Invisalign is one of the most remarkable technologies in orthodontics in the past 20 years. Computer generated aligners that move teeth sequentially from crooked to straight without brackets or wires is a scientific wonder. At first glance it might seem like your orthodontist just opens a box of pre-made aligners, hands you a set, you wear them, and your teeth magically get straight. In reality, your orthodontist spends hours diagnosing, treatment planning, and custom designing your aligners with the Invisalign company (Align Technology) well before you ever see your first aligner. Invisalign is merely a tool in the hands of a trained doctor. A computer cannot diagnose or treatment plan your case. It can only control a manufacturing process determined by your orthodontist. Examples of the decisions your orthodontist has to make on your behalf include 1) what problems exist, 2) can they be fixed with plastic aligners, 3) how will crowding be resolved (expansion, slenderizing, or extraction), 4) how will the overbite be fixed (top teeth back or bottom teeth forward), 5) how will the arches be leveled (top teet up or bottom teeth down), 6) which attachments will be required to get the desired tooth movements, 7) how fast can a tooth safely and effectively be moved, and the list goes on. Once your doctor has submitted your prescription, a technician (not a doctor) programs the desired movements into the computer. After the treatment plan is in place, it is sent back and forth between the technician and the doctor until he is 100% satisfied with the setup. Then and only then are the aligners manufactured according to your orthodontist's plan. While you are in treatment it is important for your orthodontist to see you periodically to track your progress, add attachments, and adjust the shape of the teeth if necessary. He may have to add rubber bands along the way or even order a second set of aligners to finish the job correctly (called a revision). As you can see, there is a lot more that goes into Invisalign treatment than is visible to the patient. That is the reason why some doctors are "good" at Invisalign while others may only see failure.