Invisalign: It Costs a Kidney

Aiming to correct my teeth - Invisalign

Good News:

Despite my woefully complicated case, I’m a candidate for orthodontic treatment via Invisalign. This is largely due to having selecting a ridiculously experienced provider.

Bad News:

Unsurprisingly, it does kind of cost a kidney. Some language in my dental insurance policy includes (shockingly generous!) coverage for adult orthodontic treatment, but it isn’t clear if there is an age cap or not. My treatment coordinator and I are tag-teaming my insurance provider to get clarity on this; obviously, I can begin treatment sooner if insurance is in play.

What Happens at an Invisalign Assessment

I couldn’t be more excited about this practice, honestly. It’s a little annoying to get to, but is a pretty damn cute office and everyone I dealt with was lovely.

Unflattering Photo Ops

We started off by taking some hilariously unflattering picture of my creatively arranged smile, jaw alignment (jaw is fine, but it is part of the process), etc. There were nine pictures total:

  • Straight on, mouth closed (1)
  • Straight on, full smile (2)
  • Left and Right profiles, mouth closed (3, 4)
  • Straight on, left profile, right profile, with plastic barriers in your mouth to pull your lips back (5, 6, 7)
  • Straight on with upper plastic barrier and mirror to capture inner upper (8)
  • Straight on with lower plastic barrier and mirror to capture inner lower (9)

The barriers were not painful, but definitely were awkward to place and keep in place.

Doc Talk

The treatment coordinator throws these images on a sheet for the orthodontist to evaluate. He came in, explained his background with orthodontics and Invisalign. I already knew their reputation and some history, but was pretty delighted to hear that their practice has treated over 4500 cases since Invisalign went on the market.

My case is not a cake walk but it is not unique, either; they have successfully treated dozens like it before. My case includes correction of an overjet, crossbite, and severe lower crowding. My lower gum midline is off due to shifting after an unrelated extraction. Ultimately, it can be done but treatment requires a single extraction and IPR. IPR stands for Inter-Proximal Reduction. In entirely non-medical and non-technical terminology, they basically take a thin, flexible file and reduce the space in between some of your teeth. Sounds horrible, realistically isn’t. Sensation is not described as painful, merely annoying (not unlike nails on a chalkboard).

Side note: do kids these days even know what that sound/sensation is?

As for the extraction, my trays would apparently have the appearance of a tooth so that I wouldn’t look extra-ridiculous while the space closed in. Neat!


My orthodontist suggests I would be in treatment for eighteen months. That’s eighteen months of once-weekly tray changes, 20+ hours a day of wear. You are only to remove them when eating, drinking something other than water, or brushing and flossing. You must brush and floss before you reinsert the trays after eating.

Anecdotally, many people who have pursued treatment like this end up cleaning up their diets a lot just because it isn’t worth the hassle to spend 2-3 minutes brushing and flossing to enjoy a snack! I know I wouldn’t be keen on that, so I’d need to be good about when and how I eat.

What about SmileDirect?

SmileDirectClub is a TeleOrtho service – it is kind of to clear aligners what Curology/Pocketderm is to dermatological treatment. You order a kit to take impressions on your own, you mail them in. They approve or deny your case; if approved, a treatment plan is developed, you plunk down roughly $2000 and they start shipping you aligners.

It costs a LOT less than going to a traditional orthodontist! Price does not appear to fluctuate depending on case complexity or duration, which is nice. The bad thing is that if your treatment plan includes extractors or IPR like mine does, coordination can be challenging. SmileDirectClub only has three offices of its own and they are far-flung. They have relationships with other practices who can and will execute these procedures for you.

Interestingly, SmileDirectClub has done some sponsorships with bloggers. Amusingly, their cases were all minor and simple as complexity goes. For fun, I reached out to them to see if they would be interested or willing to work out a sponsorship arrangement on a more complicated case. If these orthodontia brands are working with influencers, why exclusively work with influencers who have nearly-perfect smiles to begin with? Frankly, it isn’t a good demonstration of effectiveness. Unsurprisingly, I haven’t heard back.

Due to the complexity of my case, I decided not to shell out roughly two grand and risk it not working or risking prolonged treatment duration. I want an office near me to oversee my treatment.

My Plan

…isn’t really established, yet. Ugh! I am a planner by nature and profession. When I decide I want to do something, that’s it – I want to begin! Rushing into Invisalign, however, is not an option.

Cost is certainly a factor into my timeline. My treatment plan is more costly than I anticipated but is comprehensive – whereas other providers might nickel-and-dime you for every little thing.

My insurance only covers about 8% of the treatment cost, which is frustrating but not unheard of. I definitely want to do it, but I need to do some financial planning before I can commit to kicking off the process because … well, that’s the responsible thing to do when you are spending this much money on something.