Wiki

In this section we will try to explain, in chronological order,

what happens with Invisalign in our practice.

1. Consultation

This first step takes about 40 minutes, and involves analysis of your x-rays and an examination and discussion. We will cover all aspects of your problems and their treatment, such as:

What you want corrected
What can and can't be corrected
What else can be seen on your x-rays and from the facial and oral examination
If Invisalign is your best option
Alternative treatment options
Preliminary needs (such as a dental check-up etc, referral to other specialists)
How long treatment will take
Cost of this treatment
Retention
Any questions you have

You are then given a written quote and information about treatment. If you wish, you can then make appointments to proceed.

If you are unsure, you should take time to consider everything, maybe requiring further discussion or obtaining a second opinion. We find that many people think of questions later, and we encourage you to ring us with these, or return for further discussion. It is very important to get everything clear before you commit to 1-2 years of orthodontic treatment. More information on Consultations is on this page.

2. Records

Once you decide to proceed, we make three linked appointments.

At the first appointment, we take photographs and impressions (moulds) to send to the Invisalign laboratory, plus we make our own records. We then send instructions to Invisalign outlining the treatment required, based on the Consultation and any subsequent discussions or documents.

After about two weeks, a “ClinCheck” is posted on our section of the Invisalign Doctor's site. This is a highly detailed 3D graphic of the teeth, and the movements in treatment. We review this, and make corrections as necessary. With each alteration, a new ClinCheck is posted, and reviewed. Commonly it takes 2-3 ClinChecks to arrive at the ideal treatment plan; in some cases this can even need up to 7 or 8 modifications!

This has a simplified view of a ClinCheck - in reality it is much more complex.

For technical details about the manufacturing process, see this link.<http://www.invisalign.com/How-Invisalign-Works/Pages/Default.aspx>

3. First Aligners

The first aligners are ready to be fitted 5-6 weeks later (second appointment). Here's what they look like.

During this time you can bleach your teeth if you wish – you can use your first aligners to carry the bleach. We can sell you the bleaching gel, and explain its use. Because the attachments (see next section) would interfere with uniform bleaching, the next opportunity to bleach would be at the finish of your aligners.

At the start.

You should expect that the Aligners will feel very strange, and possibly a bit tight for the first two or three days. This will get better quickly, but not if you remove the Aligners too often.

Changing Aligners.

You will change the aligners at home for new ones every 2 weeks. Change them at night, and you will find that any tightness is mostly gone by the morning.

Wearing time.

Remove them only for eating, brushing, flossing, drinking, and sport (if wearing a mouthguard). Aim for 20-22 hours per day wearing - this is critical.

Eating.

After eating, brush your teeth as soon as possible and replace the Aligners. If you cannot brush your teeth, at least rinse thoroughly, and immediately replace the Aligners.

Drinking.

If you do not want to remove them for drinking, make sure you rinse the Aligners and the teeth immediately afterwards, then put the Aligners back in.

4. Attachments

You have 4-6 weeks to get used to the Aligners, before we fit any “attachments” necessary. These are little buttons of tooth-coloured composite dental filling material, glued to teeth where needed to give a better grip to the Aligner. Attachments can be seen here.

Most people need some attachments on their side or back teeth.

5. Appointments

We will usually check you about every 6-8 weeks – or at any stage if you have problems. Once treatment is underway it usually proceeds smoothly (if you wear the Aligners properly – sorry, did I say that before?).

This means that we can spread visits even further for our long-distance patients, or those heading off on long holidays.

Most of these appointments will be brief – just for monitoring, and we usually run on time.

6. Refinements

At the end of the Aligners, if the teeth are not corrected as planned, we send for more aligners (Refiners). Probably about 50% of our patients need some Refiners, which may add another 3-4 months. The Aligners correct most or all of the problems, and these Refiners are to ‘tweak’ the result. *Important note* - there is no extra charge for Refiners if treatment progresses normally (see “Case Refinement” at the bottom of this page).

To order Refinement Aligners, we take new impressions and photographs, and send these off to Invisalign. While we are waiting for the new ones to be delivered (about 4-6 weeks), you hold the teeth in position by wearing the last set of Aligners just at night.

Again, after Refinement, in the unlikely situation that the results are still not what was planned, we can use fixed braces (no further charge, if you have co-operated as instructed).

7. Retainers

After the teeth are straight we fit retainers. Our retainers are very like the Aligners, so they are easy to get used to. You will wear these at least 12 hours per night for the first year, then as needed for as long as you want your teeth to stay straight. As well as the retainers which we make, your last set of Aligners provides a back-up set of retainers.

We review our patients in retention for a year, after which we trust them to continue wearing their retainers, and return when necessary.

The retainers we make will usually last 3-5 years. Unfortunately, teeth keep moving throughout life. So, if the retainers are lost, worn out, or broken, they must be replaced, either by us or by a local dentist or orthodontist.

If you stop wearing the retainers, your teeth will go crooked again. If you continue to wear your retainers, your teeth will stay straight.

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And that’s just about it.

If you have any questions, please call us on (07) 3366 0022, or use the Contact Us form.

What follows is some more detailed information that we put on a CD for each of our patients, along with their pre-treatment photos and movies of their final Clincheck, to show them their treatment. Some of the following is already covered above; most is only relevant to patients already in treatment.

WHAT DO I DO IF…

* I lose or destroy an aligner?

ANSWER: Usually you can go straight to the next aligner, although this may be a little tighter than normal for a while. Please let us know if this happens, as we may need to rearrange appointments.

If you do not have the next aligner, go back to wearing the previous one, and contact us as soon as possible.

* My aligner has split?

ANSWER: If it is a small split, and you can continue to wear the Aligner, do so as long as possible up to the normal two weeks. If the aligner is too uncomfortable, or breaks completely, then follow the instructions in the question above.

* I lose several aligners?

ANSWER: Contact us ASAP. Sometimes it is possible to skip two or three sets of aligners and continue treatment normally.

If this is too painful, go back to wearing the last aligner and let us know ASAP. In that case, we would need to order replacement Aligners from Invisalign. This takes several weeks and incurs extra fees (currently about $800, depending on how many are needed).

* My aligner is not fitting fully over the teeth?

ANSWER: This often happens for the first day or two with a new aligner. If it has not improved after a couple of days, call us and we will advise you.

WARNING – The most common reason for Aligners not fitting – they have not been worn!

* My teeth are sore?

ANSWER: Most people will experience a little discomfort each time they change their aligners. This usually only lasts a few hours. A small number of patients report two or three days of tender teeth. If the discomfort is unusual, please contact us. In most cases paracetamol is sufficient to relieve any pain until the teeth settle.

It is difficult to be specific, as pain is a very personal experience, and varies with general health, mental and physical state, pain threshold and tolerance etc. Keep reminding yourself that it would be much worse with braces.

* I have lost an attachment?

ANSWER: If one of your attachments comes off, please contact us as soon as convenient during business hours. Do not change to the next aligner.

If you have the attachment templates that were given to you when they were placed, please bring these and your current set of aligners to your next appointment.

* I am reaching the end of my aligners, but some teeth are still not straight?

ANSWER: This is not unusual. The Invisalign process and charges include “Refinement” aligners if needed (and if you co-operated fully. See below). About half our patients require these.

Note - this does not apply to “Invisalign Lite”

Most commonly we will take new impressions (moulds) at the end of the initial sets of aligners, and send away for more. The good news is that these aligners usually fit better, because they are made on updated moulds.

* I have finished my aligner treatment and am wearing my retainers. My teeth keep trying to move back?

ANSWER: This is absolutely normal. Teeth continue to move throughout your life. They will move more, or less, at different periods, and in different people.

We usually suggest wearing the retainers twelve hours every night. For some people this is too much, and for some it is too little.

If the teeth are moving during the day when the retainers are out, wear them a few hours extra. In some people, this can mean wearing the retainers day and night for a while.

* How long will my retainers last?

ANSWER: If they are not eaten by the dog, run over by a lawn mower, put through the tumble dryer, lost at sea (or in your airline baggage), or cooked, they will usually last between two and five years per set. Most dentists and orthodontists can make replacements, anywhere around the world.

* When can I stop wearing retainers?

ANSWER: If you ever stop wearing your retainers, your teeth will move. Keep wearing them and your teeth will stay straight.

Case Refinement - Invisalign’s Fee Guidelines

It is important to understand Invisalign’s rules in relation to fees and treatment progress. We do not set these rules – we have to follow them!

For Invisalign Full and Teen, but not for Lite, Refinement Aligners are provided at no extra charge. However, Invisalign allow 2 weeks per Aligner, and Refinement must start within 180 days of the estimated normal finish time, or further charges apply (currently approximately $600).

360 days after the estimated normal finish date, Invisalign consider treatment completed. If more Aligners are requested after this time, this is considered new treatment, and a full fee applies.

Let's set the scene for an imaginary patient:

• Treatment starts 1/1/11

• 26 sets of Aligners

• Estimated treatment time is 26 x 2 weeks per Aligner = 52 weeks

• Invisalign’s estimated treatment finish date 1/1/12

• Free refinement is available until 1/1/12 plus 180 days – that is before 29/6/12

Now, let’s look at some possible scenarios:

Example 1: Free Refinement

• Patient co-operates normally

• Free refinement is available if needed.

Example 2: Some problems

• Patient does not wear Aligners properly, but still finishes the 26 Aligners on 2/5/12. Still in time.
• Free Refinement still available if needed.

Example 3: Extra Fees Apply

• Patient does not wear Aligners properly, and does not finish the 26 Aligners until 2/7/12. Out of time.
• No free Refinement available. Extra fees will be charged (approx $600 currently).

Example 4: Mid-Course Correction needed – extra fees

• Patient does not wear Aligners properly, and the Aligners no longer fit, but still before finish date (ie before 29/6/12).
• New impressions needed for “Mid-Course Correction”. Extra fees will be charged (approx $850 currently).

Example 5: Serious Extra Fees Apply

• Patient does not wear Aligners properly, and does not finish the 26 Aligners until 2/2/13, or just does not finish.
• No free Refinement available. Invisalign considers treatment fully completed on 1/1/13. A new treatment would apply, and full fees will be charged.