Index / Cosmetic
Invisalign
Moving a tooth
beats cutting
a tooth.
Aligners are used here for two jobs: straightening teeth for patients who want them straight, and moving teeth into position first so that any restorative work afterward can be far more conservative.
Why people come here
- He teaches occlusion and full-mouth rehabilitation to other dentists
- Fellowships in three academies — FAGD, FACE and FICOI
- The complex cases other practices refer out
- A written, itemized plan before anything is scheduled
The restorative argument
A tooth in the right place
needs less ceramic.
When a front tooth sits forward of where the finished smile should be, the ceramic has to go somewhere, and that means cutting into the tooth to make room. When the same tooth is moved back three millimeters first with aligners, the veneer can be paper-thin and the enamel stays.
The same logic runs the other way for a tooth that has tipped back or dropped down: move it, and the restoration becomes a cosmetic refinement instead of a rebuild. This is the single most reliable way to make cosmetic dentistry conservative, and it is why aligners appear in so many of the treatment plans here.
Aligners are also used before implants and full-mouth work, to open or close space and to upright teeth so the final result sits where the design wants it.
What it involves
Trays, worn, in order.
A digital scan is taken instead of an impression, the movements are planned, and a series of clear trays is made. Each one is worn for its prescribed period, moves the teeth a fraction of a millimeter, and is replaced by the next. Small composite attachments are bonded to some teeth so the trays can grip and push properly; they are removed at the end.
The trays must be worn twenty to twenty-two hours a day. This is the single factor that decides whether aligner treatment works, and it is entirely yours. Treatment that stalls almost always stalls for this reason.
At the end, a retainer is essential. Teeth that have been moved will drift back if nothing holds them, and that is true of every orthodontic method, not just aligners.
What aligners handle well, and what they do not
- Well: crowding, spacing, mild to moderate crooked teeth, relapse after childhood braces
- Well: pre-restorative movement — uprighting, intruding and repositioning individual teeth
- Less well: large skeletal discrepancies, significant jaw-size mismatch
- Less well: severe rotations of round-rooted teeth, and some impacted teeth
- Where fixed braces or an orthodontist would do a better job, you will be told that
Questions
Aligners, answered.
How long does it take?
Minor pre-restorative movement is often three to six months. A full straightening case is commonly twelve to eighteen months. The plan produced from your scan gives an estimated number of trays before you commit, and that estimate assumes you wear them as prescribed.
Can I have aligners and veneers?
That is one of the most common plans here, and the order matters: aligners first, ceramic second. Doing it the other way around means cutting tooth to compensate for a position that could have been corrected, and then possibly moving the finished veneers anyway.
Does it hurt?
Each new tray feels tight for a day or two, and teeth can be tender to bite on during that period. It is pressure rather than pain, and it settles. Most people change trays in the evening for that reason.
Will anyone notice?
At conversational distance, usually not. The attachments bonded to the teeth are tooth-colored but are visible close up, and the trays catch the light at certain angles. They come out to eat, which is the practical difference most patients care about.
Keep reading
Next step
Start with an examination and a straight answer.
A consultation includes an examination, the records the case needs and a written, itemized plan. If what you are asking for is not the right treatment, Dr. Nosti will say so and tell you what is.