There are four different Invisalign Systems to choose from:
1. Invisalign Full: This can be used to treat all types of malocclusion including those that require extractions. The treatment options are extensive and flexible and will offer a full solution to the problems you present with.
2. Invisalign Teen: This option is very similar to Full but is designed for the teenager with a developing dentition.
3. Invisalign Lite: This option is for people whose teeth are only mildly irregular. Often patients may have had orthodontic treatment in the past and the teeth have relapsed a little, or some front teeth have become a little crowded as wisdom teeth have erupted. It is limited to 14 sets of aligners and once the treatment plan has been agreed at the clincheck stage no alteration can be made. Invisalign Lite can be limited to treatment in one arch.
4. Invisalign i7: This is for even more mild problems than Lite and treatment is limited to 7 sets of aligners. Similar conditions apply as described with Lite.
You will be advised which of these is likely to be the most appropriate but this can be difficult to determine at the initial consultation. It becomes clear when the “Clincheck” is produced. At this stage one can see how much movement can be achieved with the aligners. It is possible to change between the systems during the clincheck approval phase. The Full and Teen systems will manage all aspects of treatment. The Lite and i7 systems are for minor corrections.
The aligners need to be worn 22 out of 24 hours of every day. They will improve the way your teeth fit and make them more even. This is done in a series of steps with a new appliance every two weeks. You will have a series of aligners at home and you fit them yourself. Each aligner moves the teeth in a very controlled manner. The number of aligners you need will determine the length of your treatment. Occasionally a few further aligners are made at the end just to detail some small tooth movements. Please be aware that this will add some extra time to your treatment but it is built into your treatment plan and there will not be any extra fees charged for this.
The appliances are made after taking very accurate impressions and records of your teeth. When the aligners are fitted you will require some small (1-2mm) tooth coloured attachments on your teeth to allow the aligners to hold onto and move your teeth. These attachments will be discrete and are easily removed at the end of treatment. Your teeth may require interproximal re-contouring. This is not unique to Invisalign treatment and does not damage your teeth unnecessarily. Your teeth will remain strong and as resistant to decay afterwards. Elastics are also used in some situations to help with the movement of your teeth. These are applied between the upper and lower teeth. They are recommended to be worn 24 hours a day.
Do not eat or drink with the aligners in place, except for plain water. This is to avoid tooth decay and to keep the aligners in good condition. You can clean your teeth without the aligners in place. This is one of the many advantages with Invisalign treatment. Cleaning the aligners should be done with warm soapy water and a clean brush or steeping them in “Retainer-Brite” which is available for purchase here. Each time you take them out you should try to rinse them and ALWAYS place them in the small container. They are very light and small and can be lost very easily, especially if wrapped in a paper tissue.
Supplemental orthodontic treatment may be required, including the use of bonded buttons, orthodontic elastics, temporary anchorage devices and sectional fixed appliances to achieve the desired result. All braces can cause minor changes to the roots of teeth. This is not usually a problem and it should not be of concern. Radiographs will reveal if your teeth are likely to be affected. Teeth that have been overlapped for a long period of time or that have been affected by periodontal disease may be missing the gingival tissue below the contact point. This can lead to a "black triangle" space developing between the contact point and gingival margin as they align. This will be reduced as much as possible with some judicious trimming between your teeth (interproximal reduction) to extend the contact point closer to the gingiva. If the contact point between your teeth is moved towards the gingival margin there is less chance of a black triangular space developing.
You will require 4 appointments to start treatment:
1. 30 minutes: Impressions and records
2. 3 weeks later, 10 Minutes: Clincheck approval – This can be done via email if you prefer
3. 2 weeks later, 10 Minutes: Fitting of the first aligner. This is a simple appointment to fit the first aligner. You will have a chance to practice and be given instructions on wearing the appliance and how to care for it. You will be given the first 3 aligners.
4. 5 weeks later, 45 Minutes: The attachments will be bonded to your teeth and the aligners checked for fit. Some inter-proximal reduction may be performed at this stage and you may be asked to start wearing elastics.
Subsequently, appointments will be every eight weeks and you will be given the next aligners (4 sets). Treatment progresses as the aligners are changed and this is normally every 14 to 16 days. You will be the best judge of this depending how your teeth feel. The current aligner should fit perfectly before moving onto the next stage. When you attend for visits please have the aligners in place. This is essential to allow me to judge how well your teeth are moving.
Speech may be affected at first but you will accommodate to them after a couple of days. You may have some slight discomfort when each aligner is fitted but this settles quickly. The edge of the aligner can be smoothed down if it feels rough on your soft tissues. If there is a problem with a new aligner please keep wearing the previous aligner until you can make an appointment to have this checked.
Failure to wear the appliances for at least 22 out of every 24 hours will lengthen the treatment and affect the ability of the appliances to achieve the best result. If they are not worn sufficiently then teeth will not track as they should and corrections, with further impressions and re-starting treatment, will be required. Loss of aligners will result in additional charges. You should keep all past aligners. If you lose the current aligner that you are wearing, having the immediate previous aligner provides a simple retainer to hold your teeth steady until you can make an appointment to see me. Sometimes you will need to retrace the steps of treatment if a tooth is not moving properly.
Cost structure for "Invisalign" appliance system.
Records to create "clincheck" £300 (Impressions and submission to Align Technology) the clincheck is the computer simulation of your treatment. You may choose to have the clincheck produced and then decide if you would like to proceed with treatment. If you have paid more than £300, with your initial deposit, we will refund the difference if you decide not to go ahead with treatment.
Fees (including the cost of the clincheck)
Full Invisalign, with extractions. £3900 (NB Your own dentist will be responsible for any extractions required)
Full Invisalign, Non-Extraction. £3600
Invisalign Lite, Dual Arch: £2500
Invisalign Lite, Single Arch: £1900
Invisalign i7, Dual Arch: £1800
Invisalign i7, Single arch: £1500
The clincheck provides a virtual 3D moving model (CAD image) of your teeth and the treatment proposed. I will show you this before having the aligners fabricated. It gives you a chance to see what I plan to do to your teeth and how they will look. As discussed earlier it is possible to swap between the different treatment options at this stage. Your decision will be influenced by how much correction can be achieved.
Retention is an essential part of any orthodontic treatment. The last aligner works as a temporary retainer but it is not designed for this purpose and will deteriorate over time. I will provide retainers and we will discuss which are the best for your situation. These are the options:
1. Essix type vacuum formed retainer. This is similar to an aligner but is made of different, thicker plastic. It is made here at the practice and two sets will be provided as part of your treatment fees.
2. Fixed or Bonded wire retainer. This is used in some circumstances to help hold the teeth stable but it should not be relied upon without the backup of a removable retainer. If the bonded retainer fails, distorts or debonds then the teeth will start to move out of position. The removable retainer can be used to hold them steady until the necessary repairs can be made. This type of retainer can be a problem to look after and will require regular check either here or at your own dentists. It is difficult to clean and care should be taken when brushing and flossing. An “airfloss”, produced by sonicare, may help. If it is appropriate to use these they will be included in the treatment fee.
3. Vivera Retainers. These are similar to the Essix retainer described above. However, they are made by Align Technology in a similar way to the aligners used to straighten your teeth. They are a superior form of removable retainer. You will receive 3 sets and your records will be held on file, digitally, at Align Technology. Replacement retainers can be ordered easily. They are extremely comfortable, robust and work very well. There is a fee of £300 for these and they can be made with further impressions of your teeth or by using the last stage of your treatment with the aligners.
FAILURE TO WEAR THE RETAINERS, AS DIRECTED, WILL RESULT IN YOUR TEETH MOVING OUT OF POSITION.
The retainers should be worn EVERY night. For the first week they should be worn in the evenings as well. If the retainers seem to fit less well (either too loose or too tight) you should increase the time (the number of hours in every 24 hours) you wear them. You should consider the retainers as a long term requirement. Teeth always have the potential to move out of position. I will supervise your retention for one year after treatment. Further appointments after this will attract a fee.
Replacement retainers can be made if you wish and the fee is currently £60 per retainer (£100 for both upper and lower retainers if they are made at the same time).
Once you have chosen a payment option please advise the receptionist and she will help make the arrangements. If you choose the third option, where payments are made on a monthly basis, you are responsible for setting up and monitoring the standing order. We do not operate a direct debit system. It is important that you advise us of the account name, which will be making the payments so that we can reconcile it against your account here. I cannot start treatment unless you commit to the deposit outlined below or pay a fee of £300 to cover the cost of the “Clincheck”.