Conversations with Orthodontists: Dr Teodora Todorova on Invisalign

In this part of the “Conversations with orthodontists” series, the guest is Dr Teodora Todorova. In June 2023 she wrote answers for the site to the questions her patients ask most often at a first consultation: are aligners right for me, how long does treatment take, and how much does it cost?

Here is her text, together with a few cases from her practice.

Dr Teodora Todorova graduated with honours from the Medical University of Sofia and then specialised in orthodontics at the Faculty of Dental Medicine in Sofia.
In 2020 she and her husband, Dr Genchev, founded the Iskam Usmivka (“I Want a Smile”) dental clinic, with a focus on a positive approach – they want dental treatment to be a pleasant experience, with patients arriving and leaving with a smile.
Dr Todorova’s orthodontic practice focuses mainly on Invisalign clear aligner treatment. At the time of the interview she was a Platinum Elite Invisalign Provider. The clinic also has specialists in endodontics, restorative dentistry, oral surgery and prosthodontics, so patients can get all the treatment they need in one place.

Are Invisalign aligners right for me?

Today we’ll look at the questions we’re asked most often during orthodontic consultations at our clinic. Aligner treatment is becoming more and more popular as a more aesthetic and comfortable alternative to traditional braces. That’s why patients often wonder whether their case is suitable and how aligners actually work.

Let’s start with the fact that orthodontic treatment depends on your orthodontist – they plan the sequence and the stages, and aligners are simply the appliance they use. So all complex tooth movements can be done with aligners as well as with braces, because it all depends on how they’re planned (sometimes we need extra help from additional devices – buttons, elastics, mini-implants – which are planned and added to the treatment). Almost every consultation starts with this explanation, because aligners are entirely suitable for both children and adults.

Progress in treating a severe open bite, a crossbite at the side and a shift of the lower jaw to one side.
Treated entirely with Invisalign clear aligners by Dr Teodora Todorova.

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An open bite affects speech and chewing – patients find it hard to bite into food. Correcting it is important to restore proper function.

How is the treatment plan made?

It starts with a treatment plan, which needs the following records: X-rays, photos and a digital scan showing the patient’s bite and tooth alignment. Once the digital plan is ready, the patient can see exactly what their smile will look like at the end, and which movements will happen in which weeks. The number of aligner steps matches the number of weeks the treatment will take, and each new set brings the teeth and bite closer to the final position set out in the orthodontist’s plan.

How long does aligner treatment take?

The second most common question is how long treatment takes. Unfortunately there’s no single answer, because it’s entirely individual. When the aim is to straighten the teeth without a complex bite correction, it usually takes from a few months to a year (again, it varies, of course). Complex bite corrections – for example a deep bite, open bite, Class II, crossbite or underbite (there are many, and they’re complex) – take longer: more than a year and a half.

A more specific timeframe can be given at the first consultation, once the orthodontist has looked at the patient’s particular problem.

Progress in treating a deep bite – 21 aligners apart.
Treated with Invisalign.
A few final stages remain before treatment is complete.

How much does Invisalign treatment cost?

Which brings us to the other common question – the price. It depends on how long treatment takes and how complex the change is. Your orthodontist decides which Invisalign package to use. The options are Express, Lite and Comprehensive.

• The Express package includes up to seven sets of aligners. It’s suitable for patients with one or two slightly misaligned teeth who need minimal correction.
• The Lite package is used when teeth are misaligned but the bite doesn’t need correcting. It includes up to 14 sets of aligners.
• The Comprehensive package has an unlimited number of sets. I use it for moderate or severe bite problems.
• The newest addition from Invisalign is the Moderate package. It includes 20 sets of aligners and suits cases where the bite doesn’t need correcting but individual teeth are more crooked.

Your orthodontist decides which package is best for you. This is discussed at the first consultation – the price depends on the number of sets needed. (Editor’s note: these are the packages as of 2023 – Invisalign changes them from time to time, so ask your orthodontist about the current options and prices. More on costs in how much clear aligners cost in Europe.)

I’ll finish by saying that orthodontic treatment is complex and requires commitment from both sides.

What I do for my patients is always show them the treatment plan and what their smile will look like at the end, and explain in detail the stages we’ll go through. That’s the strongest motivation on the way to the smile they’ve dreamed of.

Many thanks to Dr Todorova! You can also read the conversation with Dr Neli Dilkova, and how treatment works step by step in how clear aligner treatment works.