Invisalign refinements are a short extra set of aligners, made from a fresh scan at the end of your planned series, that finish any movements not fully completed first time. They’re common, and needing them doesn’t mean treatment has failed. At Toothi in Edgware, refinements are included in every Invisalign package, from £1,495, at no extra cost. Teeth are living things moving through bone, and the ClinCheck plan is a prediction of how they’ll respond. Most patients finish close to the plan. Some need a short extra series to close the last fraction of a millimetre on a stubborn rotation or to settle the bite. The refinement is how we get you from “nearly” to “done”.

If you’re new to the whole process, start with how Invisalign works or our Invisalign in Edgware page; this page picks up at the end of the series.

Because teeth don’t always follow the plan exactly. A ClinCheck shows each tooth gliding to its final position in neat fortnightly steps. Real teeth are less tidy. Each aligner applies a force, bone on one side of the root dissolves slightly while new bone forms on the other, and the tooth moves. How fast and how far that happens varies from person to person and tooth to tooth.

• ✓  Biology. Bone density, age and gum health all affect how readily a tooth responds. Two patients with identical plans can finish in different places.
• ✓  Wear time. The plan assumes around 22 hours a day. Aligners worn for 18 hours still move teeth, but not as far per aligner, and the shortfall adds up. This is the biggest factor within your control; see the Invisalign 22-hour rule.
• ✓  Seating. An aligner that isn’t pushed fully home doesn’t grip the tooth properly. That’s what chewies are for, as explained in Invisalign chewies and how to clean Invisalign aligners.
• ✓  Attachments. These are the small tooth-coloured bumps that give the aligner something to grip. If one comes off and isn’t replaced promptly, the movement it was there for stalls. See Invisalign attachments.
• ✓  IPR. Some plans create space by polishing a fraction of a millimetre from between teeth. If that space is created later or less than planned, crowding resolves more slowly. See what is IPR?.
• ✓  Difficult movements. Rotating round teeth like canines and premolars, pulling a tooth down into line and moving roots rather than crowns are less predictable with aligners than simple tipping. A plan with a lot of these is more likely to need a refinement, and your dentist should tell you so at the start.

None of this means something went wrong. The plan was a forecast and your mouth had its own ideas. The refinement corrects for that.

A new scan, a new ClinCheck covering only what’s left, then a short new series of aligners. Step by step:

Between the scan and the new aligners arriving you keep wearing your last aligner so the teeth hold position. How long the refinement takes depends on how much is left: a single rotation might be a few aligners, a general tidy-up rather more. We’ll give you a range once the new ClinCheck is back. Overall timelines are in how long does Invisalign take?.

Wear the aligners 22 hours a day, seat them with chewies, and keep every review. You can’t control your biology or how tricky your movements are. You can control the things that most often push a case into needing an extra round.

• ✓  Wear them 22 hours a day. Actually 22. Out for meals and brushing, in for everything else. Time out adds up faster than most people expect. The 22-hour rule explains why the margin is thinner than it looks.
• ✓  Use chewies every time you put a new aligner in. A few minutes of biting pushes the aligner fully down over the teeth and attachments. Look for air gaps at the biting edges; if you see one, chew it closed.
• ✓  Don’t skip reviews. Your 8-weekly appointments are where tracking problems get caught while they’re small. A tooth a fraction behind at week eight can often be fixed by holding an aligner a few extra days. Spotted much later, the same tooth is more likely to need a refinement. If an attachment falls off, book in that week.
• ✓  Change aligners when told, not early. Moving on before a tooth has caught up makes the lag worse. If an aligner still feels tight or shows a gap at day seven, tell us.

For day-to-day practicalities like eating out, travel or a lost aligner, see living with Invisalign.

Timing and cause. A refinement comes at the end, a mid-course correction part-way through, and relapse happens after treatment when retainers aren’t worn. All three tend to get lumped together as “extra aligners”, so it helps to know which is which when reading any clinic’s terms.

• ✓  Refinement. A new scan and a short new series at the end of planned treatment to finish incomplete movements. The most common of the three. Included at Toothi.
• ✓  Mid-course correction. The same idea part-way through, when tracking has drifted far enough that the remaining aligners wouldn’t get there. The dentist rescans and a new plan covers the rest of the treatment. Less common, and usually avoidable with good wear and regular reviews.
• ✓  Retention relapse. Teeth that were finished and have since drifted because retainers weren’t worn. That’s a retention problem rather than a refinement, and the fix is a new course of aligners charged as new treatment. Our Invisalign retainers page explains the schedule, Invisalign relapse covers what to do, and replacement retainers covers a lost retainer before the teeth have settled.

Not at Toothi. Elsewhere it depends on the provider, so it’s worth asking before you sign anything. Align’s packages give the dentist an allowance of extra aligners within a time window, but each practice decides how that’s passed on. Some include refinements, some charge separately, and some limit them to a set number or window. Plenty of patients need a refinement, so it matters. Always ask, in writing: are refinements included, how many, and for how long after I finish?

At Toothi, refinement aligners are included in every Invisalign package if clinically needed. The fixed fee quoted at your free consultation is the fee you pay.

Included in every Invisalign package: iTero 3D scan and ClinCheck · all review appointments · refinement aligners if needed · removable and fixed retainers · Airflow hygiene clean · Boutique teeth whitening. Nothing is added on later. Full detail on our fees page, our packages page and our Invisalign cost guide. Our principal dentist, who has a special interest in Invisalign, plans and reviews every refinement personally.