Invisalign for crooked teeth, A case study.

Invisalign Case Study

Today, a patient came into our office with a complaint of crooked teeth. Her first question was if I can refer her to an orthodontist for braces. After examining her, we determined that she was a good candidate for Invisalign instead of traditional metal braces.


On examination of her teeth and mouth, I found that her lower teeth had crowding from relapse after having childhood braces. Her upper teeth also had crowding. I explained to her that she was a good candidate for Invisalign instead of traditional metal braces.

Benefits of Invisalign

I explained to her that the benefits of Invisalign over metal braces were many. With Invisalign, she can remove the aligners whenever she wanted to brush her teeth, floss, and remove them when she eats, whereas traditional metal braces cannot be removed. I also explained that the inability to floss when wearing metal braces can lead to a higher incidence of cavities and gum disease.

Obviously, another benefit of using the Invisalign trays is a cosmetic one. Most people will not even notice that the patient is wearing Invisalign, whereas metal braces are very obvious.


In comparison to metal braces, Invisalign offers the opportunity to visit the dentist or orthodontist much less frequently. Metal braces require visits to the orthodontist every couple of weeks in order to tighten them. Invisalign consists of a series of many custom-made aligners that are given to the patient in advance, and the patient goes through the aligner changes on their own, every 2 weeks. They follow up with us about every 6-8 weeks to monitor their progress.


Invisalign is not indicated for every patient, however, this patient had mild to moderate crowding and was an excellent candidate.

“How does Invisalign work?”

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My patient asked me, “how does Invisalign work?” I explained to her that we would first take x-rays and photographs of her teeth. We also use a high-tech scanner that gives a 3D visualization of her teeth. Using the scanner, called an Itero, we are able to plan her entire treatment in three dimensions digitally. We are able to show patients what their teeth would look like after they complete Invisalign. At this stage, our patient got very excited to see her new smile.


The Invisalign custom aligners are fabricated and designed in order to put pressure on the teeth where necessary to slowly move the teeth into alignment over a period of time. Each aligner is worn for approximately 2 weeks before switching to the next one. At each step, the teeth are pressured into moving closer and closer to the proper place and eventually are all in the appropriate alignment.


I also explained to our patient that she was to wear the Invisalign aligners as much as possible and try to wear them 20-22 hours per day. Basically, I instructed her to remove them only when brushing, flossing, and eating. For some patients, we apply clear “buttons” onto the teeth by bonding them in place. This allows the trays to grip the teeth better and move them as necessary. Also, on some occasions, it may be necessary to file the teeth in order to allow them to fit into place better. We try to do a little filing as possible to achieve our goals. Not all patients require filing.


Invisalign can be used for teenagers and adults. Invisalign does not completely replaced the need for traditional metal braces, but in a large majority of cases, they are an excellent alternative. Invisalign can be used to treat patients with crooked teeth, gaps in their teeth, and crowding of the teeth. Some patients require Invisalign for the top teeth, bottom teeth, or both.


I discussed with my patient that it takes anywhere from 6-18 months, or sometimes even longer, for treatment. Since her case was only mild, I advised her it would be approximately 10 months. Obviously, the more complex the case, the longer it takes for Invisalign to work. In some instances, patients require multiple refinements if the teeth are not moving as predicted. Even when it takes longer, or requires multiple refinements, the teeth eventually come out straight.

“What is it like living with Invisalign?”

My patient then asked, “what is it like living with these aligners?” I explained to her that the aligners are pain-free. There may be slight tightness or discomfort when first starting to use a new tray, however, there is no pain. This discomfort usually only lasts a day or two at most.  Most patients describe this more like pressure than pain. I explained to her that she needs to clean her aligners daily by brushing them, just like one would brush their teeth.


I explained to my patient that she would need to use a retainer after finishing Invisalign in order to prevent her teeth from moving back. This is also necessary when using traditional metal braces.

Cost of Invisalign

I explained to my patient that many dental insurances will cover Invisalign at 50-60% of their cost, up until their annual maximum. I explained to her that we would check with her insurance and let her know what her out-of-pocket cost would be prior to starting Invisalign. If insurance did not cover it, I explained that the cost would be $6,000-$7,500. This covers all the exams, all the aligners, the first set of retainers and all follow-up visits.


Our patient was concerned about the cost and asked if there are alternatives if her insurance did not cover it. I explained to her that we offer 0% financing through Care Credit and Lending Club.

“I would like to get started with Invisalign!”

Our patient decided to go forward with the Invisalign. We took an Itero scan of her mouth and showed her what her teeth would look like after the Invisalign was completed. She seemed very happy. After her scan was completed, we asked her to come back in approximately 2 weeks to pick up and get started using her new aligners. We took before photographs, and will take more photographs throughout the course of her treatment, and finally after photographs.


Invisalign is an excellent choice for anyone that thinks that may require orthodontic treatment to straighten their teeth. We invite you to call today and to come in for a consultation.

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