Invisalign clear braces: everything you need to know before having the teeth straightening treatment

Doesn’t it feel like virtually everyone on Instagram is getting Invisalign at the moment? The Invisalign invisible braces treatment, which straightens teeth with a clear invisible aligner, has rapidly gained popularity in the past couple of years. Top cosmetic dentist Dr Uchenna Okoye has seen around a 70 per cent increase in patients coming to her dental clinic London Smiling for Invisalign treatment. It's a phenomenon that she puts down to the 'Zoom face boom'.  

“It’s a manifestation of all the Zoom calls we’ve been on. You don't often stare at yourself for such a long period of time. Because so many people are doing it, it no longer feels like it’s such a ‘vanity project’," she says. Our increased reliance on video calling has given rise not only to greater demand for cosmetic dentistry but all manner of non-surgical cosmetic procedures and anti-ageing tweakments.

Invisalign is popular with celebs, too. Kendall Jenner, Billie Eilish, Zendaya, Serena Williams and Justin Bieber are just a few of A-listers who have had the treatment.

Invisalign became the perfect lockdown project as it did away with some of the public awkwardness of removing the aligners every time you eat. Makeup artist Keshia East is one of many of those people to have had Invisalign fitted. “I’ve always wanted to have Invisalign but being In lockdown definitely gave me an extra push,” she previously told us. “It was the perfect time to get them done as I’m at home all the time. I had been considering it for a few years and having life stop unexpectedly does change your mindset; it made me realise that life can just change in and that there was no time like the present.”

Anyone can get Invisalign, provided they have adult teeth, “whether you’re 18 or 88,” says Dr Uchenna. You may think that teeth straightening was something you had to do in your teens or 20s, but in fact, people in their late 30s onwards may benefit equally, says Dr Uchenna.  “As we get older, our teeth move and start to get crowded because our gums are held together by collagen and when this becomes lax our teeth are not held in place so well. So your late 30s and early 40s is a good time to think about doing it, because the longer you leave it, the longer you need to wear it for."

She describes Invisalign as "age-proofing" because the effects of ageing can be most visible on the lower face. The lower third of the face begins to drop which means our bottom teeth are visible and this makes us look older, she says. Invisalign gets teeth back in line for a more youthful appearance and can have a face-lifting effect.

"By expanding your arch, it acts as a scaffold for your face, lifting and filling out the skin around your mouth so you don’t get as much creasing by your nose. I actually sometimes have to wean some of my patients off wearing their Invisalign aligners for this reason!"

Invisalign in a nutshell: 

• What is Invisalign? Invisalign is a brand that makes custom-made clear removable braces that gently move teeth to straighten them, close gaps and correct over or underbites. The treatment involves wearing a progressive series of different aligners day and night. You see your dentist for a review every few weeks.
• How much does Invisalign cost?:Invisalign costs anywhere between £2,000 and £7,000.
• How long do you need to wear Invisalign for? You need to wear Invisalign aligners for 20 to 22 hours per day, only removing them to eat, drink, floss or brush your teeth. Treatment plans can last anywhere between six months and three years, depending on the complexity of the issues it needs to fix. 

How does Invisalign work?

“Clear aligners are an orthodontic appliance based on a series of trays that you change weekly or fortnightly and every time you change the tray the teeth move,” explains Dr Rhona Eskander, cosmetic dentist at  Chelsea Dental Clinic. “With brands like Invisalign, a dentist works with you to monitor and plan your teeth movements.” 

An initial consultation typically involves going in for an assessment, X-rays and obtaining a diagnosis, explains Dr Rhona. "Once that’s done, we take scans of the teeth which are sent off for something called a Clincheck, a plan which shows your teeth and how they’ll move, which takes two weeks to come back. Once you’re happy, the aligners are ordered." So-called Invisalign attachments - which look like little white blobs - are fixed to the front of your teeth to help the liner stay in place. Your dentist may also do some filing between the teeth (IPR or interproximal reduction) to make space for the teeth to move if you have crowding. "You’re then given a bunch of trays which you change every one to two weeks at home and seen every eight to ten weeks." 

Is Invisalign the only clear aligner brand?

There are a number of different clear aligner brands that can straighten teeth, but Invisalign is by far the best known because it was one of the first. “It’s a bit like when you say, a Hoover for a vacuum cleaner,” Dr Uchenna says, adding that she chooses to use Invisalign as she finds it the "most predictable” system in terms of results.

Which dental problems can Invisalign fix?

Invisalign can solve most "mild to moderate" orthodontic problems including crowding, crossbite, underbite, open bite, deep bite and spacing. "If you have bridgework on some of your teeth or more complex issues your dentist may suggest another treatment option,” says Dr Rhona. Traditional braces are often more suitable for more challenging issues

Invisalign isn't just aesthetic but beneficial to oral health, too, points out Dr Uchenna. "When your teeth are straight you are able to clean them better, so suffer less with plaque and in turn, less gum disease," she explains. "But remember that Invisalign is only one of the things in my toolbox, I can get teeth straight with it, but it doesn't mean that they’ll look pretty, so it's about managing expectations."

What are the main benefits of Invisalign over traditional ‘train track’ braces? Is Invisalign truly invisible?

The main attraction of a clear aligner such as Invisalign is the aesthetics, points out Dr Rhona. "They’re much less noticeable than the wires and brackets of traditional ‘train track’ braces. Another bonus is you can physically remove the aligner from your mouth, say, to clean and floss your teeth, without having to work around wires and brackets.”

Train tracks, though, are usually a cheaper way of straightening teeth and can be more suitable for more challenging orthodontic issues. “The best thing about traditional braces is that the control is taken away from patients as they're permanently attached to your teeth,” offers Dr Uchenna, "whereas, with Invisalign, there is the temptation to take it out.”

How long do you need to wear Invisalign for?

Your Invisalign dentist will prescribe a treatment plan for anywhere between six months to three years in extreme cases. Dedication to your aftercare is a major element of the Invisalign treatment. After you have finished wearing your clear aligners, you’ll have to wear a retainer at night to keep your teeth in alignment for the rest of your life. Some people will need an (invisible) fixed retainer that sits behind the teeth for life.  

For Invisalign to work, it requires compliance.“You need to wear clear aligners for 20 to 22 hours per day, the only time you’re supposed to remove the aligners is when you’re eating, drinking (anything other than water), brushing or flossing your teeth,” explains Dr Rhona.  “If you don’t take the aligners out when you’re eating or drinking, food can get stuck in them,  causing bacteria to grow along your teeth or gumline, which could lead to decay. Meanwhile, liquid can seep down into them and cause staining of the aligners and your teeth.”

Ideally, you only want to take it out of your mouth four times a day, Dr Uchenna says. "First when you wake up in the morning to brush your teeth, then put it back while you have a shower and get dressed. Take it out for breakfast, lunch and dinner (then brush again). In many ways it makes you eat in a much more intentional way."

If you don’t think you can commit to wearing your Invisalign aligners for this amount of time each day, and think you may be tempted to slip them out more often, Invisalign may not be the best choice for you.

How much does Invisalign cost?

Invisalign can cost anywhere between £2,000 and £7,000, depending on where you are in the country, the treating dentist and the complexity of the dental issues. Dr Uchenna warns that if anyone is offering Invisalign on the lower end of the spectrum to “always check that retainers are included within that cost.” 

Does Invisalign hurt?

Typically Invisalign is less painful compared to traditional train tracks, according to Dr Uchenna. “Sometimes it's a bit sore the first night, I like to use the analogy of putting on a new pair of shoes, they're a little bit tight for the first few wears, and then it relaxes. But generally, it's very comfortable. I always recommend my clients practice reading out loud when they first get Invisalign as it just makes your tongue get used to having it in your mouth.”

Can you do teeth whitening or have composite bonding with Invisalign?

In terms of what order to do things in, it’s always best to wait to whiten teeth after having Invisalign treatment. “I personally love doing edge bonding after orthodontic treatment, for example, after Invisalign once the teeth are perfectly straight, we can place some edge bonding to make the edges of the teeth look neater. This is minimally invasive, long-lasting and least destructive to the teeth and edge bonding is only suitable for cases where the teeth are perfectly straight.”

Can you wear Invisalign if you’re pregnant?

Invisalign is safe for pregnant women, though Dr Uchenna generally recommends planning to have Invisalign either before or after pregnancy where possible because if you suffer from morning sickness, having an Invisalign aligner might make you gag more.

Can Invisalign help with teeth grinding?

Yes. “If you grind your teeth, it puts pressure around your mouth and the muscles around your face can go into spasms,” Dr Uchenna says. “So by having a plastic aligner, you're grinding teeth to plastic, or ideally if you're wearing top and bottom, then plastic to plastic, which is much gentler and helps to relax muscles around the face.”

Can invisible liners by mail order straighten teeth?

Both experts strongly advise against using teeth straightening treatments that do not involve seeing a dentist in person for a consultation and regular follow-ups. “You've only got one set of teeth,” says Dr Uchenna. “I get that Invisalign is an investment, but when I'm doing Invisalign, I normally see my patients every four to six weeks (I’m a bit of a control freak!), but also because I want to catch any problems early. When you are moving teeth from A to B, it's a complex process of addition and subtraction, if this process gets out of control, then you can have a whole host of problems, so it really needs to be closely monitored.”

How should you clean Invisalign?

Don’t use very hot water. "This could warp the plastic, which can alter the fit and affect your progress and the effectiveness of the aligners,” Dr Rhona instructs. Simply brush gently using your toothbrush and cold water.

MORE GLOSS: Teeth grinding: are you wearing down your teeth without realising?