Invisalign refinements explained: what they are and what to ask

What the term means

Your first set of aligners is designed from a digital scan and a planned sequence of tooth movements. Teeth do not always follow that plan exactly. When a review shows some teeth lagging behind, a new scan can be taken and a further series of aligners made to finish the movement. That further series is a refinement.

Why refinements may be needed

• Some teeth, particularly rotated or short teeth, can be slower to move
• Aligners worn for fewer hours than advised track less closely
• The finishing detail of the bite may need adjustment once the main movement is done
• You or your dentist may want a small further improvement once you see the progress

How the decision is made

At each review the fit of the aligners and the position of the teeth are checked against the plan. If a refinement is suggested, you should be told why, what it aims to change and roughly how it affects your completion date. No responsible clinician can promise in advance exactly how many refinements a case will need.

What your written plan should say

Ask whether refinement aligners, extra scans and review appointments are included in your fee, and for how long. Ask too what happens if you choose a further change after the planned result is reached. Current guide fees are on the fees page; your written plan confirms what applies to you.

After refinements: retention

Whatever the number of refinements, teeth tend to drift without retainers. Plan for retainers and their replacement from the beginning.

Questions patients ask

• Are refinements always needed? Not always. Many plans need some fine-tuning; some do not.
• Are they included in my plan? That depends on the plan. Ask for it in writing before starting.
• Will they change my finish date? Usually by some weeks. Your dentist should estimate this at the time.