Invisalign in Antalya: Suitability, Treatment Time and Cost Factors

When clear aligners may be considered

• Mild to moderate crowding and small gaps.
• Cases that do not need teeth taken out. In cases without extractions, no clear difference in treatment quality¹ has been seen between the two methods.
• People who can wear the aligners consistently, as advised. The same review concluded that the appliance should be chosen according to how complex the case is and whether the patient wears the aligners consistently.

When fixed braces come first

• Cases where teeth have to be taken out to make room. A review covered 20 studies of treatment in which premolars (the teeth just behind the canines) were taken out. Most of the studies looked back at past cases. Control of the tooth roots and of the contacts between teeth in the bite was weaker with aligners³ than with fixed braces.
• When a more precise result is needed in how the teeth line up and meet. A review of Invisalign studies only concluded that the results were not as precise⁴ as those achieved with fixed braces.

Children and teenagers

Much of the research comparing aligners with fixed braces was done in adults; these results cannot be applied directly to young people. This page does not cover the evidence on clear aligners in children and teenagers. Ask a dentist about the options for your child; general information is on the braces treatment page.

Aligners without an examination

The UK dental regulator, the General Dental Council (GDC), states that some contact between dentist and patient can take place at a distance. For other stages of care, however, a face-to-face appointment or a physical examination is needed for patient safety. According to the GDC, there is currently no effective way⁵ to replace a physical clinical examination for orthodontics. This is the view of the UK regulator, not a binding rule in Turkey. But it makes clear that aligner treatment should start with an examination, wherever it takes place.

• Not having treatment. If crowding or a gap is only about appearance, not having treatment is also an option.
• Clear aligners. They can be taken out and put back in, and are less noticeable. For mild to moderate crowding, treatment time was found to be similar⁶ to fixed braces; the certainty of this evidence is low. In another review, some additional analyses suggested¹ a shorter time with aligners; however, aligners have not been clearly shown to take less time.
• Fixed braces with metal or ceramic brackets. The brackets are glued to the front surface of the teeth; you cannot take them out. Ceramic brackets are less noticeable.
• Lingual braces. The brackets are glued to the back surface of the teeth and cannot be seen from outside. Tongue soreness and speech difficulty have been reported more often⁷ than with braces on the front of the teeth, mostly in studies with short follow-up. For fixed and lingual braces, see the braces treatment page.

Invisalign and other aligner systems

Some of the studies this page is based on were done with Invisalign only. The sources this page is based on contain no comparative study showing that Invisalign gives better or worse results than other aligner systems. Nor can the results of Invisalign studies be applied directly to other brands.

To compare clear aligners with fixed braces, read our Invisalign vs braces guide.

How often aligners are changed, how many hours a day they are worn and how often you have check-ups are set by the treatment plan. We cannot give reliable figures for these on this page. Follow the times your treating dentist gives you; if aligners are worn less than advised, the teeth may not move as planned.

On this page, "your treating dentist" means the dentist who plans and supervises your aligners. Whether that dentist is an orthodontist is a question to ask (see who carries out the treatment, below).

The total length of treatment depends on how complex the case is. For mild to moderate crowding, treatment time with clear aligners and with fixed braces was found to be similar⁶. Your treating dentist tells you the likely length of your treatment after the examination.

Risks and disadvantages

• The result may not be as precise as with fixed braces in every case. A review that pooled studies in adults covers 11 studies and 887 patients. Three studies in that review scored how the teeth were lined up and how they met at the end of treatment. In those 3 studies, the result with aligners was weaker than with fixed braces². The quality of the evidence is moderate. In cases that do not need teeth taken out, however, a newer review found no clear difference (above).
• The result depends on consistent wear. Because aligners can be taken out, treatment may not progress as planned if they are worn less than advised.
• Pain. When aligners are first put in, your teeth can feel pressure and tenderness. Some studies followed patients through the first week. In those, pain was usually at its highest in the first 24 to 48 hours and eased within about a week⁸.
• Aligners do not always cause less pain. People using Invisalign reported slightly less pain⁹ than people with fixed braces in the first few days of treatment. After that, studies that followed patients for up to 3 months found no difference; the certainty of this evidence is mostly low. These studies looked only at Invisalign and mostly at mild cases. In a single study that followed patients every month for 12 months, however, aligner users reported more pain from the second month on⁸.
• Tooth decay and gum problems. White spots (early decay) have been studied mostly with fixed braces. We cannot say on this page how often decay and gum problems happen during aligner treatment. This does not mean aligners carry no risk of white spots or decay. Brush your teeth before putting the aligner in, and keep the aligner clean.
• Gum recession. Orthodontic treatment, poor oral hygiene and thin gums are listed among the factors that may raise¹⁰ the risk of the gums pulling back. This is an expert opinion and does not give a rate. Where the gum shows no disease, the same paper considers monitoring the area the appropriate approach.
• Other possible side effects. Other side effects, such as shortening of the tooth roots during treatment (root resorption), can also happen. We cannot say on this page how often they happen; ask your dentist at the examination.
• How long the result lasts is uncertain. Whether teeth are more or less likely to move back after aligners than after fixed braces has not been studied enough¹¹. There are only 3 studies on this, and all three were done with Invisalign.

Benefits

• The aligners can be taken out while you eat and brush your teeth.
• They are less noticeable than braces with brackets.
• In mild to moderate cases that do not need teeth taken out, treatment quality has not been found to differ clearly from fixed braces (above).

If you have pain

• Over-the-counter painkillers reduced orthodontic pain compared with taking no medicine. This result comes from a Cochrane review covering 32 studies; the quality of the evidence is moderate¹². When anti-inflammatory painkillers (NSAIDs, such as ibuprofen) were compared with paracetamol, no clear difference was found; the quality of that comparison's evidence is low. Follow the instructions on the pack; if you are not sure, ask your pharmacist or doctor.
• Non-drug methods such as chewing gum, bite wafers and vibration devices have not been shown¹³ to reduce orthodontic pain. The evidence on this is of very low quality.

Cleaning and use

• Brush your teeth twice a day with fluoride toothpaste. After eating, clean your teeth before putting the aligner back in.
• Ask your treating dentist how to clean the aligner and which products could damage it.
• When you take the aligner out, keep it in its case; tell your treating dentist if an aligner is lost or broken. If you live in the UK, ask before you start how a lost or broken aligner is replaced. Ask how long that takes and who pays for it.
• Take the aligner out when you eat. Ask your treating dentist which drinks you can have while it is in.
• Alongside your aligner check-ups, keep having regular check-ups with your own dentist in the UK. How often you need them is set according to your risk of decay and gum disease¹⁴.

After orthodontic treatment ends, teeth tend to move back¹⁵ towards where they started. This is why a retainer is used after aligner treatment too.

• Most of the research is about retention after fixed braces. The Cochrane review of retention, covering 47 studies, does not include aligner studies. That review has not shown either fixed or removable retainers to be clearly better at keeping teeth straight. The certainty of the evidence is low or very low.
• For how long? Your treating dentist decides how long you wear the retainer¹⁶. A UK opinion piece reports that the British Orthodontic Society (BOS) has given patients the message that retainers should be worn for life¹⁷. The author of the piece, a dentist, argues that research does not support this general advice. In his view, most retention studies lasted 6 to 24 months¹⁷. There is no evidence-based fixed length of time, and no retention method has been shown to hold teeth completely still for life.
• A fixed retainer wire can come loose. In studies, bond failure with multistrand twisted wires glued behind the teeth has been reported at between 12 and 50 per cent¹⁸. This is not a single rate but the lowest and highest values reported in different studies; the quality of the evidence is low.
• Who looks after the retainer in the UK? Agree before you start who checks the retainer, who replaces it if it breaks or stops fitting, and whether that is part of your plan. More on retainers: retainers.

Your treatment is provided by our clinic in Antalya, Turkey, and carried out there by the clinic's dentists. On this page, "we" means that clinic.

Orthodontics is one of the nine dental specialties set by law in Turkey¹⁹. Turkish law ties the specialist title to a specialist certificate¹⁹, issued and registered by the Ministry of Health²⁰. In the UK, a dentist may call themselves a specialist only if they are on the GDC's specialist list²¹.

If you are comparing with a UK orthodontist, compare like with like. Ask who will plan your aligners, who will check your progress and who will carry out any new scan. Ask what their titles are, where they qualified, and whether the dentist planning your aligners holds a Ministry-registered specialist certificate in orthodontics. Ask for the answers in writing.

Contact your treating dentist if any of the following happens:

• Pain that lasts more than a few days¹⁶ after you start a new aligner
• An aligner that does not fit your teeth, or is cracked or broken
• The edge of an aligner making a sore on your gum or tongue
• An attachment that has come off
• Gums that bleed or are swollen, or white spots on the teeth
• A fixed retainer wire that feels loose, or a removable retainer that no longer fits

If you think you have a dental abscess, do not wait; an abscess does not go away on its own and needs urgent dental treatment²². In the UK, the NHS advises asking for an urgent dentist appointment or getting help from NHS 111²². If you have swelling in your face or jaw, or a fever, get seen the same day by a dentist where you are.

Emergencies. The following need urgent medical help²². Do not wait for a dental appointment or for the clinic's reply. In the UK, call 999 or go to A&E. In Turkey, the emergency number is 112.

• Swelling that makes it hard to breathe, speak or swallow
• Swelling around your eye or in your neck²³
• Swelling or pain in the eye, or sudden problems with your sight
• A lot of swelling inside your mouth
• Difficulty opening your mouth

Before you fly home

Know when and where your next check-up is, and who will carry it out. Make sure you have your aligners for the coming stage, their case, written care instructions, your treatment record and a way to reach the clinic.

Once you are back in the UK

If an aligner does not fit, cracks or is lost, or an attachment comes off, write to the clinic and send photographs. Ask your treating dentist which aligner to wear until a replacement arrives. See your own dentist in the UK for problems that need someone to look in your mouth. In the emergencies above, do not wait for a reply.

If you live in the UK, clear aligners can look like an easy fit, because the aligners are worn at home, one after another. But aligner treatment is not a one-trip treatment either. Check-ups follow your progress. Teeth that fall behind the plan may need a new scan and extra aligners. Attachments are removed at the end, and a retainer follows. So before you decide, the practical question is who will do each of these, and where.

Three ways to arrange it

There are three ways, and a plan may combine them. You come back to Antalya for check-ups. A dentist or orthodontist near your home in the UK sees you. Or your progress is followed at a distance between visits. Repeated trips over many months need to fit your work, your family and your budget. A UK dentist has to agree to be involved in treatment planned elsewhere, and some may not want to.

If a UK dentist does take part, agree what they are asked to do. The GDC states that when a dentist relies on another professional's examination, the responsibility for that judgement rests wholly with the prescribing dentist⁵. The GDC wrote this for dentists on its UK register. For your plan, it means asking which dentist is responsible for it.

Checks at a distance

A clinic may offer to follow your progress at a distance, for example through photographs you send. If so, ask what it checks, how often, who looks at the photographs, and what happens when your teeth fall behind the plan. We have no source on how well checks at a distance compare with check-ups in the chair. So this page does not present them as a replacement. The GDC's view (above) is that some care can be given at a distance, while other stages need a face-to-face appointment or a physical examination.

If your aligners are not tracking

If the teeth fall behind the plan, a new scan and extra aligners, often called refinements, may be needed. Before you start, ask:

1. Who decides that you need refinements?
2. Who takes the new scan, and is that in Antalya or in the UK?
3. Can a scan taken by a dentist in the UK be used?
4. Are refinements included in your plan, and does each round mean another trip?

Agree the arrangement before treatment starts, and have it in writing. It should say who checks your progress and roughly how often. It should also say who takes a new scan if extra aligners are needed, whether that means another trip, and who removes the attachments at the end.

If you are comparing aligners with fixed braces, ask the same question about their adjustment appointments; see braces treatment.

The examination comes first

Aligner treatment starts with an examination in person (see who aligners suit, above). Before you book, you receive a written preliminary plan based on the photographs and any X-rays you send. It sets out the appointments and how many days the first trip needs. It is not a diagnosis: the examination confirms or changes it, and with it the days and the cost. If it changes, you receive the revised plan in writing before treatment starts. You can say no, or ask to stop, at any stage.

Flying. We have found no guidance that sets a waiting time before flying during clear aligner treatment. A 2023 review of flying after dental treatment does give times for tooth extraction, which matters if teeth are taken out to make room. It suggests waiting 24 to 48 hours after a simple extraction and 72 hours after a surgical one²⁴. These times apply only if there is no pain, swelling or bleeding where the tooth was taken out. The authors note that the research is limited and comes mainly from military aviation. Ask the clinic when you can fly after your appointments.

Your own dentist

The General Dental Council suggests talking to your own dentist²⁵ before you go. They need to know the plan, and you keep seeing them for check-ups during treatment (see daily care above). The NHS lists exchanging medical records and arranging aftercare back home²⁶ among the things to consider before treatment abroad.

Ask for a written record of the aligner system used, how many aligners the plan has and which one you have reached. Ask for copies of your X-rays, scans and photographs too. A dentist or orthodontist in the UK needs them to see what the treatment is meant to achieve. In Turkey, the health tourism regulation entitles international patients to an itemised bill. On request, they also get free copies of the records of the materials used, the tests and the imaging²⁷.

What the NHS does and does not do

In England and Wales, an NHS dental practice that accepts you as a patient provides clinically necessary treatment, with your consent²⁸. This means the treatment that every NHS dental contract must offer. That does not mean an NHS practice will take over aligner treatment started abroad. The free repair or replacement an NHS practice can give for its own work does not apply to work done elsewhere. The NHS also states that it is not liable for negligence or failure of treatment²⁶ when you have treatment abroad. On the NHS England routes that fund planned treatment abroad, you cannot get reimbursement for dental treatment²⁹.

The NHS guidance quoted here is for England, and for England and Wales where stated. If you live in Scotland or Northern Ireland, check the arrangements there.

Travel insurance

The NHS says that most travel insurance policies will not cover you for planned treatment abroad, so you may need specialist cover²⁶. Tell your insurer about your plans. Ask before you book whether anything linked to the treatment is covered, such as a complication or an extra trip.

The General Dental Council lists questions to ask before treatment abroad²⁵. Below are most of them, with what this page can answer today and what to ask for in writing.

1. Who will carry out my treatment, and what are their qualifications? The treatment is provided by our clinic in Antalya, Turkey. Ask for the name of the dentist who will plan and supervise your aligners. Ask where they qualified and what their title is (see who carries out the treatment, above).
2. Are you regulated by a professional body and registered with it? In Turkey, a health facility needs an authorisation certificate²⁷ from the Ministry of Health to treat international patients. Authorised facilities appear in a register the Ministry publishes³⁰, so you can check it yourself. The authorisation belongs to the facility, not to the dentist, and it says nothing about the result of your treatment. Ask for the treating dentist's own registration details as well. See health tourism authorisation.
3. Is the work guaranteed, are the terms in writing, and for how long do they apply? This page makes no guarantee. Ask for the clinic's written terms for aligner treatment: refinements, retainers, and what happens if teeth move back after treatment.
4. What aftercare do you provide, and who can I contact after the treatment? Your written plan should name who to contact, how, and who checks your progress (see above).
5. If there are complications, who pays for further treatment, extra flights and the hotel? Ask for the answer in writing before you commit.
6. Do you have a complaints system, and can I see a copy? Ask for it before treatment. The GDC says it cannot resolve complaints or help with refunds³¹; its investigations concern the dentists on its own register. Turkish regulation makes the facility responsible for complications and medical malpractice arising after the health service it provided²⁷.
7. Will the dental team speak English, or will you provide a translator? Ask who will explain your plan and your consent form to you, and in which language.
8. How many times have you carried out this treatment, and what are your rates of success and complications? This page gives no figures for the clinic. Ask for them in writing, and ask how they were measured.
9. Do you have insurance to cover this treatment? In Turkey a facility treating international patients must take out complication insurance for surgical and interventional procedures carried out in an operating theatre²⁷. That does not by itself tell you whether your treatment is covered, so ask which procedures in your plan, if any, fall under it. Ask too, in writing, whether the clinic or the treating dentist holds insurance for complications or errors, what it covers and whom it protects.

The NHS names warning signs to think about before booking any treatment abroad. They are a hard sell, a lack of information, pressure to make a quick decision, no discussion of possible complications, and no mention of aftercare²⁹. Apply them to this clinic too.

This page does not show prices. A treatment plan is prepared for you after an examination. The main factors that shape it are:

• How severe the problem is and the number of aligners needed
• The likely length of treatment and the number of check-up appointments, and how many of them are in Antalya
• Extra scans and extra aligners if the teeth do not progress to plan
• Extra procedures, such as fillings or gum treatment before orthodontic treatment
• The retainer after treatment and its check-ups

Ask for the plan in writing. It should say what is included, and especially whether extra aligners, the retainer and its check-ups are included. Ask too who pays for further treatment and extra travel if there is a complication.

If you are comparing with a quote from a UK practice, compare what each one includes, item by item.