How Is the Amount Needed of Invisalign Trays Determined? Is it Determined by the Doctor or Invisalign?

Question

Different doctors gave estimated treatment time for a year or so. The doctor that unfortunally did my treatment say 10 trays will be enough. After the 10 trays the IPR gaps did not close completely and he bonded them. Now, I am so scared that invisalign might have moved my teeth too fast. I got pulpitis on one tooth. He wanted to do a root canal but I decided to wait. After 2 months the tooth is better but still a little sensitive. I want to get braces but afraid to hurt my teeth.

Gerilyn Alfe, DMD · Answer

Your dentist is the one who fills out the prescription for your treatment and then Invisalign comes up with the treatment itself, along with the number of trays needed to reach your goal.  Sometimes teeth don't move exactly as the computer simulation expects, like it sounds happened in your case.  Don't worry about your teeth having moved too fast unless you switched your trays out more frequently than every 2 weeks.  Pulpitis can happen just from the teeth moving as well as the bite changing-the sore tooth may be feeling more pressure than it did before.  The fact it calmed down is a good sign, but have your bite checked just in case.

Gilbert H. Snow, DDS · Answer

The doctor should decide how many trays are needed.  If the doctor uses Invisalign's Assist program or Express program then Invisalign has more influence over the amount of trays used. The more trays used the slower the movement. Slower movement often increases the control of the movement.

	If you and the doctor are not happy with your teeth you might consider a second try using the Case Refinement program.

	I really question the pain in the one tooth is caused by rapid movement of your tooth. Since the pain is still there and there is no obvious decay the pain could be caused by clenching on that tooth without you even being aware of the clenching. It may also be too high and you are hitting it first as you bite down further irritating that tooth.

	You should not have spaces after Invisalign unless spaces were planned. More aligners can close the spaces.In almost all cases I would not want bonding on my teeth to close spaces. 

	Yes, braces are another alternative.

Steve Alper, DMD · Answer

Hi Nana

	The Invisalign protocol will only allow for a certain amount of movement per aligner.  The pulpitis could be simply from moving your teeth. 

	I must say that it doesn't sound normal to have IPR then to close the space with bonding.  Why remove tooth structure, only to add it back?

	Also you should check the aligners and make sure that you have Invisalign and not another clear aligner brand.  There are other copy-cat systems with less restrictive movement limitations (i.e. more movement per aligner set).

	Hope this helps.

	Best!

	Dr. Alper

Brian Povolny, DDS, PhD · Answer

You should not have residual IPR spaces after completing Invisalign.  Limiting the treatment to 10 trays is less expensive, called "Invisalign Express".  Further treatment will cost a bit more since Invisalign will charge more for extra trays.  The doctor is ultimately responsible for the entire treatment including the number of trays.  Invisalign does provide a particular treatment simulation with a particular number of trays at the outset of treatment planning, but the doctor has the ultimate responsiblity of deciding exactly how the treatment progresses and how many trays are used.

Robert Waxler, DMD, MS · Answer

Spaces created by IPR should NEVER have to be closed by bonding...either too much enamel was removed or more aligners are needed to finish closing the space.  10 trays are the maximum that can be used in the doctor selected Invisalign Express which is a less costly option for simple problems (you can add additional aligners for additional money.  Tooth movement alone should not have caused sensitivity...I think you might have had too much enamel removed when they did IPR.

	Talk to your doctor and see what he/she says is the cause of the spaces...if you don't like the answer then you should seek a second opinion from an experienced Invisalign provider (my recommendation would be an Elite Orthodontists...that's what I am!)

	The number of aligners depend on what the doctor is trying to do...Invisalign just divides the movement into steps given the maximum speed that teeth can move in a two week period

Matt T. Walton, DMD · Answer

Both the Doctor and Invisalign determine the total number of Aligners. Invisalign provides the doctor a general roadmap of how treatment should progress. However, it is up to the doctor to use his/her diagnostic ability and experience to direct the final treatment plan. Invisalign is not the doctor and should not be relied upon to take that responsibility.

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How Is the Amount Needed of Invisalign Trays Determined? Is it Determined by the Doctor or Invisalign?

Answers (7)

Answer: Residual spaces after Invisalign

Answer: Residual spaces after Invisalign

Answer: How many aligners?

Answer: How many aligners?

Answer: Both Doctor and Invisalign Determine Number of Aligners

Answer: Both Doctor and Invisalign Determine Number of Aligners

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Recommended reading

Everything you need to know about Invisalign

Our mission is to create a world where every investment in modern beauty is Worth It.