Clear aligners are becoming an increasingly popular choice for teenagers as they are a discreet way of straightening teeth, and because of aesthetics and comfort .
What’s important is that they allow the orthodontic treatment to be more comfortable for them. Clear aligners can also be removed for ease of cleaning so teens can be less self-conscious of their appearance!
While there are multiple clear aligner brands available out there, in this article, however, I will be going in depth about Invisalign for teenagers. Hopefully, you will gain more insight into how Invisalign works, the prices and what to expect for a teenage orthodontic treatment.
What are clear aligners?
First and foremost, let me explain what aligners are.
Much like traditional braces, aligners work by slowly moving the position of your teeth . They can be used for different kinds of misalignments to help you achieve your desired smile.
Clear aligners are aligners that are virtually invisible. This is probably the reason why they are preferred by both teens and adults.
Clear aligners are also removable. In other words, you can take them off when you eat! So they are more comfortable and more hygienic .
In Singapore, you might have heard of brands such as Invisalign, Zenyum, and MBrace, among others. While they can all be used for orthodontic treatments, they are different in terms of:
- the materials used;
- their overall prices;
- their technology;
- supervision methods (Invisalign requires dentists to monitor treatment; there is no in-clinic monitoring by dentists for brands like Zenyum, Wondersmile, Franksmile etc.).
Either way, you should consult a dentist or orthodontist first to see which one is more suitable for you.
The treatment really depends on the current condition of your jaw and teeth. Besides your condition, some of the other factors that you might want to consider include:
- How many patients have been treated successfully with a particular brand?
- Is it approved by the United States Food and Drug Administration (FDA)?
- Are there any shortcomings or side effects?
Do not ignore your teen's misaligned teeth!
A smile is one of the most important features of the face. In fact, it is the first facial feature many people notice, according to a survey. Not only that, research has also shown that crooked teeth affect first impressions.
Crooked teeth or jaw disharmony can cause problems in socialisation . In our growing-up years, some teenagers can be quite cruel, so teenagers with malocclusion may become a target for bullying . On the other hand, a perfect smile often gives you :
- extra self-esteem,
- a boost in confidence and
- a better overall quality of life.
In addition, crooked teeth are hard to clean and maintain . Hence, they increase the chance of tooth decay and gum issues. A bad bite can make eating or chewing more difficult. It may even affect your ability to make certain sounds .
If these issues are not addressed early, the teeth may be worn down abnormally, and excessive stress will be placed on the supporting bone and gum tissue. Without treatment, these problems may get worse.
What orthodontic treatments are available for teenagers?
In general, all types of available orthodontic treatment tools are suitable for teens.
Here are some examples of orthodontic treatments:
- Growth modification appliances
- Clear aligners such as Invisalign
- Metal braces
- Ceramic braces
- Self-ligating braces
- Lingual braces
How long does Invisalign treatment take?
In Singapore, Invisalign is the first established company that offered clear aligners for a wide range of misalignment cases.
In addition, the aligners are custom-made — they're usually computer-generated from a mould or impression of the patient's teeth. Thus, the fitting is unique to each patient.
You must be asking: "How long will it take?"
Well, a complete treatment can be done in as quickly as 6 months, while others may take up to 24 months or more, depending on the difficulty of the case. However, here are a few main factors that cause variations in treatment durations:
Crowding occurs when there is disharmony between the tooth-to-jaw size. Here are some reasons why your child's teeth may be misaligned due to crowding:
- early or late loss of primary teeth
- improper growth of teeth
- smaller jaw
- larger teeth (too little room)
In short, teeth will require more moving if there is more dental crowding. This will lengthen the treatment duration.
Gaps in teeth
Medically known as diastemata, gaps in teeth have many causes such as :
- missing teeth
- large jaws
- extra teeth — in some cases, extra teeth in the bone can prevent other teeth from coming through, causing a gap.
- small teeth
If your teeth have big gaps, they will need more time to fix. The orthodontist/dentist may suggest other forms of treatments after Invisalign to close the gaps fully. These orthodontic treatments may include bonding or veneers.
Invisalign is ideal for adults and teenagers! However, your age can definitely affect the duration of the treatment. Teenagers' teeth tend to move much more easily and quickly than adults.
Despite that, regardless of age, some people's teeth just tend to move faster than others, so any age is great for clear aligners to work.
Amount of hours worn
Invisalign recommends that they are worn 22 hours a day in order to be effective. They can be taken out when you are eating, brushing your teeth and when they are being cleaned. With that said, you should be using it at any time of the day or night!
If you are unable to wear them for the recommended time, be sure to inform your dentist. This is because there is a high chance that your teeth will move back to their original state.
How does Invisalign help me know if my teen is wearing them faithfully?
As mentioned above, it is recommended that the aligners are worn for at least 22 hours a day. Since Invisalign aligners are removable, it can be very tempting for teens to remove them more often than they are supposed to be removed.
So, orthodontists in the past could rely only on whether the teeth were moving to check whether the aligners had been used for the number of hours intended. However, times have changed.
Compliance indicators on aligners are an option to see if the wearer has complied with the directions on wearing them. They do not affect the treatment in any way.
Each aligner has a series of blue dots, which will fade the more frequently the aligners are worn. Hence, if the dots are rather visible during your next orthodontist visit, he can tell that you have not worn them often enough.
If the directions on wear are not complied with, the treatment period will take longer than planned. In my practice, I inform the teen, as well as his or her parents, that it is important to wear the aligners as recommended. In some cases, when the wearer is unable to comply, I would discuss other orthodontic options available to ensure that the wearer gets his or her perfect smile.
In very rare cases, there is not much tooth movement despite the aligners being worn diligently. When this happens, adjustments to the treatment plan can be made.
How much does Invisalign cost for my teen?
Invisalign prices range from S$5,500 to S$10,000. Nevertheless, the price and length of the treatment can vary according to the severity of the case as well as your choice of braces. Treatment will take longer for those who require growth modification. The average total period of treatment ranges from 18 to 30 months.
The costs of braces can vary considerably from clinic to clinic. They are largely dependent on:
- the amount of treatment needed
- case difficulty (the more complex = longer treatment time = more expensive)
- orthodontic material used
- level of expertise of the dentist/orthodontist
However, instalment plans are available in most clinics. Be sure to check with your clinic as different clinics have different instalment policies.
How does Invisalign affect my teen’s lifestyle and diet?
Teens can expect less pain and discomfort when using Invisalign compared with using braces. Braces can cause ulcers and there is a risk of the wire breaking. With Invisalign, they do not have to worry about these problems.
Invisalign is practically invisible. Teenagers who are self-conscious about having braces can smile more comfortably with Invisalign.
No dietary changes are needed. Your teen can eat whatever his/her heart desires, from chocolates to popcorn (of course, they should still maintain proper oral hygiene). They also do not have to deal with food particles stuck on wires or between the brackets.
It is possible to plan for long trips without disrupting or prolonging the treatment. Your doctor will be able to provide additional aligners for the duration of the trip, as aligners are changed every 2 weeks.
The time between follow-up appointments may vary from 4 to 8 weeks as compared with using traditional braces, for which appointments take place every 4 weeks.
Teenagers who are physically active also do not have to worry about issues like sports injuries.
Will misalignment reoccur?
Teeth love to move, and will continue to move for the rest of your life, whether you are a teenager or an adult. So, whether you use traditional braces or clear aligners, your teeth will move.
The tongue and cheek muscles move and apply pressure on our teeth and can cause them to move. If you want your teeth to continue to look great, then you will need to continue to wear your retainers for years to come.
Misconceptions surrounding Invisalign clear aligners
1. "Invisalign is less effective than traditional braces."
Both clear aligners and braces are effective in treating misalignment. In fact, Invisalign aligners have shown to be effective in treating a wide range of bite issues. As the trays are replaced every few weeks, they are uniquely designed to move into a specific bite pattern.
It has also been shown that clear aligners are able to fix bites and get the desired smile in a shorter period in some cases.
2. "Invisalign is unnecessarily more expensive than traditional braces!"
The cost of orthodontic treatments can indeed discourage parents greatly. One common misconception is that the cost of Invisalign is not as worth it compared with that of other options.
However, the truth is that the cost of Invisalign treatment depends on the complexity and severity of your teen’s case. Besides, Invisalign requires fewer visits to your orthodontist compared with using traditional braces. This will free up some time for teens to focus on more essential activities such as their studies, sports and their passions. Therefore, Invisalign may be preferred during this crucial period of cognitive, psychological and social development for teens.
There would also be fewer emergencies such as fallen brackets or loose wires during critical periods like national exams. Invisalign thus gives teens the peace of mind to focus on activities that are essential for their development.
Finally, as the treatment is a rather long process, a minimal amount of downtime is desired.
In general, the benefits of Invisalign greatly outweigh the initial cost.
3. "I am too old or too young for Invisalign."
Anyone can get Invisalign, regardless of age. Many of my patients get this treatment when they lose their baby teeth. Orthodontists can also anticipate the eruption of permanent teeth and make adjustments for it during the Invisalign treatment.
4. "Invisalign will affect my speech, hence, the way I talk!"
In the first few days, wearers might develop a slight lisp, so Invisalign will indeed affect speech slightly.
But once your tongue gets used to it, the lisp will disappear and your speech should return to normal.
5. "Food will get caught in my Invisalign, making it look old after awhile. It also makes my child feel uncomfortable."
Unlike Invisalign, braces have wires and brackets that trap food and bacteria if they are not cleaned properly. Invisalign wearers, however, are advised to remove their trays before eating. After the meal, they are also advised to brush and floss before putting it back on.
Apart from that, Invisalign clear aligners can indeed appear darker when they:
- are not properly cared for
- are exposed to high temperatures
- come in contact with staining agents.
With that said, I often advise patients NOT to:
- rinse and brush the aligners with warm water
- drink dark liquids such as coffee, red wine and tea with Invisalign on
With Invisalign, you have the flexibility to eat and drink everything. However, you should take the trays out first to prevent them from being stained them. Before putting them back on, you should brush your teeth, or at the very least rinse them thoroughly to prevent rapid tooth decay.
Is Invisalign suitable for my teen?
While the ideal time to undergo orthodontic treatment for most patients is during their teenage years, there are some exceptions:
Irregular jaw growth
Teens with excessive lower jaw growth (long or slanted lower jaw) should wait until the growth of the jaw has stabilised before starting orthodontic treatment. Usually, the lower jaw growth stabilises at around 18 to 21 years old . This can be confirmed with serial lateral cephalogram x-rays.
Poor oral health
Teens who have active tooth decay or poor oral hygiene should manage their general dental health condition first before embarking on their orthodontic journey. This is to reduce complications or worsening of their existing dental problems . Going through orthodontic treatment with these dental problems could compromise the treatment results.
The success of orthodontic treatment requires cooperation between the teen and the orthodontist/dentist . Therefore, it may not be in the best interest to force your teenager to start orthodontic treatment if they are either unwilling or uninterested.
Additionally, it is important for the teenager to build a good rapport with their orthodontist/dentist before the start of treatment. This is to ensure the teenager is on board and comfortable going through with the treatment.
Previously, we have encountered teenagers who are not interested in brushing their teeth properly, yet they were forced by their parents to get braces. Not only did their treatment process take much longer than expected, they also developed tooth decay as a result of poor oral hygiene.
Where can teenagers get Invisalign in Singapore?
In Singapore, orthodontists and dentists who have gone through a certified course conducted by Invisalign can do the treatment. Dentists can also obtain orthodontic knowledge by attending part-time courses and conferences.
With that said, some general dentists do great orthodontic work. Others, however, may have minimal experience in treating malocclusions.
Orthodontists are certified dental specialists by the Ministry of Health, with a verified level of knowledge in:
- the treatment of crooked teeth through braces
- the control and modification of different parts of facial and jaw growth.
Orthodontists go through an extra 3 years of full-time specialised education, where they learn the skills required, which includes:
- managing tooth movement
- guiding facial development
After gaining at least 5 years of clinical experience, they can be recognised by the Singapore Dental Council after taking an exit exam conducted by the Dental Specialist Accreditation Board.
The experience of using Invisalign as an orthodontic treatment tool also depends on the individual orthodontist or dentist. You can check with your preferred orthodontist or dentist about their level of experience in using Invisalign. You may also ask him/her to show you some past cases to know more.
Why you should not get online orthodontic treatments for your teen
Dentists/orthodontists do not encourage online orthodontic treatments. This is because some of these treatments may not be designed by dental professionals with sufficient orthodontic knowledge.
All forms of orthodontic treatment have to be closely monitored by your orthodontist/dentist. They should be the one who designs the treatment for you as they have examined your condition both clinically and through x-rays in order to determine your problem.
Complications can arise during orthodontic treatment. These issues can be missed if your child is undergoing online orthodontic treatment. Furthermore, the cost of rectifying these issues may be much more than seeing an orthodontist/dentist for in-clinic treatment.
Do teens need parental approval before getting Invisalign?
In Singapore, a person is legally considered an adult when they reach the age of 21 . However, there is no statute law in Singapore that defines the legal age to give consent for any medical treatments. Having said that, the parents or guardians should be directly involved in consent giving as most teenagers are financially dependent on them.
In addition, it is crucial to communicate directly with the teenager going through the treatment. This will allow the teenager to take ownership of the treatment and be more motivated and involved, thus ensuring the success of the Invisalign treatment.
In summation, a great smile not only gives teens an extra confidence boost, but also makes it easier for them to manage their oral health.
There are many treatment tools that can help your teen get that perfect smile. The technology available now has indeed helped many teens achieve that. Invisalign is a great option for teenagers who want to improve their smile in the most comfortable way, with just little changes needed to their diet or lifestyle. Additionally, with fewer emergency visits, Invisalign is easier for those with busy schedules.
With the removable option presented by Invisalign, oral hygiene is much easier to manage, and it's the most discreet way for your teen to achieve that Instagram-worthy smile!
Dr Enrica Sham is an orthodontist and Clinical Director of TLC Dental Centre. She also serves as a part-time clinical tutor at the Faculty of Dentistry, National University of Singapore. Dr Sham is also featured on our list of orthodontists you should consider for Invisalign.
Read more of Dr Enrica Sham's QnA here.
1. Jiang Q, Li J, Mei L, et al. Periodontal health during orthodontic treatment with clear aligners and fixed appliances: A meta-analysis. Journal of the American Dental Association (1939). 2018;149(8):712-720.e12. doi:10.1016/j.adaj.2018.04.010
2. Orthodontic treatment. Vic.gov.au. Published 2012. Accessed December 2, 2019.
3. Ke Y, Zhu Y, Zhu M. A comparison of treatment effectiveness between clear aligner and fixed appliance therapies. BMC Oral Health. 2019;19(1). doi:10.1186/s12903-018-0695-z
4. Samsonyanová L, Broukal Z. A Systematic Review of Individual Motivational Factors in Orthodontic Treatment: Facial Attractiveness as the Main Motivational Factor in Orthodontic Treatment. International Journal of Dentistry. 2014;2014:1-7. doi:10.1155/2014/938274
5. Bullying and Youth with Disabilities and Special Health Needs. StopBullying.gov. Published 2012. Accessed December 2, 2019.
6. Afroz S, Rathi S, Rajput G, Rahman SA. Dental Esthetics and Its Impact on Psycho-Social Well-Being and Dental Self Confidence: A Campus Based Survey of North Indian University Students. The Journal of Indian Prosthodontic Society. 2013;13(4):455-460. doi:10.1007/s13191-012-0247-1
7. Oral Health Care Zone for Grown-ups - Oral Care Tips - Clean the teeth - Clean the tooth surfaces by toothbrushing. Toothclub.gov.hk. Published 2019. Accessed December 2, 2019.
8. Leavy KM, Cisneros GJ, LeBlanc EM. Malocclusion and its relationship to speech sound production: Redefining the effect of malocclusal traits on sound production. American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics. 2016;150(1):116-123. doi:10.1016/j.ajodo.2015.12.015
9. Teeth - gapped teeth. Vic.gov.au. Published 2012. Accessed December 2, 2019.
10. Love RJ, Murray JM, Mamandras AH. Facial growth in males 16 to 20 years of age. American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics. 1990;97(3):200-206. doi:10.1016/S0889-5406(05)80052-6
11. Wisth PJ, Nord A. Caries experience in orthodontically treated individuals. The Angle orthodontist. 1977;47(1):59-64.
12. Sarul M, Lewandowska B, Kawala B, Kozanecka A, Antoszewska-Smith J. Objectively measured patient cooperation during early orthodontic treatment: Does psychology have an impact? Advances in clinical and experimental medicine : official organ Wroclaw Medical University. 2017;26(8):1245-1251. doi:10.17219/acem/65659