Orthodontist Palo Alto CA | Pristine Orthodontics | Invisalign: What you need to know

Invisalign Palo Alto


What You Need to Know about Invisalign

Invisalign is a great way of getting orthodontic treatment, but not everyone qualifies as an ideal Invisalign patient. Give our office a call to schedule your free complimentary exam and have Dr. Lee determine if you are a good candidate for Invisalign!



Unlike conventional braces which allow teeth to be pushed or pulled, Invisalign aligners can only push to move teeth. Each aligner is also limited in the amount of movement allowed. Therefore, to maximize the movement of each tooth, Dr. Lee will need to place attachments to push teeth in the right direction. They appear as “bumps” on the teeth and covered by the aligners during treatment. To incorporate better hygiene around the attachments, Dr. Lee uses a special light to clean off any excess material to allow for better oral hygiene practices by his patients.


 This procedure is used for both braces and Invisalign

Interproximal reduction

In order for teeth to be moved properly, excess enamel may be removed in order to alleviate crowding. Interproximal reduction (also known as IPR) helps create space by opening up the contacts between the teeth. This process is either done with a drill/disc, or manually with diamond strips flossed between the teeth. Typically it is done during the beginning and middle stages of treatment. This helps also ensure better tooth contacts that are tighter to promote good gum (periodontal) health. This procedure will not hurt you or your enamel, and may be necessary in order to achieve detailed and optimal results.


An Invisalign refinement is a common stage of treatment with this system.  It is similar to orthodontic treatment with traditional braces. At some point in treatment, the orthodontic specialist may determine that certain braces or brackets need to be repositioned for better advantage and/or the arch wires are adjusted to specifically move certain teeth.  These changes “refine” the positioning of the teeth being addressed by those procedures to improve esthetics or the fit of the teeth together.  With Invisalign, all of those “tooth movements” were intended to have been predicted and prescribed in the original ClinCheck and series of aligners.  The same was the case when the orthodontist first placed the braces on the teeth.  However, there are a myriad of reasons why adjustment or changes from that original prediction must be accomplished to further “refine” a patient’s results.  In some instances, several refinements may be necessary.  In other words, it is probably best for patients to understand that Invisalign may be a “multi-stage” treatment from the onset as more than one series of aligners may be required.  

The refinement process involves removing any attachments, new impressions or digital scans of the teeth, and the orthodontist performs a revised examination and prescription (ClinCheck).  It is critical that the last set of aligners is worn until the new series is initiated; otherwise, teeth will begin moving and the next aligners will not fit properly.  

A refinement should not cause for concern with your orthodontic specialist; however, if for some reason you are deciding to transfer to another orthodontist then there are some steps that will be required.  After an examination with the next orthodontist, your original records and ClinCheck will need to be requested from your first doctor and new orthodontic records will be required at the new office as well.  Only in that manner can the new doctor determine a course of treatment.   When you change to a new orthodontist you should also expect some new fees.


Just like with regular orthodontic treatment, there may a need to wear elastics throughout treatment. The elastics act as the additional forces needed to get the bite into the right position for the most ideal treatment outcome. Dr. Lee will go over how he would like you to wear your elastics as you progress through Invisalign treatment.


Your aligners should have no visible space seen between the edge of the teeth, and the aligner itself. The aligners should always fit tight over the teeth so no space is visible at the edge of the teeth. If a gap exists, aligner chewies should be used faithfully until the aligner fits properly.


To use the chewie, bite down and hold in the area where the aligner needs to fit better for 5 seconds, then release. Repeat this process for 10 minutes at a time, up to 3 times per day, until the gap is reduced.

**If you have a history of TMJ, do not use the chewies, but instead use steady finger pressure to push the aligner in place instead, always making sure not to put pressure on your lower jaw if the problem is on the lower teeth