In this blog Paula Buffham gives advice on teeth straightening treatment with Invisalign. The current scientific evidence has shown that the effectiveness of aligner type treatments, such as Invisalign, in moving teeth is less than fixed “train-track” braces – about 59% compared to over 90% for a fixed brace. However, as a clinician I know from experience that what you put into any treatment is what you get out of it.

There are 2 really important aspects to make Invisalign work well:

Patient compliance:

It is true to say that Invisalign will only deliver a good result if the patient wears the aligners for at least 22 hours a day – without fail! The patient also has to accept that there will be visible attachments glued onto the teeth. Although these attachments are tooth coloured, they will stand proud of the teeth and be as big as a cosmetic “fixed brace” bracket in some cases. These attachments help grip the aligners and transfer the movements from them to the teeth.

Patients must also use an aligner chewie as much as possible. This is a soft cylinder that helps seat the aligner fully onto the teeth. Ideally this should be used when driving, watching TV etc. The patient may also need to have some of their teeth ‘shaved’ to help them fit together better and in order to release the tight contacts between each tooth for freer movement.

Treatment with Invisalign may also take a little longer than fixed braces to see any visible change in the front teeth, but do persevere and remain compliant as the outcomes are well worth it!

Proper treatment planning:

Invisalign have a team of technicians who set up the cases but they need to be fully directed by the clinician. If the clinician gives them little input, the patient will get what the clinician set ups, even though the technician has never seen the patient. The technicians are also not in a position to consider the imitations of any treatment, so proper treatment planning by the clinician is essential.

I recently attended a breakfast symposium held by Invisalign at the British Orthodontic Conference in Edinburgh and I got a huge amount out if it. The key learning was that any Invisalign case needs to be planned out in the same way as you would a fixed brace case. I had worked to this principal with my Invisalign cases already, but it was nice to be shown some more advanced cases that I normally would not have recommended Invisalign for. This has opened up more possibilities for using aligners in our practice, even cases that need to have teeth removed.

By planning everything properly, it is possible to deliver as good a result with Invisalign as can be achieved with fixed braces. And even if it’s not, we have the tools and training to get you there with a short course of fixed braces.

So Invisalign is a good alternative to fixed braces when properly planned, and for those clinicians who have a good understanding of the principles of orthodontics. With the understanding of what is needed to finish a case, and in the right hands, you’ll get the result you are looking for without the need for long treatment with fixed braces. But the patient plays a huge part in the success of Invisalign treatment, and in working together with the clinician the best possible result will be achieved.


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