An Orthodontist's Complete Guide To Invisalign In Singapore (2019)

An Orthodontist's Complete Guide To Invisalign In Singapore (2019) undefined
Table Of Contents

As an orthodontist over the past 10 years, I’ve seen many Singaporeans with severe misconceptions about Invisalign and clear aligners treatment.

This guide will you all you need to know about Invisalign in Singapore, including perennial favourites such as:

  • How much you can expect to pay for Invisalign treatment in Singapore
  • The different types of Invisalign treatments available 
  • My opinion on the key differences between Invisalign and traditional braces (as someone who still uses both for treatment on a regular basis) 

It's a long 2904-word post as I wanted to address all your questions thoroughly (yes, I'm a mind reader, ha!), so feel free to skim through the main headers to locate the information you're after. :-)

Disclaimer: This article is NOT sponsored by Invisalign. Opinions expressed are my own.

What is Invisalign?

woman at dinner table with clear aligners

Invisalign is a custom-made set of clear aligners for your teeth. They serve as an invisible alternative to conventional braces.

Each new set of aligners gradually moves your teeth into the desired position. Do note that Invisalign does not decide the treatment plan - your dentist does.

There are many brands of clear aligner systems in the Singapore market. In my opinion, Invisalign is the most advanced and established.

How does a dentist become an Invisalign treatment provider in Singapore?

doctor talking to woman about invisalign

Invisalign offers three-day training courses to dentists.

It is "easy" to start offering Invisalign treatment as a dentist - all one needs to do is attend a 3-day Invisalign provider course.

Does that make one proficient in providing Invisalign treatment? For simple cases, perhaps, but probably not for the more difficult cases.

The "Invisalign Status" of the provider reflects the accrued experience through the number of cases of Invisalign seen. The tiered statuses are as follows:

  • Bronze (performs the least number of Invisalign cases a year)
  • Silver
  • Gold
  • Platinum
  • Platinum Elite
  • Diamond
  • Black Diamond
  • Blue Diamond (performs the most number of Invisalign cases a year)

Do note that some clinics have several dentists "chalking up cases" under the same Invisalign account, so achieving Black or Blue Diamond status will be a lot easier for them, as compared to a single doctor's practice.

Are all invisible braces and clear aligners the same as Invisalign?

illustration of clear aligner treatment

There will inevitably be some differences in aligner material and technology between different companies. 

The popular clear aligner brands available in Singapore are:

  • eCligner (Korean)
  • MBrace (Singaporean)
  • K Line (German)

Speaking from someone who has tried some of the more common clear aligner brands in Singapore, I currently only use Invisalign because of its ability to treat most types of cases effectively, including complex ones.

For example, Invisalign introduced the use of tiny attachments on your teeth, which enables dentists to perform specific types of teeth movement. The variety of attachments specially designed by Invisalign  are not available in most other clear aligner systems.

This does not mean that the other brands do not work -- they definitely do, especially in the hands of dentists who use them more often. Like most things related to dental treatment, it boils down to finding the "right treatment" for the appropriate patient!

 

Does Invisalign work for everyone?

smiling asian girl

Invisalign can work for almost everyone, from teenagers to adults. However, the first question I always ask patients who are interested in Invisalign is: "Are you able to wear the aligners for 20 - 22 hours a day?"

Compliance is paramount to the success of your Invisalign treatment -- I cannot emphasise this enough. Tooth movement usually occurs within the first few days, and the remaining days are for repair of the bone into the areas where your teeth have moved. I have had a case progress only 20% in one year due to a lack of wear. We had to convert the patient to fixed braces at the end of the day. 

The second most important factor is how complex your case is - if it is too complex, you might be better off going with traditional braces, or otherwise combining the two systems.

Everyone is different, so it is important to discuss all the options thoroughly with your dentist before embarking on any treatment.

How fast does Invisalign work?

The average Invisalign course takes a year, but most of my patients start seeing some improvements after wearing their retainers for 2 – 3 months. [1]

For the best results, you are advised to wear your aligners for 20 - 22 hours a day, although I find that 18 - 20 hours a day works just as well - enjoying a relaxing long meal after a hard day’s work is always well deserved.

Traditionally, you would need to change your aligners every two weeks, which means that you would be looking at a total treatment time of one to two years, depending on how many sets of aligners you were issued.

However, Invisalign is now promoting weekly changes of aligners to reduce the overall treatment time.

Whether you are eligible for quicker changes of aligner depends on factors such as:

  • How well you wear your aligners
  • How difficult your tooth movements are
  • Whether you require extractions
  • Your age - younger patients teeth generally move faster than older patients, due to higher cell activity

I still tell my patients to start with two weekly changes, but I am sometimes able to reduce the number of days between changes according to their progress and amount of wear.

How much does Invisalign cost in Singapore?

clear aligners

In Singapore, Invisalign costs range from about $8000 – $9500 in total for treatment by an orthodontist. Many dentists are happy to give you free treatment cost estimates, according to your condition.

You can read this post for a more detailed explanation of Invisalign costs in Singapore. To summarise simply, the cost of Invisalign varies according to:

1. The complexity and duration of the treatment

2. The dentist or orthodontist you choose to see. Orthodontists (specialists) may charge more as they undergo an additional three years of specialised training in the field of orthodontics (braces treatment).

3. Your Invisalign "package"

  • Invisalign i7 (cheapest) – Provides up to 7 aligners only; the most economical package available from Invisalign.
  • Invisalign Lite – Provides up to 14 aligners and treatment of about 6 - 7 months only. Used for simple cases or teeth that have shifted a little after previous braces treatment.
  • Invisalign Full (most expensive) – For more complex cases with many aligners required. Allows refinements.

Why I choose not to use Invisalign i7 and Invisalign Lite for simple cases

invisalign price plan

Example of Invisalign packages in Singapore.

Almost all the patients I see are Invisalign Full cases.

For simple cases that need three to five aligners only, I am able to create in-house aligners at a much lower cost than Invisalign. I can do this thanks to the use of an intra-oral scanner, which allows us to create a digital model and customised aligners for your teeth.

Any more complex cases that require more than five aligners, I leave to the experts - Invisalign.

I also rarely use Invisalign Lite because it requires super strict compliance. The treatment will fail if you do not wear your aligners well. If this happens, you will end up paying more than what you expected.

Will Invisalign treatment be shorter and cheaper if my teeth have shifted after previous braces treatment?

clear dental aligners

These "relapse cases" will not be too complex most of the time, and your Invisalign treatment will not be as long as your original braces treatment. [3]

The amount of treatment time required for relapse cases, and how much it will cost depends on:

  • How much your teeth have shifted
  • The type of tooth movement and time required to move them to an ideal position

Do note that treatment may be shorter time wise (eg. 8 to 10 months instead of 18 to 24 months), but costs may not be cheaper if it still fall under an Invisalign Full case.

To get a better sense, you can explain your situation directly to dentists, who will then be better able to advice you on treatment time and costs.

If the shifting of your teeth is mild, then of course you will have other options to realign your teeth, such as Invisalign Lite, and in-house aligners or retainers.

What are the advantages of Invisalign over traditional braces?

woman holding out a clear aligner and a dental model with braces

There are pros and cons to every treatment option. As an orthodontist who uses both systems, I have drawn up this summary table to try to illustrate the differences as best as I can for you.

 

InvisalignTraditional fixed braces
AppearanceVirtually invisible/clearMetal or ceramic braces cemented on the outer surfaces of teeth
Maintenance of teethEasy maintenance, just remove aligner when brushingMore difficulty in maintaining good oral hygiene, more time required during brushing and flossing
Maintenance of applianceEasy maintenance, brush aligner to keep clean. Change to new aligner every 1 - 2 weeksGood brushing required about brackets and wires, special brushes, floss required. Waterpik devices recommended.
Special precautions when eatingNone, aligners are removed when eatingAdvised to avoid eating hard and sticky foods, may need to cut food up into smaller pieces at times
Breakage of applianceRarely, sometimes tearing of the aligners may occur at areas where the teeth are very crooked. Attachments may dislodge occasionallyIf not careful when eating, brackets or braces can break off, or the wire may poke, requiring an extra visit to the orthodontist
ComfortVery comfortableLess comfortable
Frequency of review visitsLess frequent visit required, range from 4 - 10 weeklyEvery 4 weeks/once a month
Ability to treat all types of casesDifficulty with complex cases such as very deep bite cases, cases requiring jaw surgery. Not impossible, but may require a short period with fixed braces to assist treatmentAble to treat all types of cases
Compliance dependencyVery dependent on good aligner wear of 20 - 22 hoursMinimal compliance required
How long treatment will takeDepends on complexity of case, age of the patient and how well aligners are wornDepends on complexity of case and age of the patient
Need for retainers after treatment is completedYes!Yes!
CostHigher cost (due to lab fees)More economical

The total treatment time for Invisalign or traditional braces is the same

 

The treatment time between the two is not very different overall, despite what most people believe about Invisalign taking longer.

However, I always mentally prepare my Invisalign patients that they may not see their teeth straightening out so quickly in the beginning. Space needs to be created first before the teeth can be aligned, and this takes time. [2]

Conversely, the wires used with traditional braces will start working right away once the brackets are cemented onto your teeth. Teeth alignment occurs first, followed by the closing of spaces. Some patients see an improvement in their alignment by the next visit!

If you have had friends who told you that their Invisalign treatment took much longer, it is likely because they were not very obedient with following their dentist's instructions! What I have found in my patients is that after the novelty wears off, people tend to get lazier with their aligner wear. Their teeth then do not move as well as before, which results in the need for additional aligners and treatment time.

Are the benefits of Invisalign over braces only cosmetic?

person wearing invisalign

Although cosmetics is Invisalign’s biggest selling point, I find that easy maintenance of teeth hygiene, and the ability to eat whatever you want are close contenders.

Many of us Singaporeans live to eat (versus eating to live!), and wearing fixed braces makes it difficult to enjoy eating all your favourite foods. This is because with traditional braces:

  • You will need to cut your food into smaller pieces at times
  • Avoiding hard and sticky foods is strongly advised to avoid breakages - I have had many patients come in for unscheduled appointments due to breakages of their braces from unexpectedly biting onto a popcorn kernel that was hiding in their popcorn during a movie!
  • Maintaining oral hygiene is difficult, especially for those who are prone to tooth decay or have trouble maintaining good oral hygiene. You will need to clean very well around the brackets and the wires to prevent further tooth decay or gum disease

Additionally, wearing Invisalign aligners at night also provides protection against grinding, and some of my patients with TMJ pain do report improvement.

Are there any other aesthetic options for braces besides Invisalign?

Some orthodontists also offer lingual braces (braces on the inside of the teeth). An example would be the Incognito system, which is possibly even more "aesthetic" and invisible than Invisalign.

However, the cost of lingual braces is even higher than Invisalign. It can also cause more discomfort as the presence of braces on the inside encroaches on your tongue space.

I personally recommend lingual braces for very selective cases only.

What is involved in starting Invisalign treatment?

dental x ray

Once you and your dentist have decided on the treatment plan (eg. whether extractions or interproximal stripping is required), you will need to take:

  1. X-rays of your teeth and jaws
  2. Photos of your facial profile and smile
  3. An impression mould or digital scan of your teeth

All this information will then be submitted to an Invisalign technician for processing and creating a Clincheck plan for you.

The Clincheck is a 3D video of your projected tooth movement. It gives you a simulated end result of what you can expect once treatment is completed.

clincheck screen for invisalign treatment

While some dentists may not be comfortable with sharing the Clincheck results with you, I always suggest for my patients to make that extra trip down to discuss their Clincheck.

This additional discussion allows me to:

  • Get their input on simulated results to better understand their needs
  • Determine how comfortable they are with the location and appearance of the attachments
  • Give patients a rough idea of how many aligners they have, and how long their treatment will be

Once the Clincheck is approved, Invisalign will proceed to manufacture and send over your aligners in 2 weeks.

Is Invisalign treatment painful?

In general, Invisalign is less painful than fixed braces.

Having said that, any tooth movement will cause some form of discomfort. This occurs most commonly in the form of an aching sensation of your teeth, and especially when eating.

The discomfort does not last more than a few days. I liken it to wearing a new pair of shoes! It hurts a little in the beginning, but once you break into them, wearing them becomes very comfortable.

Can you avoid having Invisalign attachments on your teeth?

woman with invisalign on her teeth

Invisalign attachments are small, tooth coloured bumps placed on your teeth. They come in different shapes and sizes, depending on what tooth movement they are trying to achieve.

The attachments help by:

  • Providing a better grip of your aligners
  • Enabling better tooth movements 

In the past, I tried my best to oblige patients who really objected to placing attachments on their front teeth.

However, I have since found that for certain tooth movements, attachments are a must to move the tooth successfully.

 

Will crowns, bonding, or veneers affect my Invisalign treatment?

This is not an issue at all with Invisalign! Teeth with crowns/bonding or veneers can move just as well.

The only consideration is that the glaze on the porcelain of your crowns/veneers may be affected, or removed during the placement/removal of attachments.

One option would be to avoid placing any attachments on teeth with crowns or veneers. Your dentist or orthodontist can discuss this with you.

Will dental implants affect my Invisalign treatment?

Dental implants are fused to the bone and cannot be moved. Your orthodontist will have to work around the position of the implants.

Do the results of Invisalign treatment last forever?

dentist holding a model of teeth and clear aligners

Yes, but only if you wear your retainers regularly - this applies for ALL types of orthodontic treatments, including traditional braces.

The purpose of retainers is to hold your teeth in its new position. Without retainers, your teeth WILL shift, and you will lose the great results which you had worked so hard to achieve.

To me, retainers are more important than Invisalign treatment itself. I see so many patients coming in for orthodontic treatment a second or third time, simply due to lack of retainer wear.

What retainer options do you have after Invisalign?

dental retainers

You have two main options for retainers after your Invisalign treatment:

1. Removable retainers – Examples include clear retainers, or the more traditional retainers with a wire across the outer surfaces of your teeth (Hawley retainers). Invisalign also has its own Vivera retainers, which can be ordered once treatment is completed. Retainers need to be worn for at least six months full time (day and night). They are only removed when eating, brushing, and during active sports, similar to Invisalign.

2. Fixed retainers – Fixed retainers consist of a thin wire that is bonded onto the inner surface of your front 6 teeth. It is suitable for the less compliant, and those who are tired of having to remove their aligners or retainers whenever they eat. These fixed retainers can be removed after a few years.

How to choose the best Invisalign provider for your needs

a gloved hand holding up invisalign aligners

There is a tool on the official Invisalign website which helps you to locate Invisalign doctors near you. The results shown includes both general dentists and orthodontists (dental specialists) offering Invisalign at their clinics.

I would suggest for you to send an enquiry to a few dentists or orthodontists. This allows you to find someone whom is able to answer all your queries, and who will discuss all the possible treatment options available for you.

At the end of the day, I always believe that good communication between you and your clinician is the best way to ensure your treatment goes smoothly and successfully. So please ensure that you are fully comfortable with the treatment plan proposed by your Invisalign provider!


Dr Geraldine Lee is an orthodontist and Dean’s List graduate from the National University of Singapore (NUS). She obtained her Masters of Dental Surgery in Orthodontics from NUS, as well as the Membership in Orthodontics of the Royal College of Surgeons Edinburgh. Dr Lee previously served as President of the Association of Orthodontists (Singapore) (AOS), and has been an executive committee member of AOS since 2009. As a mother of two young boys, she loves travelling and the great outdoors.

References:

1. https://www.ncbi.nlm.nih.gov/pubmed/28153154

2. http://www.angle.org/doi/10.2319/061614-436.1

3. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008734.pub2/full

26388 views 23 Jan 2018 Medically reviewed by Dr Geraldine Lee on 10 May 2019.
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Disclaimer: Any answers provided are for general informational purposes only and is not a substitute for professional medical advice. If you think you may have a medical emergency, call your doctor immediately. Always seek the advice of your doctor before starting or changing treatment.

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