If you are looking into orthodontic treatment, you might be feeling a little lost in the myriad of options available today. Amongst choices such as ceramic, lingual, and metal braces, we also have Invisalign, a form of clear aligners that is primarily known for its near-invisible look.

Invented in 1997, Invisalign is the world’s first complete aligner system. Over the years, this FDA-approved technology has become a choice alternative to traditional braces not just for its invisibility, but its comfort, removability, and overall convenience.

The innovation behind Invisalign makes it possible to fix nearly all common teeth misalignments with minimal disruption to everyday life, but as with all other types of orthodontic treatments, there are still pros and cons to consider.

There are several clear aligner brands in Singapore, including Zenyum, ClearCorrect and Aurora. For the sake of this article, we’ll be focusing on Invisalign, one of the more popular clear aligner systems. 

What is Invisalign, and how does it work?

Invisalign is a form of clear aligners made of a patented blend of plastic. Like other forms of braces, these aligners assert pressure on your teeth to slowly move them into a better position.

Though Invisalign is a solid piece of plastic, they are not to be confused with retainers because the former actively moves your teeth to reshape your mouth and jaw, whilst retainers simply hold your teeth in place.

What is the process of getting Invisalign in Singapore like?

To get Invisalign treatment, you’ll first have a consultation with your dentist. They’ll study your smile, observe your oral health, and take 3D images and impressions of your mouth and jaw. 

Following which, your custom fit aligners will be made. Your orthodontist will also create a treatment plan, and make a series of customized plastic aligners for you.

Invisalign aligner trays are usually replaced every one to two weeks. Each replacement tray will feel slightly different, as they’re each designed to continually shift your teeth.

Your dentist will also serve as your partner and guide in helping you achieve the dental results you desire.

Types of malocclusions Invisalign can correct 

Invisalign not only corrects crooked teeth, but it also corrects malocclusions.

Malocclusion refers to when your teeth are crowded, meaning your teeth are too large for your mouth, or crooked. It can also refer to misaligned upper and lower jaws, and while most malocclusions are treated with orthodontics or braces, some serious cases might require surgery.

Malocclusions can cause a range of dental issues, depending on type and severity. Treatments such as Invisalign can help to prevent future dental issues such as gum recession, bone loss, or chipped teeth.

Here are four types of malocclusions Invisalign can help correct:

• Cross Bite: When the top and bottom jaws do not meet up properly due to a lateral misalignment of the upper and lower arches. It is usually characterised by some of the top front teeth sitting inside the front lower teeth.
• Open bite: When the top and bottom jaws do not meet, or there is a gap between the top and bottom teeth, making biting and chewing highly difficult. 
• Overbite: When the top front teeth overlap the bottom front teeth by more than 25%. Corrective treatment may be required to prevent future jaw pain and premature tooth wear.
• Underbite: A reverse overbite. With an underbite, the lower front teeth overlap the top front teeth as the lower jaw is too far forward, making it difficult to chew and speak properly.

Read: Can Invisalign fix my underbite?

How long do I have to be on Invisalign for?

While the length of Invisalign treatment depends on the complexity of your case, you could complete your treatment in 6 months. Most Invisalign patients also start seeing results in a matter of weeks! 

After assessing your case, your orthodontist will recommend an Invisalign treatment plan that best suits your need. 

*Each set lasts one to two weeks.

What comes after Invisalign?

Similar to other types of orthodontic treatments, you can expect to use a retainer to keep your teeth from shifting back to their original positions. Retainers can either be removable or cemented to your teeth, and tend to cost roughly $150–$450 per set.

Your orthodontist will introduce different types of retainers to you and explain their pros and cons. They’ll also advise you about how long you’ll need to be wearing your retainers for each day.

The five types of retainers commonly available are:

• Essix retainers: Removable and clear plastic retainers that resemble aligners. Made of thinner plastic than Vivera retainers.
• Vivera retainers: Made of thicker plastic than Essix retainers, these are Invisalign branded retainers which offer the advantage that the retainers can have the same teeth alignment as the last set of Invisalign aligners with straight teeth.
• Zendura retainers: Zendura is a robust rigid polyurethane material which was developed specifically for retainer and aligner applications, and is optimised to have the ideal strength for durability and comfort as a retainer. These are the top choice for clear retainer materials.
• Hawley retainers: A removable combination of metal wire and acrylic. A traditional type of retainers that are usually given for young patients. They can be uncomfortable as the acrylic arches are bulky and can reduce the amount of space in the mouth.
• Permanent retainers: A metal wire that is bonded to the inside of one’s teeth, holding the teeth in place. These wire retainers are not easily visible from the outside. 

Each type has different pros and cons in the areas of durability, ease, comfort, and cost. Permanent retainers, on the other hand, are great for patients who might want a more carefree approach to maintaining the alignment of their front teeth. 

Is Invisalign as effective as braces?

Studies[2] have consistently shown that when it comes to the correction of mild to moderate malocclusions (imperfect positioning of the teeth when the jaws are closed) in non-growing patients who do not require tooth extractions, Invisalign is a choice alternative to traditional orthodontic therapy. 

Moreover, Invisalign aligners can predictably level, tip, arch expansion and closure of extraction spaces in teeth, similar to traditional fixed braces.

On the other hand, Invisalign may have more limited efficacy when it comes to mesially impacted molars and severely rotated teeth. Your dentist may suggest auxiliaries that, together with the Invisalign treatment, can treat these situations more predictably.

Conversely, Invisalign’s advantage lies in the efficient movement of teeth, and shortened treatment duration[3] as well as visualisation and greater control over the final outcome by the patient.

In conclusion, the real question to ask is not if braces or aligners are better, but which type of orthodontic treatment best suits your needs.

Is Invisalign painful?

Both aligners and traditional braces come with a level of initial discomfort. But you’ll be happy to know that:

• Invisalign has proven to be more comfortable than braces, especially in the first week of active treatment.
• Most people do not describe Invisalign as being painful.
• Invisalign is less uncomfortable both when you’re chewing and at rest.
• Invisalign is less uncomfortable than braces when it comes to subsequent adjustments.

A study[4] has also shown that more patients with fixed braces reported taking painkillers during their first week of treatment than those with aligners.

Read: When is the pain from Invisalign a concern?

Is there a minimum age requirement to get on Invisalign?

Not at all. Be it for adults or teens, Invisalign can be a great solution for those looking to improve their smile in an inconspicuous manner. In the same vein, there is no maximum age limit for Invisalign treatment.

Additionally, younger patients can opt for additional blue wear indicators on the outside of their aligners that will help them ensure they’re wearing their clear aligners for long enough daily.

Pros and cons of Invisalign

Do’s and don’ts with Invisalign 

Here’s the good news: You can eat what you want during the course of your treatment. Because Invisalign aligners are easily removable, there’s usually no need to refrain from your favourite foods.

However, we strongly recommend that you follow these Invisalign do’s and don’ts:

• Do be disciplined with wearing them: You should only take your aligners out when you are brushing your teeth, drinking, or eating. Additionally, you should be wearing them for at least 20-22 hours a day.

• Avoid heavily pigmented drinks: It’s important to drink nothing but cool or body temperature water when your Invisalign aligners are in. Anything dark or pigmented, such as coffee, has the potential to stain them.

• Take care of your Invisalign braces: Maintenance is the key to success. In order to prevent any unnecessary woes, clean your Invisalign braces regularly. Failing to do so will cause plaque and bacteria to accumulate. Your aligners can also get distorted or break if they are taken out with too much force, so handle them with care.

• Don’t rush your treatment: Your teeth need to move at a consistently slow and gentle pace for treatment to be effective. Thus, it is important that you follow your dentist’s instructions for the hours of daily wear and interval between changing aligner sets. Rushing the treatment can cause teeth to not track or follow the movement planned for them, which will require more treatment time and cost to recover.

• Don’t play with your Invisalign braces: You’ll be doing your best to get used to your aligners during the first couple days of treatment. During this period, leave your aligners alone. Avoid examining the edges of the aligners with your tongue, or biting your teeth together as a habit, or they may get scratched.

• Don’t leave them in when eating: Needless to say, before every meal, you should safely remove your aligners and place them in their container. Eating with aligners on could damage them, and delay your treatment. 

How much does Invisalign cost in Singapore?

The price of Invisalign treatment in Singapore tends to range from $4,500 to more than $10,000, and largely depends on the type of Invisalign plan (Express, Lite, Moderate, or Comprehensive) that your dentist recommends.

Other factors that affect the cost of Invisalign treatment include:

• The complexity of your oral health needs, and how much orthodontic work is needed
• Whether you need related treatment such as teeth extractions or auxillary appliances to speed up or assist the treatment 
• Your location and the average prices in your country or city
• The type of retainer you choose after Invisalign

Can I use Medisave or insurance to pay for Invisalign? 

MediSave in Singapore is only claimable for dental treatments that involve surgery, and for medical reasons. As Invisalign is non-surgical and is considered an aesthetic treatment, it is not claimable by MediSave.

Some types of insurance will cover Invisalign as it is a form of orthodontic treatment. It would be best to bring this up to your dentist during your initial consultation should you want to claim for Invisalign under your insurance plan.

You may also opt to create a monthly payment plan for your Invisalign treatment. This will allow you to make lower payments every month; your dentist will likely ask for a down payment at the beginning of your treatment.

In conclusion…

If you think your teeth need some fixing, or simply want a more beautiful smile without going through metal braces, we highly recommend Invisalign. Contact us today to begin your Invisalign journey.

References:

1. Vivera Retainers - From The Makers Of Invisalign . (n.d.). Www.invisalign.com.sg. Retrieved August 14, 2022, from https://www.invisalign.com.sg/vivera-retainers

2. ‌Papadimitriou, A., Mousoulea, S., Gkantidis, N., & Kloukos, D. (2018). Clinical effectiveness of Invisalign® orthodontic treatment: a systematic review. Progress in Orthodontics, 19(1). https://doi.org/10.1186/s40510-018-0235-z

3. ‌Ke, Y., Zhu, Y., & Zhu, M. (2019). A comparison of treatment effectiveness between clear aligner and fixed appliance therapies. BMC Oral Health, 19(1). https://doi.org/10.1186/s12903-018-0695-z

4. ‌ White, D. W., Julien, K. C., Jacob, H., Campbell, P. M., & Buschang, P. H. (2017). Discomfort associated with Invisalign and traditional brackets: A randomized, prospective trial. The Angle Orthodontist, 87(6), 801–808. https://doi.org/10.2319/091416-687.1

If you’re a Singaporean who is interested in getting braces, you’re not alone. Locally, there is a rising trend of adults seeking orthodontic treatment at the National Dental Centre of Singapore (NDCS), as seen from statistics from 2011 to 2017[1]. 

When getting braces in Singapore, it’s important to know the treatment options available, and your finance solutions.

Read on to find out more about the cost, process, and subsidies available for orthodontic treatment in Singapore. 

What causes crooked teeth?

How do braces work?

Simply put, braces work by applying pressure on your teeth over time to move your teeth in a desired direction. What occurs simultaneously is that the shape of the bone supporting your teeth will also change.

Orthodontics is the specialisation of treating patients with crooked teeth. This is done by using braces and other methods to straighten teeth and other issues. A combination of methods is used to ensure a better-looking smile and better overall health.

Braces can be fixed to your teeth, or removable. Clear aligners, such as those by Invisalign, are one such example.

What are the benefits of braces?

From improving your self-confidence or self-esteem to correct speech impediments, braces are beneficial for many reasons. 

How much do braces cost in Singapore? 

The average cost for braces can range from as low to $2,000 or as high as $11,000. Because orthodontic treatment is highly customised, prices tend to vary largely, and are affected by factors such as your age, insurance and type of braces.

The cost of braces is also dependent on factors such as:

• The complexity of your case
• The extent of treatment required
• Type of orthodontic material used
• Whether you will need extraction or jaw surgery
• Your dentist’s level of expertise

While public institutions offer cheaper priced services, do know that waitlists can stretch as long as two years. However, a private clinic will be able to provide you with quicker service and more attention. 

Now, there are a few main types, like metal, ceramic, and clear aligners. Here, we’ll assess the costs, plus pros and cons of each one. 

With the above in mind, remember that your dentist can always help you decide what type of braces are best for you. If you’re an adult or working professional, you might want to prioritise looking for braces that will not dampen your smile. 

Can braces be paid by MediSave or insurance?

Unfortunately, dental treatments like braces and extractions are generally not claimable under the MediSave[3] scheme, unless the treatment involves surgery and is deemed medically necessary.

Read: Dental treatments that can be paid with MediSave

In terms of insurance: you will need to secure a health insurance plan with dental coverage added to it. At Dental Designs, we are an accredited provider for most major international insurance companies, including AIA, MHC and AON IHP. 

Find out more about our dental insurance coverage.

Expats: You can purchase an add-on to your international health insurance plan that could cover up to 50% of your orthodontic costs. And if you already have a private health insurance plan, you can also add on coverage for braces.

With that said, we do not recommend buying a plan just to get coverage for braces since the annual cost of some of these plans is nearly the same as getting braces.

Are there subsidies for braces in Singapore? 

Your dentist might be offering a special discount on braces, so never be too afraid to ask. Additionally, they might offer a family treatment discount, or concessions if you pay for your treatment in full.

Some dental practices in Singapore also offer discounts for students and NSF personnel.

• Student packages typically include a consultation, X-rays, scaling and polishing and braces, sometimes at up to a 25% discount.
• Full time NS personnel with a valid 11B are also offered similar packages and discounts. Orthodontists might also subtract the consultation fee (up to a few hundred dollars) from the total bill.

Speak to our friendly team to find out more about your multiple financing options! 

Why are braces so expensive? 

Orthodontics is highly labour-intensive and is therefore costly. We have to take into account the dentist's working time, which covers everything from time spent diagnosing your case to forming an effective plan, to treatment.

Here’s a deeper look at why braces are not cheap:

• Appointments over a few years

Getting braces means a load of chair time. Your orthodontic work can take a few years for you to see your desired results. With a typical two to three year plan, a patient is likely going to be sitting in a chair for up to an hour at a time. Plus, you’re looking at an average of around 30 visits, and potential emergency appointments.

• The mechanisms used for braces

Braces aren’t as simple as they seem. There are many detailed mechanisms inside of them that help move your teeth. After all, the moving of teeth through the bone can prove to be tricky, and even the slightest mistake can cause complications to one’s jaw and teeth.

This is why orthodontists go to school for as long as they do – students need to complete four years of undergraduate dental school and undertake a three-year full-time residency training program before becoming recognised as a fully-fledged orthodontist.

• Materials and supplies

Not only are you paying for the intricate mechanisms of the braces that help move your teeth, but you are also paying for:

• The supplies used each time you visit
• The costs of the sterilisation equipment
• The time and expertise spent in a laboratory
• Products that are used during treatment

• Labour costs

Keep in mind that you’re also paying for your orthodontist’s knowledge, skill, and work (and their team’s). They have rent to pay, staff to remunerate, and other patients who they care about.

With these factors taken into consideration, hopefully it now makes a little more sense the next time you ask yourself why braces are so ‘expensive’.

What is the timeline and process of getting braces like? 

The length of treatment largely depends on two factors: Complexity and age. 

Braces cases that are more complex (eg. they require extraction, or jaw surgery) will take a longer time to complete. Adults can also expect a longer treatment time than children. While some can solve their orthodontic issues in six months, most typically wear braces for an average of about 22 months. Treatments tend to last from 18 to 30 months.

Here’s a general timeline for orthodontic treatment in Singapore:

• Step one: Evaluation

You’ll meet with us to assess your bite, teeth alignment and spacing issues. You will also be guided in your decision of what type of braces are best for you and your lifestyle.You can expect to go through examinations like X-rays and a bite analysis. You might be recommended to get additional dental care (eg. address cavities, extractions) in preparation for braces.

• Step two: Getting your braces

Your teeth are prepared for bonding with an application of etchant. A special adhesive holds your braces in place and is hardened via a special curing light.

Our orthodontist will then ‘sew’ it all together – an arch wire will be fed through the braces, and tightened. Unless you’ve got self-ligating braces, elastic bands will also be inserted.

• Step three: Living with your new braces

• First few weeks: Your teeth and gums will feel extra tender, so you’ll be eating soft foods for a while. You might also have to adapt to using new dental tools and cleaning requirements, and you will have to keep up an excellent standard of dental hygiene.
• After 4-8 weeks: You’ll visit us for an adjustment and progress check. 
• For the first few months: The focus is on correcting your alignment. Once those issues have been addressed, we’ll work on adjusting your bite to a more natural position.  
• Regularly till the end of your treatment: You’ll return for regular appointments. Make sure to ask questions, discuss any concerns, and follow care instructions.

• Step four: Your last appointment

At this stage, we’ll take off your braces and remove the residue left over from the bonding material. This process shouldn’t take longer than 15 minutes, and will leave you with the perfect smile you have been dreaming of. 

• Step five: Maintaining your results

To ensure your teeth do not gradually shift back into their previous positions, you’ll have to wear a retainer. This is where many patients tend to get complacent and slack off – but do not let your time, effort and money go to waste! 

Additionally, these add-ons could affect the length of your treatment plan:

• Rubber bands
  These attach to braces to treat jaw misalignment.
• Palatal expanders
  These fit in the roof of your mouth and use gentle force to widen your jaw. These are prescribed in children who are still growing, and can help avoid a future need of braces or lessen the time needed for potential treatment.
• Headgear
  This is a device you might mostly wear at night, over your head or on your face

What is the best age for braces?

There is no ‘best age’ for orthodontic treatment per se, but many orthodontists believe that it is beneficial to start treatment from as early as seven years of age. 

Interceptive braces can be used to correct dental problems and help with jaw growth disharmony and a poor bite. Furthermore, early braces treatment in children can also help to eradicate bad habits like thumb or digit sucking, and facilitate and guide permanent teeth growth.

Are braces safe?

Braces are usually safe for most. However, those with a nickel allergy should avoid traditional metal braces*. The material used for their brackets and wires generally tend to contain nickel, so if you’re one of those who constantly feels itchy when wearing non-precious jewelry, metal braces might not be the wisest option.

*Thankfully, there are now many alternative materials available for you to choose from. Your orthodontist will be able to guide you regarding these issues.

How to make braces more affordable for yourself

Follow these guidelines so that you won’t have to go through treatment twice, or risk breaking your braces, which could result in more time and money spent. 

What happens if you don’t fix crooked teeth?

In many cases, braces are not just an aesthetic procedure. Here’s what could happen if you do not fix crooked teeth:

• Crooked teeth, especially upper front teeth that stick out (protruding upper incisors), are more likely to become damaged.

• Other types of misaligned teeth can also cause jaw joints to ache, make a clicking or popping sound, or become “blocked”. This can make it hard or impossible to open your mouth wide.
• Compensatory movements and teeth grinding can cause your teeth to wear each other down.
• Some types of misalignment might make it harder to clean teeth properly, which can lead to tooth decay and periodontal disease[4].
• Chewing, speech and digestion problems.
• Lowered self-esteem.

Plus, it is easier for orthodontists to perform restorative procedures such as crowns and bridges on aligned teeth. 

Choose a skilled dentist

If you are worried about the cost of braces, you might be tempted to go with the cheapest dentist who might not be the most skilled or experienced. But by cutting corners now, you might be putting yourself at risk for future financial and physical complications.

Additionally, if you end up having to undergo orthodontic treatment more than once, you will not only have to go through twice the porridge dinners but double the discomfort too. 

As the old adage goes, you get what you pay for, so always do your research and place your trust in an orthodontist who has a good reputation, reviews and skills.

Getting braces can be an incredible journey that could help bring out the best version of you and impact your wellbeing greatly.

Contact us for the straight, healthy teeth you’ve always dreamed of. 

References

1. https://apospublications.com/orthodontic-treatment-in-national-dental-centre-of-singapore-trends-toward-higher-proportion-of-adult-patients/
2. InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Misaligned teeth and jaws: Overview. 2020 Jan 16. Available from: https://www.ncbi.nlm.nih.gov/books/NBK553375/
3. https://www.cpf.gov.sg/member/faq/healthcare-financing/medisave/can-i-use-my-medisave-savings-for-non-surgical-dental-treatments
4. https://www.healthline.com/health/dental-and-oral-health/crooked-teeth#complications 

Many patients undergo Invisalign treatment for straight teeth expecting it not to hurt at all. This is hardly surprising, as Invisalign in Singapore is often advertised as being pain-free or a lot less painful than metal braces. While it’s true that Invisalign is a lot more comfortable compared to traditional braces, it is not true that it is not painful at all. As with all orthodontic treatments, when moving and straightening teeth, there is bound to be some pain and mild discomfort.

How intense is this pain, and how long will it last? This article will explore all you need to know about Invisalign treatment in Singapore and pain.

Does Invisalign hurt, and to what degree?

In general, Invisalign may cause mild pain initially but is a lot less painful than braces. Any pain or discomfort experienced is temporary and will fade after the teeth adjust to wearing the Invisalign clear aligners. For many patients, this acclimatisation takes place within a week of using their new aligners. Since the Invisalign treatment plan requires new aligner trays every 2 weeks, it is possible to experience some discomfort within the first few days of each cycle. In terms of pain level, this will depend on a few factors such as your tolerance towards pain and the presence of sensitive teeth and gums.

A 2005 study reported that 54% of Invisalign patients experienced mild pain, while 35% did not. Of the 54% who did, 44% complained about discomfort during chewing. From the numbers, we can conclude that not every Invisalign user will have pain, and even so, the discomfort does not surface all the time. To add on, it’s possible for pain symptoms to be less pronounced as you get used to wearing your aligners.

Why does Invisalign hurt?

Pain from Invisalign can be credited to a few factors including:

Friction from aligners

Sores and ulcers are common with traditional braces due to the brackets rubbing against the inside of the mouth and wire placement. To combat this sensitivity, the mouth develops calluses, which results in pain. The same goes for Invisalign aligners but on a much smaller scale. The edges of the clear aligners —albeit not sharp—can irritate your gums and lips as your mouth adjusts to wearing them. Some patients may find that they develop some calluses in their mouth over the first couple of weeks, but this is normal and necessary to prevent irritation. Usually, this pain goes away once you switch out your first set of clear aligners and your mouth adjusts to having plastic retainers.

Teeth movement

In order for Invisalign treatment to shift your teeth and give you healthier and straighter teeth, some pressure is necessary — and pressure means soreness. This soreness is most pronounced during the first few days of wearing a new set of Invisalign clear aligners, but it eventually goes away till the next cycle. If anything, few patients would describe this soreness as pain but rather a discomfort.

Improper finishing of the aligners

When you run your tongue along the edge of your aligner, you should not be getting cuts. Any cuts or rough edges against your tongue is a result of improper finishing of your aligners. This side effect can be easily remedied by bringing it up to an Invisalign accredited dentist who will adjust the edges accordingly.

When is the pain from Invisalign a concern?

While it’s possible to experience mild pain in the teeth, jaw and tongue within the first week of wearing your new set of aligners, the pain should not be severe to the point where it interferes with your daily activities. Call your dentist immediately if you experience:

• Bleeding in your teeth or gums
• Pain when eating, drinking or swallowing food
• Facial swelling

How can I reduce pain from Invisalign?

1. Apply dental wax

If you’re experiencing gum pain from Invisalign, some dental wax might help. Apply a small portion on the top edges of your aligners or where it hurts. Lubricating those areas can reduce any friction that might be causing gum pain. If there is a particular spot wax can’t cover, you might need to ask your dentist to file it down for you.

2. Take OTC medicine

You may consider taking over-the-counter pain relief medication like panadol during the first few days when pain is the most severe. However, do consult your doctor if it’s safe for you to take painkillers especially if you are on other medications.

3. Avoid taking out your aligners

As tempting as it is, avoid taking out your Invisalign aligners for prolonged periods of time unless recommended by your dentist. Invisalign should be worn at least 22 hours a day. Not wearing your aligners would not only extend your treatment time but decrease your overall pain tolerance to the trays as well.

4. Remove your aligners cleanly and safely

Always practice good hygiene when removing your invisible braces. This includes washing your hands thoroughly and taking out your aligners with care.

References

1. Nedwed, V., & Miethke, R. R. (2005). Motivation, acceptance and problems of invisalign patients. Journal of orofacial orthopedics = Fortschritte der Kieferorthopadie : Organ/official journal Deutsche Gesellschaft fur Kieferorthopadie, 66(2), 162–173. https://doi.org/10.1007/s00056-005-0429-0
2. Miller, K. B., McGorray, S. P., Womack, R., Quintero, J. C., Perelmuter, M., Gibson, J., Dolan, T. A., & Wheeler, T. T. (2007). A comparison of treatment impacts between Invisalign aligner and fixed appliance therapy during the first week of treatment. American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics, 131(3), 302.e1–302.e3029. https://doi.org/10.1016/j.ajodo.2006.05.031

Gapped teeth may not appear to be much of a problem as compared to crooked teeth, but if not treated accordingly, it can cause the gums to be sore or develop gum disease. In dentistry, gapped teeth is known as a condition called diastema. The gap typically appears between the two upper front teeth, but spaces can form anywhere in the mouth between two teeth. Gapped teeth are considered a type of malocclusion and are caused by multiple reasons.

Reasons that cause spaces in teeth

Genetics

More often than not, malocclusions are inherited, and that includes spaces between teeth. If gapped teeth run in your family, chances are you may have them too.

Bad oral habits from childhood

About 97% of children have gaps between their baby teeth and close naturally once their permanent teeth grow. However, excessive thumb sucking can place excessive pressure on the front teeth, pulling the front teeth forward and triggering the formation of a gap.

Extra, undersized or missing teeth

Some children are born with missing, undersized or extra adult teeth which leave a gap. In some cases, extra teeth can prevent the eruption of other teeth, causing a gap.

Overgrowth of labial frenum

Spaces between teeth can also be caused by an overgrowth of tissue at the area between your upper front teeth and gum line. This tissue is known as the labial frenum. An oversized labial frenum can create a gap between the front teeth.

Uneven jaw and teeth size

Spaces may form in between teeth when the teeth are too small for the jawbone. As a result, the teeth appear far away from each other. The size of your jawbone and teeth usually run in the family; so if you have gaps, you may notice the same for your parents and other family members too.

Swallowing problems

Some people develop a reflex problem known as tongue thrusting, where the tongue pushes against the front teeth instead of staying at the mouth roof when swallowing food. Over time, due to excessive pressure on the front teeth, separation can occur.

Gum disease

Gapped teeth can also be caused by gum disease. When the gums get swollen, they can damage the supporting tissues around the teeth, causing gaps and tooth loss.

What are my options for fixing spaces between teeth?

There are a few options patients can choose to treat gapped teeth. Some of the most effective treatment options include:

Dental bonding

Tooth bonding is ideal for tiny gaps or if a chipped tooth is the reason behind the gap. The dentist uses UV light to bond tooth-coloured resin to the tooth. This option is however the least strong or long-lasting.

Dental veneers

Since dental veneers are highly customizable, they are suitable to treat minor teeth gaps by making them slightly larger than your natural teeth. To make it more natural, more veneers can be done to equalize the gaps and make the teeth more proportionate and natural. The dentist first matches the veneer to your natural teeth colour and removes a thin layer of enamel from your tooth to bond the veneer.

Dental implants

In cases where the gap is caused by a missing tooth, your dentist may suggest a dental implant to fill up the tooth gap.

Surgery

If the cause behind your gapped teeth is an enlarged labial frenum, a type of surgery called a frenectomy is necessary to remove it, followed by appropriate treatment such as Invisalign.

Invisalign

While braces are a suitable option to treat spaces between teeth, many patients opt for Invisalign due to obvious reasons like comfort and aesthetics (no need for noticeable metal wires to close the gap). The Invisalign system is equally equipped to treat spaces between teeth and may in fact be more effective as each treatment plan and set of aligners are uniquely customised. Patients are also required to remove their aligners during meals and while brushing and flossing, ensuring healthier gums and teeth. In cases where a big gap is present, Invisalign may be used in tandem with dental bonding or veneers to close the gap fully. If gum infection is present, it must first be treated before going ahead with Invisalign treatment.

How long does Invisalign take to close spaces between teeth?

Invisalign moves teeth about 0.2mm per aligner, which is changed every 2 weeks. So if you have a gap of 1.5mm, it would take roughly 12 weeks or 3 months to close the gap. However, because other teeth gaps might be created during the process of bringing the original tooth gap together, it might take about 3-6 months for a smile with completely no spaces at all.

If you have spaces between teeth that you are concerned about, feel free to reach out to our team of qualified dentists and we will assess your condition and recommend a treatment plan.

References

1. Sękowska, A., & Chałas, R. (2017). Diastema size and type of upper lip midline frenulum attachment. Folia morphologica, 76(3), 501–505. https://doi.org/10.5603/FM.a2016.0079
2. Suter, V. G., Heinzmann, A. E., Grossen, J., Sculean, A., & Bornstein, M. M. (2014). Does the maxillary midline diastema close after frenectomy?. Quintessence international (Berlin, Germany : 1985), 45(1), 57–66. https://doi.org/10.3290/j.qi.a30772

There are many misconceptions about Invisalign, with one being it can only fix slightly crooked teeth and will not work on overcrowded teeth. This is simply not true — Invisalign is far more than just a retainer and can be used in almost all dental situations to straighten teeth. Granted, severely crooked teeth might need traditional metal braces, but this is usually due to severe misalignment of the jaw that Invisalign cannot fix. Otherwise, in general, Invisalign can straighten crooked teeth caused by crowding and give you the perfect smile you’ve always dreamed of.

How do I know if I have crowded teeth?

Crowded teeth may either be mild or severe, but they are usually characterised by poor alignment of the upper and lower teeth. They cause symptoms which include:

• Altered facial appearance
• Discomfort when biting or chewing
• Biting of the tongue or inner cheeks, can occur when chewing or talking
• Noticeable speech problems that sounds like a lisp
• Breathing difficulties (in severe cases)

What causes crowded teeth?

In most cases, crowded teeth are inherited. If you have crowded teeth, your might notice that your parents and siblings likely have this dental issue too. Genetics aside, certain habits and conditions especially if developed since young can alter the shape and structure of your jaw, leading to crowded and crooked teeth. They include:

• Consistent use of oral objects in early childhood, including thumb sucking and/or continuous use of a pacifier past age three or four
• Extensive use of bottles in early childhood
• Early loss of baby teeth
• Injuries or trauma that misaligned the jaw
• Cleft lip or palate
• Gum disease
• Excessive pressure on teeth and gums
• Ineffective dental care i.e. poorly fitted dental crowns, braces or fillings

Why is it important to fix crooked teeth caused by crowding?

Apart from aesthetic reasons which some may or may not mind, it is important for misaligned teeth to be fixed as they can cause:

• Difficulty chewing
• Straining of the jaws and teeth
• Teeth to be broken easily
• Difficulty cleaning teeth, increasing the risk of gum disease, cavities and tooth decay

How can Invisalign fix crowded teeth?

To first ensure your suitability for Invisalign, your dentist will take X-rays and 3D images of your face and teeth and make teeth impressions. The X-rays will allow the dentist to locate the exact position of your teeth and their roots, as well as see if there are any teeth hidden in the gums. Your dentist will likely also use the 3D images to study the relationship between your teeth, jaw and head. At Dental Designs, we use an Invisalign iTero scanner that can successfully capture teeth from all angles to help us create aligners.

Most patients with misaligned teeth should be able to qualify for Invisalign, as these are strong, hard plastic that is capable of shifting very crooked teeth. During the entire treatment process, patients wear their custom-made aligners over their teeth for at least 22 hours everyday, and take them out during meals or when brushing and flossing.

About every two weeks or so, patients switch to a new set of aligners to keep moving their teeth in the right direction. Each set of aligners might look slightly different, as they place gentle pressure on teeth to force them into moving into their correct positions. Treatment times vary depending on each patient’s condition, but the average time is about 12 to 18 months.

How can I benefit from using Invisalign to treat my crowded teeth?

Some of the main benefits existing patients enjoy and future patients can look forward to are:

Improved appearance

Patients can expect straighter teeth without any obvious metals or wires showing when they smile. Unlike traditional braces, Invisalign aligners can hardly be seen. This allows patients to still look good even during the treatment.

Better dental hygiene

The clear aligners must be taken out during meals and when you brush and floss your teeth. This ensures no food particles will get stuck in the aligners and your teeth remain clean.

Personalised treatment

Each aligner is uniquely designed based on your condition. They fit securely thanks to the accurate 3D impressions taken, and are the most comfortable form of straightening treatment for overcrowded teeth.

Convenient and fits into your lifestyle

As mentioned, the Invisalign aligners must be removed during meals and cleaning, but you can take them off anytime you need to, such as during an outdoor game. As long as the aligners are on for at least 22 hours daily, they can be removed anytime to accommodate your lifestyle.

References

1. Fernandez, C., Pereira, C., Luiz, R. R., Vieira, A. R., & De Castro Costa, M. (2018). Dental anomalies in different growth and skeletal malocclusion patterns. The Angle orthodontist, 88(2), 195–201. https://doi.org/10.2319/071917-482.1
2. Weir T. (2017). Clear aligners in orthodontic treatment. Australian dental journal, 62 Suppl 1, 58–62. https://doi.org/10.1111/adj.12480

Invented in the late 1990s, Invisalign has since become a mainstream alternative to traditional metal braces. This treatment system involves wearing a series of clear aligners over different phases or months, with each set of aligners slowly moving teeth to their proper position. Due to their transparent colour, Invisalign aligners are barely noticeable to others, unlike metal braces. It is precisely this characteristic that makes Invisalign so popular across different ages.

How does a typical Invisalign treatment process look like?

In general, patients are advised to wear their aligners about 20-22 hours a day for 2 weeks. Following which, they’ll receive another set of aligners and so on. Unlike traditional metal braces, patients with Invisalign do not need to adhere to a soft diet and are allowed to eat whatever they want. This is because patients are required to remove their Invisalign when they eat or drink anything apart from water.

Some patients might see improvement in their teeth in as little as 10 weeks or even two — this is not rare. Everyone’s teeth and condition is different, so there’s no hard-set timeline on how long Invisalign treatment will last. But in general, the average treatment process takes about 12 to 18 months

After treatment is complete, patients will need to wear retainers to allow the bones around their jaw to get used to the new teeth placements. You may opt for a wire retainer or a product from Invisalign known as Vivera. Vivera retainers are a little thicker and more durable, but they are not meant to be changed bi-weekly as with Invisalign trays. It is recommended to wear a retainer months immediately after treatment to prevent your teeth from shifting. Ideally, you should also wear a retainer a few times each week for the rest of your life.

What age groups can wear Invisalign?

While Invisalign treatment accounts for 31% of adult orthodontics, it is available to individuals across all age groups including children. In fact, children as young as 6 can start wearing Invisalign as long as they are under the watchful eye of an orthodontist. There is no specific age requirement for wearing Invisalign; rather, it depends on the development, maturity and arrangement of teeth.

Here’s how Invisalign works differently for different age groups.

Invisalign for young children

Invisalign First is a treatment plan designed specifically for young children aged 6-10. According to Invisalign, orthodontic treatment in this age group is known as Phase 1. Under Phase 1 treatment, the goal is to treat a broad range of teeth straightening issues like crowding and making space for existing and incoming permanent teeth. Phase 1 treatment can also stop pre-existing bite problems and assist with habits like thumb sucking. Eradicating these will shorten the time required for future orthodontic treatments. As with regular Invisalign aligners for adults, Invisalign First aligners are removable for hygiene and designed without wires or brackets for comfort.

Invisalign for teenagers

As a teenager’s teeth aren’t as fixed in position as an older person’s teeth, Invisalign for teenagers can be a highly effective treatment method. It comes with a mandibular advancement feature and precision wings to fix overbites in teens and gradually move the lower jaw. That being said, for teens to undergo Invisalign, they must have most of their permanent teeth around and the discipline of an adult.

For Invisalign treatment to be effective, the clear aligners must be worn for at least 20 hours a day, though 22 hours would be the best. If a teen does not have the discipline to wear their aligners for the stipulated number of hours daily, then Invisalign might not be the best course of treatment. Fortunately, Invisalign for teens comes with a built-in safeguard for parents to monitor if their kids are wearing their aligners long enough everyday.

Invisalign for adults

Invisalign for adults may take a longer treatment time to yield desirable results compared to younger patients. This is not a universal rule but a noticeable trend as younger mouths are typically healthier. Regardless of the time taken, Invisalign has helped many patients in their 20s and above and even seniors achieve a beautiful smile. There’s even been cases of patients in their 80s who experienced life-changing results because of Invisalign. Often, bone density is what determines whether an adult is suitable for Invisalign. As older individuals tend to have problems with bone density, some teeth may have problems or move very easily. A good dentist will do the necessary checks to ensure Invisalign can produce fruitful results.

Invisalign can benefit almost anyone

So long as an individual meets the necessary criteria and wears the aligners as instructed, they will definitely benefit and see desirable results. The longer the retainers are worn, the faster the teeth move and the cleaner the results. If you considering waiting till you are older to get Invisalign, be careful not to wait till your bone density or mouth health declines and risk missing out on the window of opportunity to get a beautiful smile.

What sort of retainers are best for me?

After your smile is corrected with Invisalign, you will need to wear a night retainer in order to maintain your new straightened teeth. At Dental Designs, we highly recommend you use the Zendura retainer. It boasts the benefits of having:

• Proven resistance to stains
• Improved durability against trauma
• Safe and non-toxic polyurethane (PU) material

References

1. Haouili, N., Kravitz, N. D., Vaid, N. R., Ferguson, D. J., & Makki, L. (2020). Has Invisalign improved? A prospective follow-up study on the efficacy of tooth movement with Invisalign. American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics, 158(3), 420–425. https://doi.org/10.1016/j.ajodo.2019.12.015
2. Kuncio D. A. (2014). Invisalign: current guidelines for effective treatment. The New York state dental journal, 80(2), 11–14.

Invisalign is a game-changer for those who desire healthy and perfectly aligned teeth. This clear plastic aligner system allows you to achieve straight teeth without the drawbacks and hindrance of metal braces.

If your appearance is important to you, or if your job requires you to attend social events and make important presentations, perhaps Invisalign might be a better option than having metal braces on your teeth. Here are some reasons why we prefer Invisalign over traditional metal braces:

1. Easier to clean

When you have on Invisalign, you are required to take them off when eating and to also brush them with toothpaste and warm water regularly. This ease of application makes Invisalign easier to clean and you don’t have to worry about food stuck in metal brackets.

2. No need for food adjustments

As mentioned above, you have to take off your Invisalign during meal times. To some, this might be a hassle, but think about it — you get to eat and drink whatever you want even during the initial phase of treatment! That’s a win, at least for me. Most patients with metal braces have to keep to a soft diet for the first few weeks.

3. Less discomfort

If you’ve ever worn braces, you’ll know the discomfort that comes with it, especially when it’s time to tighten the brackets. I’ve seen many patients (both adults and children) experience sores and ulcers. As a dental health provider, as much as my job requires me to fix people’s teeth, I want to make their treatment experience as comfortable as possible. This is why I would recommend Invisalign first; the clear plastic doesn’t scrape against your tongue, cheek or gums.

4. Fewer inpatient office visits

When you start an Invisalign treatment program with us, we’ll give you your aligner trays for the current phase and the next several phases. Having these trays in advance means you can continue treatment without requiring too many visits to the clinic. But of course, patients who wish to come in, are always welcome to do so.

What can Invisalign treat?

Invisalign can treat a range of orthodontic issues including:

Gaps in teeth

If you have a gap between your teeth, you have a spacing issue. This excess space can appear either in one area of your mouth or through your entire bite. It is usually caused by abnormal jawbone growth or tooth loss which caused surrounding teeth to shift. The fashion industry might have at some point glamourised the gapped teeth look, but in orthodontics, having gaps in teeth is an invitation for food to be caught between the teeth and gums, leading to pain and gum disease!

Overcrowding

When there is not enough room in your mouth for your teeth to sit and grow comfortably, they can overlap and twist. This is known as overcrowding, which typically happens in people with small jawbones. When not addressed, overcrowded teeth can become crooked and affect your bite. They are also harder to clean, which increases plaque buildup and your chances of tooth decay and gum disease.

Overbite and underbite

An overbite occurs when the lower front teeth protrudes or extends outward past the upper teeth. Having an overbite is frequently described as ‘bugs bunny teeth’ or protruding teeth. An underbite is the exact opposite (extend over lower teeth), and could be caused by having a larger lower jaw. If you have an overbite or underbite, you may find it hard to pronounce some words properly.

Crossbite

When you close your mouth and some upper teeth sit inside your lower teeth, you have a crossbite. A crossbite can result in severely worn teeth, receding gums and bone loss.

Open bite

Yes, Invisalign can fix an open bite too, one of the less common malocclusions. This condition is when the upper and lower teeth do not meet even when the two jaws are in contact. In Singapore, open bites are frequently seen among those with speech issues.

What Invisalign cannot treat

While Invisalign can treat a myriad of issues, however, it is not without its drawbacks. If you decide to use Invisalign, you need to know that you have to consistently wear the Invisalign clear aligners for a minimum of 20 hours daily. As the Invisalign can only work when they are on your teeth, the longer they are on your teeth, the more effective they will be at achieving the desired result. You can remove the Invisalign clear aligners just for eating and brushing your teeth. You should also take them off if you are drinking anything that is not plain water. Once you are done with your meal or drink, you should brush your teeth to clean them off any food particles, then put on your Invisalign clear aligners again.

For complex cases, Invisalign alone may not be enough. There are also other supportive mechanisms that can be utilized in order to solve the complex cases with Invisalign so as to achieve a similar result as metal braces. For example, you may be asked to use orthodontic elastics which are similar to what is used for metal braces, in order to push the teeth in a certain direction.

References

1. Lagravère, M. O., & Flores-Mir, C. (2005). The treatment effects of Invisalign orthodontic aligners: a systematic review. Journal of the American Dental Association (1939), 136(12), 1724–1729. https://doi.org/10.14219/jada.archive.2005.0117
2. Kravitz, N. D., Kusnoto, B., BeGole, E., Obrez, A., & Agran, B. (2009). How well does Invisalign work? A prospective clinical study evaluating the efficacy of tooth movement with Invisalign. American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics, 135(1), 27–35. https://doi.org/10.1016/j.ajodo.2007.05.018

Invisalign, a modern alternative to traditional metal braces, has seen a tremendous rise in popularity in recent years. The benefits to Invisalign are clear (pun entirely intended) and many-fold. Your friends, family and work acquaintances aren’t going to know that you’re undergoing orthodontic corrective work from sight alone. Gone are the days you need to walk around with a mouth full of metal.

They also require minimal maintenance. Just light brushing a couple of times a day for cleaning and they’ll be good as new. Perhaps most importantly, to some, is the relative safety and comfort that they provide. They are much more physically comfortable to wear than the sharper-edged wires and brackets of traditional metal braces. In the past, getting occasional painful nicks and cuts on the mouth was almost a given. Invisalign’s grooves are smooth, are made out of a much softer material and feel much similar to modern mouth guards.

However, it is still too early to anoint Invisalign as a true panacea for all orthodontic problems. There are various (perhaps not so obvious) drawbacks and inconveniences that come with wearing invisible aligners that we don’t experience with traditional metal braces.

Misplacing your aligners

This is a very real problem that virtually everyone who’ll go through invisible aligner therapy will experience at least once. Invisalign has taken some measures to mitigate this possibility – they provide a nice pocket-sized round carrier, lined with rubber material inside, to keep your aligners when you have to remove them. The problem with this is that many Invisalign patients don’t actually carry this container around: many prefer to just wrap their aligners up in tissue paper and leave them on the table while they enjoy their lunch.

Alas, even if you do remember to pick up the inconspicuous ball of tissue with your aligners hidden within them, your friends or the staff of the eatery may not be as aware. Throwing away invisible aligners by mistake is probably the #1 reason that most patients lose them. This can get costly over time as well – it costs up to $100 to get one tray of invisible aligners replaced!

They stain easily

While the cleaning routine for Invisalign isn’t all that time consuming or difficult, there are certain behaviours that will develop dark, noticeable stains on your aligners permanently. Smoking and drinking black coffee are probably two of the biggest culprits. Of course, your dentist will recommend that you always remove your aligners prior to having a cigarette or starting to drink your morning coffee, but that’s a huge hassle that many Invisalign patients find it tough to stick to, especially if they’re the type that enjoys sipping their coffee throughout a long workday.

For habitual smokers, this gets even more troublesome; Imagine having to remove your aligners and washing them every single time you have a cigarette! Cigarette smoke will stain your once pristine aligners even after just a couple of cigarettes and give your set of aligners an unmistakable pale yellow hue – not exactly the most flattering looking colour.

Wearing them at least 22 hours a day

Putting everything else aside, in order for the treatment protocol your dentist designs for you to work as intended, you’ll have to wear your aligners at least 22 hours a day. Many Invisalign patients don’t actually hit this 22 hour a day mark – resulting in a far longer treatment schedule than they once intended.

Let's be honest. It can be quite difficult to truly not wear your aligners for only a couple of hours a day. While taking them off during meals is a given, many Invisalign patients don’t actually enjoy wearing them during meetings or presentations. Although most patients will eventually get used to the presence of them in their mouths, some patients still speak with a slight lisp even after months or a year wearing Invisalign. Hence, in the professional world, it’s very reasonable to expect that some patients will remove their aligners for several hours a day during important meetings or presentations, to that ensure fluency while speaking.

The same goes for those looking forward to a fun night out at the club or bar during the weekend; between all the bar snacks and alcohol and socializing; it becomes an attractive prospect to simply leave your aligners at home and not have to worry about them while you paint the town red. It’s also quite a real possibility that upon arriving home from a late-night out partying that you’ll be too inebriated to remember to wear your aligners before collapsing into bed!

Just like any other modern dental technology, Invisalign has many attractive pros, but it also comes with its cons. A dental routine that is easy for one person to be compliant to could be almost impossible for another person to follow; it’s important to communicate with your dentist to ascertain whether Invisalign is really the right treatment for you.

Find out More on Invisalign here!