With the growing popularity of Invisalign, more orthodontists and dentists are offering clear aligner therapy. While many of them dabble in this modern approach to straightening teeth, I specialize in Invisalign and have a hand (or, more specifically, a computer mouse) in designing the clear aligners for my patients.

As an Elite Premier Invisalign Provider—ranked in the top 100 providers in the world—I have been privileged to get an up-close look at how these clear aligners are made. Several of my staff members also have done extensive training at the company’s design lab in Costa Rica, including my technician, Lorraine, who was the subject of a pilot study arranged by the vice president of operations of Align Technology, makers of Invisalign.

It is a collaboration of not only my staff in our Northeast Ohio offices, but also a design lab and production facility—all digitally connected. Here are the many behind-the-scenes steps to attaining a perfect smile.

  1. I make a 3-D copy of the patient’s mouth in our office with an intraoral scanner (a sophisticated camera that takes thousands of pictures and constructs them into a virtual copy of a patient’s mouth).
  2. This information is then sent to the Invisalign design lab, where a computer software program isolates each individual tooth as a separate object. The software program arranges the teeth according to an algorithm determined by my answers to a dozen questions. Each of these questions is like a branch in the algorithm, so by the end of questionnaire the software sets up the teeth in the determined pattern. The Invisalign design technician takes this computerized information and makes sure it conforms to my preferences and specific instructions. As an Elite Premier Invisalign Provider, I am fortunate to have the most senior technician assigned to me to work on my patients’ cases.
  3. I was one of the beta developers for this software so, unlike many orthodontists, the file is sent back to me and I actually do the final movements—having control over each and every tooth. This varies from minor touchups to significant revisions. I spend 10 to 12 hours a week in the office just on the design process when there are no patients in the office.
  4. When the desired result are specified, I send the file back to the lab where the computer looks at the original position of teeth and final desired position, and then figures out the pathway (hitting a pause button in the morph every two tenths of a millimeter or two degrees of rotation) to go from original crooked to final straight.
  5. The file is then sent to the manufacturing facility, where, robotically, it prints out each step as a 3-D digital model, heats a piece of plastic, adapts the shape, trims it, and then it is numbered and bagged in sequence and sent to our office.

By touring these facilities, along with two of my staff, and seeing how everything works behind the scenes, it helps us better work together for the best results.