Invisalign Treatment - Information and Glossary

This page is additional information for patients considering, or currently having, Invisalign treatment.

At tooth we always aim to communicate in a language that is easy to understand for our patients. Invisalign and related treatments use some words and phrases you may not have heard before, so here is a handy glossary of what each thing means. If you have any questions throughout the process, please ask.

Glossary:

Attachments: Small, tooth-coloured bumps bonded to certain teeth to help the aligners grip and move teeth more effectively. They provide extra force and control for complex tooth movements and are removed at the end of treatment.

IPR (Interproximal Reduction): A technique where tiny amounts of enamel (0.2-0.5mm) are polished away between teeth to create space. This helps teeth move into better alignment, reduces crowding, and can minimise the appearance of black triangles as it improves the shape of teeth.

Bite Ramps: Special features built into the aligners, usually on the inside (lingual side) of the upper front teeth or on the chewing surfaces of back teeth. Bite ramps help correct deep bites, crossbites, and open bites by keeping certain teeth apart and guiding the bite into a better position.

Buttons and Elastics: Buttons are small attachments placed on teeth to anchor elastics (rubber bands). Elastics are worn between the upper and lower teeth to help correct bite issues, such as overbites or crossbites. They can also be worn between two or more teeth on the same arch to help close or open spaces or to de-rotate teeth, depending on the specific movement required during treatment.

TADs or Mini Implants: Tiny titanium screws temporarily placed in the jawbone. They act as stable anchors to help move teeth more efficiently in complex cases. TADs are removed once they are no longer needed.

Additional Aligners: These may be required if at the end of the initial planned treatment, the teeth are not fully aligned as predicted. Some additional aligners may be included in the treatment. However, it is important to note that additional aligners are required to achieve the initial treatment goals, not new or additional requirements (such as additional teeth to be moved or bite to be corrected) if this was not part of the original agreed plan.

Post-Orthodontic Retention:

After your orthodontic treatment is complete, retainers are essential to maintain your teeth in their new positions and prevent relapse. Retention is a lifelong commitment, as teeth shift naturally over time. It is important to note that, in many cases, both fixed and removable retainers are recommended for optimal stability.

Even with excellent compliance and both types of retainers in place, teeth may still shift unpredictably. This is particularly relevant when closing a gap between the top front teeth or correcting severe crowding or rotation of the lower front teeth. Early detection and intervention are crucial to address any unwanted movement.

Types of Retainers and Retainer Information:

Removable Retainers:

There are a few types of removable retainers. The most common are Essix-type retainers, made by local dental laboratories, and Vivera retainers, made by Invisalign. Vivera retainers are supplied only as sets of three.

Both types are clear and custom-fitted, but Vivera may include special features such as a tighter fit for cases where large spaces were closed, or bite ramps to help preserve deep bite correction. All removable retainers require periodic replacement, especially in cases of teeth grinding, which can cause them to wear out more quickly. Replacement retainers are chargeable.

Removable retainers are easy to clean and allow for normal oral hygiene, but their effectiveness depends on wearing them as instructed. Not wearing the retainers will result in teeth shifting and relapse. There is a risk of losing or damaging them if not stored or worn properly, so please keep them in the cases provided when not in use.

Fixed (Bonded) Retainers:

These are thin wires bonded to the back of the front teeth (usually lower and/or upper). Sometimes, if there is not enough space between the upper and lower teeth at the end of treatment, an upper fixed retainer may not be placed as it could interfere with the bite and may break. In some cases, especially where spacing has been corrected, a larger space may be left between the top and bottom teeth to allow for a fixed retainer. These wires can be placed freehand chairside by the dentist or pre-bent by a dental technician to fit the natural contour of the teeth more closely. Either method is at risk of breaking or bending over time, but the retainer can be removed and replaced if needed. Fixed retainers provide continuous retention without relying on patient compliance but require careful cleaning around the wire to prevent plaque build-up and may occasionally need repair if they become loose.

Additional Post-Orthodontic Procedures:

Frenectomy: A frenectomy is a minor surgical procedure to remove or modify a frenum (a band of connective tissue, usually between the upper front teeth). This is sometimes recommended after orthodontic closure of a gap (diastema) between the front teeth, especially if a thick or low-attaching frenum could cause the gap to reopen. The procedure is performed under local anaesthetic and helps reduce the risk of relapse (gap opening) and improve lip mobility.

Periodontal Gum Graft: Gum grafting is a surgical procedure used to treat gum recession, which may be pre-existing or develop during or after orthodontic treatment. A small amount of tissue (often from the palate) is grafted onto the receded area to cover exposed tooth roots, reduce sensitivity, and restore gum volume for better aesthetics and long-term stability. Gum grafts are commonly recommended to protect teeth and enhance the appearance of your smile.

Teeth Whitening: After orthodontic treatment, professional teeth whitening may be considered to improve the overall appearance of your smile and achieve a more uniform tooth colour. Whitening should be performed prior to any restorative work (such as composite bonding or veneers) to ensure that the final colour of the restorations matches your natural teeth.

Restorative Treatment (Composite Bonding and Veneers): In some cases, restorative dental treatments may be recommended to achieve optimal aesthetics and function. Composite bonding can be used to correct minor shape discrepancies, close small gaps, mask black triangles, or restore areas affected by tooth wear, especially in the upper front teeth. Veneers are thin porcelain or composite coverings placed over the front surface of teeth to improve their shape, size, or colour, and are particularly suitable for more extensive cosmetic corrections, including significant tooth wear, severe discolouration, or mis-shaped teeth. These treatments may be suggested if there are significant tooth shape, size, or wear issues, or if further enhancement of your smile is desired after orthodontic alignment.

Enameloplasty (Tooth Reshaping/Contouring): Enameloplasty is a quick, painless cosmetic procedure where small amounts of enamel are gently removed to adjust the length, shape, or surface of teeth. It is often performed after orthodontic treatment to smooth uneven edges, correct minor chips, or achieve a more balanced smile. The procedure is typically used for front teeth and can improve symmetry. Results are immediate and permanent, but enamel cannot be replaced once removed, so it is only suitable for minor corrections.

Remember, if you have any questions just ask your treating Dentist or one of our team and we will be happy to help.