Switching From Braces to Invisalign Mid Treatment
Switching from braces to Invisalign mid treatment means restarting the treatment plan from a new scan. The brackets come off, and we re-sequence the remaining tooth movements for clear aligners instead.
Patients wearing braces ask me about the switch at every stage of treatment. The patient who makes it also takes on the daily responsibility of keeping the aligners in.
Of the more than 5,000 Invisalign cases our team has planned, the ones that began in braces have required a fresh scan and a rebuilt plan rather than a continuation of the original plan.
New Scan Behind Every Switch to Clear Aligners
A clear aligner, the removable plastic tray Invisalign uses to move teeth, is manufactured from a model of the teeth as they sit today, not as they sat on the first day of treatment. By the time a patient asks about switching, the braces have already moved the teeth. The records taken at the start of treatment no longer match the current positions of the teeth.
In our offices the switch follows a set sequence. We scan for a temporary retainer while the braces are still on, remove the brackets, and deliver that retainer the same day.
At the same visit, we take a second scan on an iTero scanner, a digital scanner that maps every tooth surface. That scan captures the partial correction the brackets achieved and the tooth movements they left unfinished. The aligners built from it normally arrive about three weeks later.
The temporary retainer holds the teeth in place during those three weeks. A patient making the switch never spends a day without an appliance protecting the correction.
We treat that second scan as day one of a new case. The new aligner series is built from the scan. The length of the new plan depends on the tooth movements that remain, not on the months already spent in brackets.
A mid treatment switch may slightly extend the total treatment timeline. The months already spent in brackets buy progress toward the final result, not a shorter aligner plan.
Invisalign’s planning software, called ClinCheck, generates a default plan from the scan. Approved without modification, that default achieves about half of the desired clinical result.
We program every remaining tooth movement manually, setting the direction, distance and rotation for each tooth. To land a tooth 2 millimeters from where it sits, we program 2.5 millimeters in the software, because tissue resists the movement and the tooth stops short of the programmed position.
Most cases also need attachments, small tooth-colored composite bumps bonded to the enamel. Without them, the smooth aligner slides over the smooth tooth. Attachments go on at the start of the aligner phase and get polished off at the end.
A switched case also finishes like an aligner case. Refinements, a follow-up round of aligners that fine-tunes the result, are a standard part of treatment rather than an exception. I tell every patient to assume at least one.
No part of the bracket-phase plan carries over. A patient making the switch goes through the same sequence I describe in what really happens after you sign up for Invisalign.
Daily Wear Hours After Trading Brackets for Invisalign Trays
A bracket works around the clock because it is bonded to the tooth. An aligner works only while it is worn.
The standard we hold patients to is 20 or more hours of aligner wear per day. Below roughly 18 hours, the aligners stop fitting correctly and the results fall short, a pattern that shows up within the first eight to 12 weeks.
In my experience, patients tend to be consistent about wear hours. The ones who start well finish well. When wear falls short, I re-plan the case around a result the aligners can actually reach.
Poor wear is by far the most common reason a case takes longer than planned, a pattern I laid out in compliance determines Invisalign case length.
Honest Assessment Before Leaving Braces for Invisalign Treatment
In our offices, the barrier to switching from braces to Invisalign is rarely the remaining tooth movements. Our team treats most cases with either braces or Invisalign. The barrier is the honest assessment of the patient’s daily habits.
A patient six months from completing treatment in braces, and unsure about 20 hours of daily aligner wear, is usually better served finishing in braces. Teeth only move while force is applied. An aligner sitting in its storage case applies no force to the teeth.
The patients who do best after a switch wanted the aligners for a specific reason that will still matter a year into treatment. Brushing and flossing without wires in the way is the reason I hear most.
The other motive I hear is wanting a treatment other people will not notice. Invisalign is not invisible once attachments are bonded to the teeth.
In my observation, attachments rarely get noticed when patients interact naturally. Patients who try to conceal them draw more attention than the attachments do.
For on-camera professionals at our West Hollywood office, we place attachments behind the six upper front teeth instead of on the visible surfaces.
Switching from braces to Invisalign works when the patient understands the restart and still wants the trays. The switch means a new scan, a re-sequenced plan and the daily responsibility of keeping the aligners in.
The restart is not a reason to avoid the switch. It is a reason to make the switch only for motives that will still matter a year into the new plan.
