"It's like having a railway line in your mouth": that's Lisa Andrews' definition of traditional braces, an analysis delivered with some ruefulness as her braces were fitted before global growth in a new, easier way to straighten teeth: clear aligners.
Clear aligners are a modern orthodontic treatment to straighten teeth; their recent popularity is because, compared to conventional metallic or ceramic braces, the clear trays which fit over the teeth are more comfortable and less intrusive. More to the point, many users think they look better than a mouth crammed with steel or ceramics.
Because the almost-invisible aligners can be removed, they allow users to eat anything they want, unlike traditional braces – an advance Andrews says she missed out on.
Invisalign, one of the leading providers, claims that more than 10 million patients worldwide have used Invisalign clear aligners as they have become a widely accepted orthodontic treatment.
Christchurch orthodontist Dr Ronald Sluiter* says clear aligners mean that straightening teeth doesn't have to compromise looks or lifestyle: "The reason for the growth is that they are aesthetically pleasing – and more people are taking advantage of the huge strides
technology has made over 20 years ago."
Sluiter estimates over 50 per cent of patients at his practice opt for clear aligners over braces and other methods – and he expects that to increase to 60-70 per cent in coming years.
"I don't want to give the impression that clear aligners are some kind of silver bullet. As orthodontists, we have to find the best way to help our patients and get results – and each case depends on the patient and their particular circumstances and requirements. We have a treatment plan and an objective plan and we use whatever tool is needed to achieve those objectives.
"In some instances, an old-fashioned tool like fixed appliances [braces] may be better for certain patients than clear aligners – and vice versa. But we do find the aesthetics and the ease of use means clear aligners tend to sell themselves when patients have a choice."
The Invisalign system is a customised treatment based on over 20 years of research and intelligence. The system uses a series of custom-made clear, removable plastic aligners to move teeth into the desired position over time. The aligners fit over teeth and are changed every few weeks.
Sluiter says the treatment is often a little more expensive or about the same as traditional braces. While every case is different, average time for teeth straightening (whether using braces or clear aligners) is somewhere between 12-24 months, depending on the complexity of the case.
The aesthetic element stems from the transparent aligners – allowing people to smile with more confidence even during treatment – and there are no metal brackets which catch the gums or inside of the mouth. Because they are removable, wearers can take them out to eat (something braces users can't do), and to brush or floss their teeth, within the 22 hours a day they are required to wear the clear aligners.
Suitably qualified and experienced experts need to be part of the care throughout the patient's procedure – and orthodontists are an essential part, Sluiter says. That's because of the technology involved and also because highly trained professionals can uncover other problems that the patient may not be aware of and which may affect treatment and outcomes.
An orthodontic-prescribed treatment such as Invisalign clear aligners is completely customised, every detail designed especially for a particular patient – achieved after a precise digital 3D scan of a patient's mouth and smile. That allows the specialist orthodontist or dentist to assemble a plan to straighten the teeth effectively in a reduced timeframe.
"There's no doubt many people like the advantages of clear aligners," says Sluiter. "I always tell my patients about the big advantage of being able to take them off and eat whatever they like.
"But I also always tell them that taking them off is a big disadvantage too. The aligners need to be worn to do their work – teeth movement is caused by force on a tooth and if that force is not there, there is no movement.
"So I tell patients that clear aligners will be good for them as long as they are good to the clear aligners and good to themselves by doing what they should do."
Sluiter says news of the clear aligners has spread fast: "It's like wildfire, especially among teenagers, and sometimes if I say we can't use clear aligners for their particular problem, there is extreme disappointment."
Some clear aligners are only designed to address minor to moderate teeth correction. For more complicated issues – or where a dental professional has identified a more complex problem with a patient's bite – research is recommended to find out what aligner can fix those specific problems.
For more information: www.invisalign.co.nz/beclear
*Dr Ronald Sluiter is an Invisalign provider and key opinion leader for Invisalign NZ Limited. No payment was provided to Dr Ronald Sluiter for this article and the opinions expressed are his own. Invisalign treatment is a series of clear plastic removal orthodontic aligners that gently move patients' teeth. Invisalign must be administered by a healthcare professional. You should always read and follow their directions for use. © 2021 Align Technology, Inc (San Jose, California). All rights reserved.