Written by Dr. Adriana Leone, DMD, founder of Wall Street Dental Spa · Medically reviewed October 2026
There’s no single published failure rate for Invisalign, and I haven’t found a study behind the 96% success figure that circulates online. The research measures refinements instead. In a 2023 study of 324 Invisalign patients, 99.4% needed at least one round of refinement aligners to finish. When Invisalign truly fails, the usual causes are low daily wear time and a case that was a poor fit for aligners from the start.
There’s no single, well-supported failure rate for Invisalign. The figures you’ll see online range from 4% to 20% or more, and I haven’t been able to trace any of them to a published study.
The research that does exist measures pieces of the picture. Some studies track how many patients need extra aligners, some measure how consistently people wear them, and some compare aligners with braces. Put together, they explain where treatment goes wrong far better than one number could.
| Study | What it measured | What it found |
|---|---|---|
| Journal of Orthodontics, 2023 (324 Invisalign patients) | Refinement aligners needed to finish | 99.4% needed at least one refinement phase |
| Journal of Clinical Medicine, 2021 (2,644 adult aligner patients) | Daily wear compliance | 36.0% fully compliant, 38.3% fairly compliant, 25.7% poorly compliant |
| BMC Oral Health, 2019 (systematic review of 8 studies) | Aligners compared with braces | Both effective; braces better for bite contacts, torque and retention |
| Journal of Pharmacy and Bioallied Sciences, 2024 (teens aged 12 to 18) | Successful correction, aligners vs braces | 88% with Invisalign, 90% with braces |
That last study is the source of the 88% figure some sites quote. It looked only at teenagers, it was retrospective, and it excluded patients with unfinished treatment records, so it tells us little about adults or about people who stopped partway.
I’ve treated more than 500 Invisalign cases in the Financial District. In my experience, the cases that struggle almost always trace back to wear time or to a plan that asked aligners to do something they do poorly.
A true Invisalign failure is a case where, even with good wear, the aligners can’t bring the teeth and bite to an acceptable result.
That’s different from needing refinements. A refinement is a new set of aligners made from a fresh scan, partway through or near the end of treatment, to correct teeth that lagged behind the plan.
A 2023 study in the Journal of Orthodontics found that Invisalign patients were prescribed almost double the number of aligners their first plan predicted. Hearing that, patients sometimes assume their case is going badly. It usually means the treatment is being adjusted the way it’s designed to be.
I’d describe three outcomes that feel like failure but have different causes:
Invisalign fails most often because the aligners aren’t worn enough, and less often because the case was a poor match for aligners.
Low wear time. Aligners move teeth only while they’re in. I ask patients to wear their aligners 20 to 22 hours a day, and a 2021 study of adult aligner compliance used 22 hours as its bar for full compliance. When aligners spend long stretches in a case, teeth fall behind and the next tray stops fitting.
Poor case selection. Some movements are harder for aligners, especially large rotations of rounded teeth and pulling teeth down into place. A plan that leans heavily on those movements carries more risk.
Planning that isn’t adjusted. The digital plan is a starting point. Teeth that lag need attention early, through attachments, extra time on a tray or a refinement scan.
Missed check-ins. A tooth that stops tracking is easy to correct when it’s caught in the first week or two. Months later, it can mean going back several steps.
Lost or broken attachments. Attachments are the small tooth-colored bumps that give the aligner grip. When one comes off and stays off, the tooth it was guiding can slow down.
People usually quit Invisalign because the daily routine is harder to live with than they expected, and the reasons tend to build on each other.
These are the reasons that come up most often in my practice:
The 2021 study also found that patients who’d had orthodontic treatment before were less compliant than those who hadn’t. That matters because many adults straightening their teeth had braces as kids.
If you stop Invisalign early, your teeth stay roughly where they are when you stop, and they can drift if nothing holds them in place.
A few things are worth knowing if you’re thinking about stopping:
If you’re struggling, tell your dentist first. Sometimes the fix is a slower plan, a different schedule for tray changes or a simpler goal that can finish sooner.
Braces make more sense than Invisalign when the case depends on movements aligners handle less reliably, or when the patient knows the daily wear won’t happen.
A systematic review comparing clear aligners with braces in BMC Oral Health found both were effective. Braces did better at producing good bite contacts, controlling root torque and retention, while aligners had a shorter treatment time and handled some staged movements well.
In practical terms, I’m more cautious about aligners alone for:
For crowding, spacing and many mild to moderate bite issues in adults, Invisalign treatment is often an excellent fit. I’d rather have that conversation at the consultation than halfway through treatment.
Invisalign stays on track when wear time is consistent, problems are caught early and the plan fits your life.
It also helps to understand how Invisalign moves teeth stage by stage, since a small delay makes more sense when you can see why it happens.
Myth: Needing refinements means Invisalign failed. In the 2023 study, 99.4% of patients needed a refinement phase. It’s how aligner treatment normally finishes.
Myth: Invisalign has a 96% success rate. I haven’t found a published study behind that number. Treat any single percentage with caution.
Myth: If aligners don’t work, the teeth can’t be straightened. Cases that stall with aligners can usually be completed with braces or a combination of both.
Myth: Wearing aligners harder for a few days makes up for missed days. Teeth respond to steady, consistent force. Skipped days put the tray and the teeth out of step, and extra hours later don’t simply cancel that out.
Red flags
Any of these deserves a call to your dentist rather than waiting for your next appointment.
There’s no reliable published figure for how many people quit Invisalign. The closest data is on compliance. In a 2021 study of 2,644 adults using clear aligners, 25.7% were classified as poorly compliant with wear time. Poor compliance is often an early sign of quitting, which is why early support from your dentist matters.
Dentists may recommend braces over Invisalign when a case needs movements aligners handle less reliably, such as large rotations, pulling teeth down or significant jaw-related bite problems. A dentist may also hesitate if a patient is unlikely to wear aligners 20 to 22 hours a day, because inconsistent wear is the most common reason treatment stalls.
Some people do regret Invisalign, usually because treatment took longer than expected, the daily routine was harder than they thought or a case was a poor fit for aligners. Regret is less common when expectations are set clearly at the start, including the likelihood of refinements and the need for a retainer afterward.
If you stop Invisalign early, your teeth stay close to where they were when you stopped, and they can drift without a retainer. Your bite may also be left partly corrected. Restarting later usually requires a new scan and plan, so ask your dentist whether a simpler plan could finish sooner.
Invisalign and braces are both effective for many cases. A 2019 systematic review found braces performed better for bite contacts, root torque and retention, while aligners had shorter treatment times. For crowding, spacing and many mild to moderate bite issues, Invisalign is a strong option when it’s planned well and worn consistently.
If you’ve tried aligners before and stopped, or you’re worried about starting and not finishing, the right first step is a consultation where we scan your teeth and talk through what a realistic plan looks like for your schedule. That includes how long treatment should take, whether refinements are likely and whether aligners alone are the right tool for your bite.
Wall Street Dental Spa is at 30 Wall Street, Suite 720, New York, NY 10005, in Manhattan’s Financial District. We’re open Monday to Friday, 8:00 am to 6:00 pm, and you can reach us at 646-566-3307. Your visit includes our complimentary spa services, so the appointment feels calmer than a typical dental visit.
Dr. Adriana Leone, DMD, is the founder of Wall Street Dental Spa in Manhattan’s Financial District. A graduate of Tufts University School of Dental Medicine, she has practiced dentistry since 1999 and opened her boutique practice in 2005. Dr. Leone is recognized among America’s Top Dentists and is one of New York City’s most experienced Invisalign providers, with more than 500 cases completed. She built Wall Street Dental Spa around calm, judgment-free, wellness-focused care for busy NYC professionals.
