replacing the aligner trays. This is a must. Otherwise, the aligners will trap food residue and squash it against the teeth.  Moreover, it’s best practice to clean the aligners themselves before putting them back in. Cleaning aligners is pretty simple. You brush them inside and out and rinse. Rinse in cold water, because heat can deform an aligner. This distorts the pressure pattern it applies to teeth. That’s also the reason for avoiding hot liquids.

TOO MUCH TROUBLE?

You’ve figured out this means packing a toothbrush, toothpaste, and floss everywhere you might be eating. In fact, your orthodontist may even give you a special brush for the Invisalign trays. And, of course, you’ll need someplace to stash trays while they’re out.  There may be more than the normal number of trips to the bathroom. That’s pretty much the whole enchilada of Invisalign’s “burden” on patients.  People adapt very quickly. Weigh this against the upside.

HURT MUCH?

Fair question, if you’re still looking for a catch.  Most orthodontists agree that the Invisalign causes less pain than metal braces.  Moreover, any pain is usually less intense and shorter-lasting.  The research tends to confirm what orthodontists know from their experience.  Research also shows that Invisalign comfort and treatment outcomes are best when aligners aren’t deformed. The technology enabling the fine precision in shaping each patient’s aligners is a key part of the Invisalign advantage. Thus, the importance of avoiding hot drinks, as noted before.  Invisalign trays treat a patient well when the patient treats the trays well!

EXPECTATIONS

In sum, the Invisalign option offers real plusses over metal braces. In “exchange”, the patient needs to make a few lifestyle adjustments.  That said, we know that these habits are easiest to learn when patients fully understand, up front, what they’re going to have to do. What the “deal” is.  Near-invisibility, more comfort, better oral health, less chance of injury. Isn’t that worth a little bit of extra effort? The whole thing is over a lot sooner, too, than with metal.

FOR YOU?

So, back to the question of why anybody would choose metal braces over Invisalign. Invisalign works well for most, but not all of the scenarios we’ve always treated with metal bands. These include overbite, underbite, crossbite, gap teeth, open bite, crowded teeth, and crooked teeth. If there’s any kind of catch, it’s this: Invisalign isn’t the best treatment choice for all patients. Is it right for you?

Your Serene Dental orthodontist makes that call.  Each patient and each mouth is unique. For some patients, Invisalign isn’t right.  Even when an orthodontist okays Invisalign, though, the ball lands back in the patient’s court. People who won’t or can’t care for their teeth and their trays properly, for example, have some reflecting to do. If the ducks are all in a row, and all lights are green, a patient can go into Invisalign with solid confidence in a comfortable process with a great outcome. This is the Invisalign advantage.