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Invisalign Process: Step By Step From Start To Finish

The entire Invisalign treatment can take months or even years to complete but it depends on how complex your orthodontic case is. Regardless of the case complexity, every treatment plan will go through a similar process.


It's just that some people will spend a longer duration of time in the teeth moving step.


invisalign tray
invisalign tray

This is your guide to the Invisalign process, broken down by each individual step. Yes, we'll walk you through it step by step so you know what to expect.


Invisalign process - Step by step

  1. Preliminary consultation. To determine if you're a candidate for Invisalign.

  2. Financial arrangements. To figure out insurance coverage and payment plans.

  3. Orthodontic records. Take photos and impressions of your teeth.

  4. Review Invisalign plan. Review proposed plan and ask for modifications if needed.

  5. Order Invisalign aligners. Trays can be ordered after plan approval.

  6. Place attachments. This is the appointment that you finally get your trays.

  7. Mid-treatment modifications. Attachments, IPR, or corrections.

  8. Invisalign refinement. Typically one refinement is recommended before finishing.

  9. Evaluate for completion. Remove all attachments and evaluate for completion.

  10. Order retainers. The Vivera retainers needs to be ordered.

  11. Daytime retainer wear. Wear retainers until teeth stabilize.

  12. Nighttime retainer wear. Wear retainers while asleep to hold teeth in place.


That's right, there is a grand total of 12 steps to the entire Invisalign procedure. Was that more or less than you thought?


Preliminary consultation

The purpose of the first step of the Invisalign process is to determine if you're a candidate for Invisalign. Patients often come in saying that they want it but before we can answer that, it needs to be suitable for you first.


What to expect: 15 min visit

  • Oral evaluation to see if you're eligible for aligners.

  • Get an estimate for how long your Invisalign treatment will take.


What your dentist is looking for:

  • Previous orthodontic history.

  • Do you have dental malocclusion or skeletal malocclusion?

  • Tooth conditions: spacing, crowding, open bite, cross bite, etc.


Last but not least, are you cavity free? You will need to have all active dental diseases treated prior to starting.


Financial arrangements

The second step of the Invisalign treatment is to agree upon a financial arrangement, which includes insurance coverage and payment plans. The treatment isn't free so you will need to figure out the total cost and how you'll pay for it.


What to expect: 15-30 min visit

  • Submit to your dental insurance for Invisalign pre-approval to check how much coverage and benefits you will receive. This may take two weeks for a decision.

  • Discuss with your dentist how you wish to pay for the non-insurance covered portion.

  • Pay via cash, debit, or credit?

  • Get third party financing such as Carecredit, Lendingclub, Lendingpoint, etc?


The average cost of Invisalign is $5,651.81 if you have no insurance coverage. Although if you see a specialist such as an orthodontist, the average cost will be $6,385.28 which is higher.


Most dental insurances will have orthodontic coverage and here are the ones which we've seen with benefits/coverage:

  • Delta dental

  • Guardian

  • Cigna

  • Metlife

  • United Healthcare

  • Aetna

  • Principal



delta dental has 50% orthodontic coverage
delta dental has 50% orthodontic coverage

Exception: However, you should be aware that while some plans may have coverage, they may have exclusions that deny you benefits. One such clause is the orthodontic coverage age limit, where if you're over a certain age you won't get coverage.


Orthodontic records

The third step of the Invisalign process involves taking orthodontic records, which includes photos and impressions of your teeth.


What to expect: 15-30 min visit

  • Impressions of upper and lower teeth. Alternatively you can scan the teeth.

  • Bite registration to see how the teeth come together.

  • Teeth photos: straight shot, left occlusion, right occlusion, upper arch, lower arch

  • Facial photos: no smiling, smiling, side profile


The collage of photos above is what is typically known as an "orthodontic record", which will be submitted to Invisalign for evaluation. Admittedly, we're not the best photographer...



Review Invisalign plan

The fourth step of the Invisalign treatment is to review the proposed plan and ask for modifications if needed. We will also provide two examples of actual Invisalign plans from our patients.


What to expect: 15 min visit

  • You will review the plan together with your dentist.

  • Now is the time to ask questions.

  • You may request modifications to the plan if you don't like the anticipated end result.



Possible modifications:

  • Flare the teeth out more.

  • Bring the teeth in.

  • Make one tooth longer.

  • Rotate the tooth a little more.




Essentially, the modifications are endless and you can ask Invisalign to change whatever you want. However, if what they propose looks good you don't need to modify it.


modification request
modification request

Note: If you do ask for a modification, it will take an additional 2-3 days for them to formulate a new treatment plan. You will have to return to evaluate it once more.


Order Invisalign aligners

The fifth step happens after the Invisalign plan review and all it requires is approval from you. As long as you like the plan and you wish to proceed with it, your dentist can order your Invisalign trays. All they have to do is click the "approve" button.


invisalign plan approval
invisalign plan approval

This is a very quick visit and is often combined with the Invisalign plan review step. From the approval date, it usually takes Invisalign about a week to make the trays and to ship them to your dentist.


Place attachments

The sixth step of the Invisalign process involves getting your aligners as well as having attachments put on your teeth. Yes, you will be finally getting your trays and starting your teeth straightening journey.


What to expect: 30-45 mins visit

  1. Place attachments on all of the teeth.

  2. Etch and bonding placed on enamel.

  3. Attachments will be a translucent colored composite resin.

  4. Remove excess bonding by polishing it off with high speed handpiece.

  5. Your dentist will show you how to put on and take off the trays.

  6. Give you instructions on what to do and what not to do with the aligners.

  7. You will leave the office with a couple set of aligners.


The entire process should be painless and you do not require any numbing at all.


invisalign attachments - various sizes, shapes, quantity
invisalign attachments - various sizes, shapes, quantity

The purpose of the Invisalign attachments (buttons) is to give the trays more leverage to move the teeth in the desired direction. The attachments come in different shapes, sizes, and amount of them. They're meant to mimic how the metal brackets for braces help move the teeth.


Mid-treatment modifications

During the middle of the Invisalign treatment, sometimes the plan will call for additional procedural steps by your dentist.

  • Extra attachments. Some plans require additional attachments to be placed during the middle of treatment. It is usually a few at most and not as many as the first visit.

  • Interproximal reduction (IPR). If there is excessive crowding, your dentist may need to create spacing between your teeth where you floss.

  • Corrections. If your trays don't fit because the teeth aren't tracking or you were non-compliant in wearing them, you will need a correction. Your dentist will remove all of the attachments and take new molds/scans of your teeth and reorder the trays.

If any attachments fall off during the process, you should have them put back on.


Invisalign refinement

The eight step of the Invisalign process is to do a refinement once you finish all of your trays. This will be required if your teeth aren't completely straight after the last set of trays.


However, even if they look straight we still recommend doing one because Invisalign always finds an unperceived imperfection to refine.


What to expect: 30 minute visit

  1. Remove all attachments.

  2. Take new impressions/scans of the teeth.

  3. Take new photos.

  4. Send the case out to Invisalign.


It'll most likely take about an additional 1-2 weeks for Invisalign to send you additional trays for the refinement. Once your dentist receives it, you will need to come in to pick them up and also place additional attachments if needed.


Note: Please continue wearing your last aligner while you wait for the new trays to come in.


Evaluate for completion

The ninth step of the process is to evaluate for completion which is when you've finished all of your refinements. Your treatment is considered complete once you are happy with the results.


What to expect: 15-30 mins visit

  1. Remove all of the attachments from your teeth.

  2. Take new impressions for retainers if needed.

  3. Alternatively, your dentist could order it without new impressions based off of your last set of trays.


Note: Please continue wearing your last aligner while you wait for the new trays to come in.


Order retainers

It will take about 1-2 weeks for your dentist to order your permanent retainers from Invisalign.


The product which Invisalign offers is called the Vivera retainers.

  • It comes in a set of 4 identical retainers, 4 on upper teeth and 4 for the lower teeth.

  • Each set will last about 1.5-2 years.

  • If you break one or lose one, move onto the next set.


Daytime retainer wear

Once your vivera retainers arrive, you will need to come in and pick them up.


What to do with the retainers:

  • You will stop wearing the last set of your aligners and switch to the retainers.

  • Wear the retainers 24/7 for the next 3-6 months, depending on what your dentist says.


Yes, you need to wear the retainers ALL the time and the first six months is critical to do so. You may have notice but without the retainers on, you can try wiggling your lower front teeth. The teeth will be mobile and loose.


You want to wear the retainers to hold the teeth in place so that your body can rebuild bone around the teeth. This process may take 3-6 months before your teeth become fully stabilized and not loose.


Nighttime wear maintenance

The twelfth and last step of the Invisalign process is to switch to nighttime wear for the retainers. That means you can stop wearing them 24/7 and only wear them while you sleep.


The purpose is to prevent the teeth from shifting. You can switch to nighttime wear once your teeth have fully stabilized and are no longer loose. The daytime wear process usually takes about 3-6 months but everyone's a little different in how fast they rebuild bone.


That is basically the entire process and what you can expect for Invisalign.

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About the author: Dr David Chen, DDS

Hello, I'm Dr Chen and I'm an actively practicing dentist in Long Island City, NY. I graduated from Columbia University College of Dental Medicine in 2016 but prior to going to dental school I was already working in the dental field. It's been more than a decade since I first got to know dentistry and let me tell you, time flies by quickly. Since then I've developed a fondness for writing, which is how this all got started!

Association Memberships:

Medical Disclaimer:

This blog is purely meant for information purposes and should not be used as medical advice. Each situation in your mouth is unique and complex. It is not possible to give advice nor diagnose any oral conditions based on text nor virtual consultations. The best thing to do is to go in person to see your dentist for an examination and consultation so that you can receive the best care possible.

The purpose of all of this oral health information is to encourage you to see your dentist and to inform you of what you may expect during your visit. Due to the unfortunate nature of dentistry, there isn't really any true home remedies that will get rid of dental problems. Roughly 99.99% of them require in-person intervention by a healthcare professional.

Hint: That is the reason why you can't eliminate seeing dentists in your life!

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