Am I a Candidate for Invisalign?

What aligners are genuinely good at

Mild to moderate crowding, spacing, and mild bite corrections in a patient with healthy gums and no missing teeth: this is the majority of adult cases walking through the door, and aligners handle it well. Relapse cases sit here too. If you wore braces as a teenager and your lower front teeth have drifted since, that is often a short, straightforward aligner case.

Aligners are also strong where the appliance itself is the obstacle to treatment. If you would not have started at all in visible brackets, then the option that gets you into treatment is the right one.

Where I hesitate

Severe rotations, particularly on canines and premolars. Large bite discrepancies where the jaws themselves are mismatched rather than the teeth. Cases needing extractions, where teeth must move bodily across a space rather than tip into it. Significant vertical movement, such as closing an open bite or intruding front teeth.

None of these are absolute exclusions. Aligner systems have improved considerably and I do treat some of them. But the predictability drops, refinements become more likely, and I would rather set that expectation before we start than mid-treatment.

What has to be true before any orthodontic treatment

Healthy gums come first. Tooth movement relies on healthy bone and periodontal support, so active gum disease is treated and stabilised before anything else. Untreated decay is dealt with first for the same reason. If a tooth needs a filling or a root canal, doing it mid-treatment complicates everything.

Existing crowns, veneers or implants are not a barrier, but they change the plan. Attachments do not bond to porcelain the way they bond to enamel, and implants do not move. Both are workable, they just need to be accounted for at the planning stage rather than discovered halfway through.

The part nobody wants to hear

Aligners only work while they are in your mouth. Twenty to twenty-two hours a day, every day, for the length of the treatment. That is not a guideline I am padding for safety, it is the number the tooth movement is planned around.

I have no way of assessing your discipline at a first appointment, and I am not going to pretend otherwise. What I will do is be direct about the consequence: trays that spend lunch in a napkin do not move teeth, and a case that stalls costs you months and often additional refinement trays. If you know that routine is difficult for you, fixed braces remove the variable entirely, and there is no shame in choosing them for that reason.

Age is not the deciding factor

There is no upper age limit for orthodontic treatment. Bone remodels throughout adult life and teeth move at forty as they do at twenty, sometimes a little more slowly. What changes with age is not whether treatment works but what else is going on in the mouth: previous restorations, gum recession, missing teeth, years of uneven wear.

At the other end, aligners can work for teenagers, and there is a version designed for growing patients. The deciding factor there is compliance rather than age.

How the assessment actually settles it

The appointment is a clinical examination, photographs, a digital scan of your teeth, and X-rays where they are needed. From that I can see the position of the roots, the state of the bone, how the bite meets, and how much room there is to work with. None of that is visible from the outside.

The scan then produces a treatment simulation showing where each tooth would end up and roughly how long it would take. That simulation is a plan, not a promise, and I will tell you which parts of it I am confident about and which parts depend on how your teeth respond.

If aligners are not right for your case

I will say so, and I will explain what specifically about your case makes them a poor fit rather than leaving it at a no. Usually there is a workable alternative: ceramic brackets if discretion was the reason you wanted aligners, or a combined approach where a short phase of fixed braces handles the movement aligners struggle with before switching over.

What I will not do is start an aligner case I do not believe will finish well. A treatment that stalls at eighteen months is worse than the fixed braces you did not want at the start.