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Planning Invisalign® in Arlington, Virginia

Planning for Invisalign®/What Do Buttons And Slenderizing Do?

Invisalign® was developed as an option to move teeth without using traditional braces. The technology works by taking the registration of a patient’s current dentition and using CAD/CAM technology to virtually manipulate the teeth into a desired esthetic and functional position. This measured movement is equally divided into 2 week segments that correspond with custom-manufactured aligners. Aligners (trays) are made of hard plastic and provide the necessary forces to move teeth to the next position predicted by Invisalign’s software. If more movement is required then more aligners will be needed.

Buttons? Slenderize?

Using “buttons” and “slenderizing” teeth are very common and both are often needed with adult cases. Buttons are small, transparent dental plastics placed on teeth to help facilitate movement. We describe them as Invisalign®’s more esthetic version of brackets that are used with traditional braces (they are usually unnoticeable by the casual observer). When buttons are prescribed, their purpose is to gain desired tooth movement. “Tooth slenderizing,” referred to as IPR (interproximal reduction) is simply removing a small amount of tooth structure between crowded teeth so they can move into alignment. Usually only the thickness of a fingernail is removed (0.1mm - 0.3mm). This process does not harm teeth.


Invisalign® is only effective when trays are worn 20+ hours a day. Most people describe the first 3 days of each aligner as “pressure awareness.” Invisalign® is not painful; however, we recommend changing trays at night and taking ibuprofen to help with any initial discomfort. Usually, after three days of wearing an aligner, the teeth will move to their new location, the pressure subsides, and trays become easier to place and remove. If the aligners are not fully seating or fully engaging the buttons, after 7 days, please call our office for an Invisalign check.

Keeping aligners clean is important. Aligners should not be worn when eating or drinking (water is okay). We recommend brushing trays with a toothbrush and toothpaste each time you brush your teeth. You may want to brush them more often!

Your Invisalign® Delivery Appointment

At your invisalign delivery appointment, you will be given your first three aligners. By this time, if buttons or slenderizing were needed for your case, you will already have been to your appointments for these. 

YOU MUST WEAR YOUR ALIGNERS! Your teeth will not move if you do not wear the aligners for AT LEAST 20+ hours EVERYDAY!!!

  • Aligners should be out when you eat and drink anything but water. They should be worn at ALL other times.
  • You will change your aligners to the next set after 14 days.
  • Expect pressure for the first few days of wearing each aligner. When it is time to change aligners, our advice is to start the new aligner at night just before bed. Take 400-800mg of Motrin (assuming not contraindicated) at the same time. In the morning, most of the pressure will be gone!
  • Brush your aligners with toothpaste and water at least every time you brush your teeth (no less than 2x/day). This will keep them clean.
  • If a button comes off, do not worry. At your next appointment we will most likely replace it.
  • It my take a few days for the aligners to seat completely. Continue to use thumb and finger pressure to force the teeth into their new position.
  • Your bite will change over the course of treatment. You will notice this when the aligners are out. Do not worry. At the end of your case we will adjust your bite.
  • In order to fine tune a case, additional aligners are sometimes necessary, this is referred to as a refinement. New impressions will be necessary and there is no fee for a refinement assuming aligners have been worn properly and adequately. A $600 processing fee will be applied to refinements if aligners have not been worn adequately.
  • At the end of your case, you will want to choose a method to “retain” the movement and prevent relapse. We have found the longest lasting and best option for retainment of teeth movement and prevention of relapse is for patients to wear an upper hard night guard and lower removable retainer. Other options include a fixed wire on the back of teeth or lastly upper and lower removable retainers.