Quick Answer
Both SureSmile and Invisalign are clear aligner systems that may straighten teeth, and they differ in case complexity, cost, and how much published evidence sits behind them. The introduction of a systematic review of Invisalign describes aligner use surging as a preferred alternative to braces for mild to moderate malocclusion (teeth and bite that don’t line up) in non-growing patients, and notes that efficacy diminishes on complex movements. One hedge on that: a 2020 meta-analysis found adults finished with worse results on aligners than on braces on average, while a 2025 meta-analysis found no difference in non-extraction cases and braces superior in extraction cases. For SureSmile, Dentsply Sirona markets it for “simple to complex” cases, and the only peer-reviewed outcome study of SureSmile aligners we found is a 14-patient series, so the case-complexity call rests on your provider’s own record. In our reading, the choice comes down to your case’s complexity, your budget, and which system your provider works with. The American Dental Association notes that the kind of orthodontic treatment you have will depend on your preference and the options provided by your dentist or orthodontist. If you’re also comparing Invisalign to traditional braces, our Invisalign vs braces guide covers that decision in full. Our Byte vs Invisalign article is now a historical comparison: Dentsply Sirona’s 2025 annual report says Byte was no longer offered to new patients after October 24, 2024, and its site says it has concluded its operations.
SureSmile vs Invisalign at a Glance
| Feature | SureSmile | Invisalign |
|---|---|---|
| Best For | Simple to complex, per Dentsply Sirona; published evidence is thin | Mild to complex; strongest evidence in mild to moderate cases |
| Typical Cost Range | About $2,000–$4,500 (independent estimate) | $1,800–$8,100 for clear aligners as a class (see our cost guide) |
| Treatment Duration | 6–18 months (NewMouth estimate) | NewMouth’s estimate is also 6–18 months; Invisalign says as little as 6; one 500-patient study averaged 22.8 months |
| Additional aligners included | Complete plan: refinements for up to 3 years; Select plan: pay per aligner | Comprehensive package: unlimited sets for 5 years; a 3-year, 3-set option also exists |
| Refinements Reported | 50% fewer, per the company’s own data against a 2020 JCO survey*; company says 75% of cases need one or none | 6% of patients in one 500-patient study needed no refinement scan |
| Attachments Used | Yes, as needed | Yes (SmartForce attachments) |
| Removability | Yes | Yes |
| Provider Network | General dentists and orthodontists | About 130,000 active trained doctors worldwide (Dec 2025) |
| Track Record | Aligners since 2018; brand since 1994 | Company founded 1997; about 23 million patients treated (June 2026) |
| Technology | 3D digital planning (SureSmile software) | iTero scanning, ClinCheck software |
*Dentsply Sirona compares its own SureSmile refinement-rate data with a 2020 JCO clinician survey (Keim/Vogels/Vogels); company data, not an independent outcome study.
What Is SureSmile?
SureSmile is a clear aligner system from Dentsply Sirona. The SureSmile brand traces back to a wire-bending system for traditional braces that OraMetrix developed in 1994, and SureSmile Clear Aligners followed in 2018, according to Orthodontic Products.
Treatment planning is 3D and digital: the software maps out a customized tooth movement plan, which dentists and orthodontists use to guide treatment. Dentsply Sirona’s clinician literature describes the aligner material as Essix plastic: a 2018 doctor flyer says the aligners use “the latest materials from industry leading Essix plastics.” Ask your provider what material your own aligners are made from.
The most notable claim about SureSmile is fewer refinements, meaning fewer additional aligner sets to finish treatment. Dentsply Sirona’s straight-facts page says users reported 50% fewer refinements than the average aligner treatment; its footnote bases that on the company’s own global refinement-rate data compared with a 2020 JCO clinician survey (Keim/Vogels/Vogels). That is company data measured against a practice survey, not an independent outcome study. The company’s newer figure comes from its own internal analysis: 75% of 109,273 cases started and completed between January 2021 and May 2025 required one or no refinements. Fewer refinements would matter most if your provider bills them separately.
Dentsply Sirona’s value page says its Complete plan includes “unlimited refinements throughout treatment time up to three years” from first aligner production, while its general-practitioner brochure describes the Select plan as “Only pay for the number of aligners you need.” Which plan applies is the dental office’s choice, so the three-year window is not a guarantee for every patient. SureSmile is sold through both general dentists and orthodontists (Dental Products Report reported at the 2018 launch that both would be able to offer it), which may make it more accessible in communities without a dedicated orthodontic practice nearby.
What Is Invisalign?
Invisalign is made by Align Technology, and Invisalign’s own timeline starts with the company in 1997. Align’s quarterly filing says approximately 23 million people worldwide had been treated with the Invisalign system as of June 30, 2026.
Align’s own iTero intraoral scanners are used for Invisalign case submissions, and treatment is planned in Align’s ClinCheck software, whose plan simulates tooth movement in stages, according to Align’s annual report for 2025. The treating dentist or orthodontist reviews and approves that plan.
A key feature of Invisalign is its SmartForce attachment system: small tooth-colored bumps bonded to teeth that work like handles, giving the aligners something to push on so more targeted force reaches specific teeth. That helps when a tooth needs more significant movement or when bite correction is involved, though predictability still diminishes on the most complex cases. Invisalign is also sold as several treatment packages rather than one, with dedicated named lines such as Invisalign Go offered through general dentists and Invisalign First for children. The annual report lists compliance indicators (built-in wear-time trackers) among the features of its Comprehensive product family, which is where teen cases sit. What a practice quotes therefore depends on which package your case is planned under.
The Comprehensive package includes unlimited additional aligner sets for five years, and the annual report says a three-year, three-set option also exists. Align reported about 130,015 active Invisalign-trained doctors worldwide at the end of 2025 (a count of doctors who submitted at least one case in the prior 12 months, global rather than US-only).
Cost Comparison
Cost is one of the most significant factors patients weigh when choosing between SureSmile and Invisalign, and both systems typically fall within ranges that may vary based on location, provider expertise, and case complexity.
SureSmile has no published patient price, because your provider sets it. One independent estimate, from NewMouth, puts it at $2,000 to $4,500; other estimates we came across run wider. That lower starting point may appeal to patients with straightforward alignment needs or those working within a tighter budget.
Invisalign publishes no price either. It says treatment cost is “comparable to the cost of braces”. The range our Invisalign cost guide uses is CareCredit’s survey of clear aligners as a class: $1,800 to $8,100, with a national average of $5,108 without insurance. That covers clear aligners generally, not Invisalign alone, so treat it as a benchmark rather than a quote. Invisalign is sold as several packages, so ask which one your quote is for.
Insurance may cover a portion of clear aligner treatment under orthodontic benefits, regardless of brand. Patients are encouraged to confirm coverage directly with their insurance provider. Both systems are generally paid for with HSA and FSA funds; confirm with your plan administrator. The Invisalign cost guide linked above walks through insurance limits and how to save in more detail.
Hidden cost considerations to keep in mind:
- Refinements: Ask whether refinements are included or billed separately.
- Retainers: Post-treatment retainers are typically an additional cost with either system.
- Provider fees: Some practices bundle all visits into a flat fee; others charge per appointment.
Pros and Cons
SureSmile
Pros
- Independent estimates put the starting price lower
- May require fewer refinements, per the manufacturer’s own data compared with a 2020 practice survey
- Sold through general dentists as well as orthodontists
- The Complete plan includes refinements for up to three years, if your office uses it
- Digital 3D planning workflow
Cons
- Shorter track record than Invisalign: aligners since 2018
- Published outcome evidence on SureSmile aligners is thin: one 14-patient study we found
- We found no published provider count, so availability near you is worth checking
- We found no published eligibility table by case complexity, so ask your provider about their own SureSmile case record
- Fewer published figures on its reach (no provider count), so if you might move mid-treatment, ask how a transfer to another SureSmile office would work
Invisalign
Pros
- Company founded in 1997, with about 23 million patients treated
- Marketed for mild to complex cases
- About 130,000 active trained doctors worldwide
- The Comprehensive package includes unlimited additional aligner sets for 5 years (a 3-year, 3-set option also exists)
- SmartForce attachments are designed to give aligners more to push on
- Multiple product tiers to match treatment scope
Cons
- Cost is not published, and clear aligners as a class run up to $8,100 in one survey
- Refinements are common: in one 500-patient study only 6.0% finished without a refinement scan
- Treatment outcomes still depend on patient compliance (20 to 22 hours a day of wear, per Invisalign)
- Attachments may be more visible on teeth in some cases
Who Should Choose SureSmile?
SureSmile may be a strong option for patients who:
- Have mild to moderate alignment concerns, such as minor crowding, small gaps, or slight spacing issues that do not require complex bite correction.
- Are working within a budget and want a lower-cost option: independent estimates put SureSmile lower, though the published outcome evidence on SureSmile aligners is one small study, so ask the provider about their own SureSmile case record.
- Prefer treatment through a general dentist rather than seeking out a specialty orthodontic practice, since general dentists offer it.
- Want fewer refinement appointments and a streamlined treatment experience, particularly if the manufacturer’s claim of reduced refinements holds true for their case.
- Are adults or older teens who can commit to consistent aligner wear and understand the responsibilities involved in removable orthodontic treatment.
Patients considering SureSmile should ask their provider to review their specific case complexity before committing, as not every SureSmile provider may be equipped to handle severe malocclusions. Maintaining good oral hygiene during aligner treatment is essential; the best electric toothbrush for braces and best mouthwash for braces work just as well for clear aligner wearers.
Who Should Choose Invisalign?
Invisalign may be the better fit for patients who:
- Have a case your provider judges suitable, including moderate cases. The cited review found aligner efficacy diminishing on complex movements such as arch expansion, significant overbite correction and extraction space closure, so for a complex case ask about the provider’s record with cases like yours rather than the brand name.
- Want the more established system, with the longer track record and more published research behind it than SureSmile aligners have.
- Prefer access to a specialist, such as a board-certified orthodontist, and want to choose from a broad network of Invisalign-trained providers.
- Anticipate a longer treatment timeline and want the security of the Comprehensive package’s unlimited additional aligner sets for 5 years (a 3-year, 3-set option also exists, so confirm which one your office quotes).
- Live in an area with limited SureSmile providers, making Invisalign the more practical choice simply based on availability.
- Have previously started aligner treatment with another system: ask whether the provider takes over mid-treatment cases before you switch.
Evidence Receipt
- Aligner use has surged for mild to moderate malocclusion in non-growing patients. The introduction of a systematic review of Invisalign predictability describes aligners as a preferred alternative to braces for those cases and notes that efficacy diminishes on more complex movements such as arch expansion, significant overbite correction and extraction space closure.
- Adults finished with worse results on aligners than on braces, on average. A 2020 meta-analysis found aligners associated with worse treatment outcome than fixed appliances (braces) in adult patients.
- Case type changes the answer. A 2025 meta-analysis found no significant difference in treatment quality between aligners and braces in non-extraction cases, and braces superior in extraction cases.
- Refinements are the norm. In a 500-patient private-practice study of Invisalign, only 6.0% of patients finished without a refinement scan, and the average was 2.5 scans.
- Wear time matters most for the lower arch. A 2025 randomized trial found 12 hours a day adequate for the upper arch only in very mild crowding, and correcting the lower arch was significantly less efficient than with 22 hours.
- Attachments help. A 2023 systematic review concluded that attachments significantly improve the expression of tooth movement and aligner retention.
- SureSmile aligner evidence is thin. The only SureSmile-aligner outcome study we found is a 14-patient series of in-office-made SureSmile aligners that showed acceptable accuracy for anterior translational movements, while angular movements frequently exceeded the clinical thresholds.
FAQ
Q: Is SureSmile as effective as Invisalign?
A: We found no published head-to-head trial of SureSmile against Invisalign, so we can’t say one works better. What the research does show is about clear aligners as a group: a 2020 systematic review found they can give clinically acceptable results comparable to braces for incisor inclination in mild to moderate cases, at low-to-moderate certainty. Invisalign has more published research behind it than SureSmile aligners, whose only outcome study we found covered 14 patients. Effectiveness ultimately depends on the individual case and provider skill.
Q: Which is cheaper, SureSmile or Invisalign?
A: Neither company publishes a patient price. One independent estimate from NewMouth puts SureSmile at $2,000 to $4,500. For Invisalign, our cost guide uses CareCredit’s survey of clear aligners as a class: $1,800 to $8,100, average $5,108. The final price for either system will vary based on case complexity, geographic location, and the specific provider you choose.
Q: How long does SureSmile treatment take compared to Invisalign?
A: NewMouth’s estimate is 6 to 18 months for both systems. Invisalign says treatment can be completed in as little as 6 months, but one 500-patient study averaged 22.8 months, 5.1 months more than the estimated length. More complex cases with either system may require longer treatment, and both timelines are heavily influenced by patient compliance with wearing aligners as directed.
Q: Can I switch from SureSmile to Invisalign, or vice versa?
A: In some cases, patients may be able to transition between aligner systems, but this depends on the stage of treatment, the provider’s capabilities, and whether a new treatment plan needs to be created. We recommend speaking with a qualified dental provider before making any changes to an active treatment plan.
Q: Do both SureSmile and Invisalign require attachments?
A: Both systems may use tooth-colored attachments (small resin bumps bonded to teeth) to help aligners achieve specific tooth movements. Whether attachments are needed for your treatment depends on the complexity of your case, and your provider will advise you accordingly.
Q: Is SureSmile or Invisalign better for teens?
A: Both systems offer options for teen patients. Align’s annual report lists compliance indicators (built-in wear-time trackers) among the features of its Comprehensive product family, which is where teen cases sit. Dentsply Sirona says SureSmile is designed for simple to complex cases in mixed and permanent dentition (a mouth with both baby and adult teeth, or adult teeth only). A consultation with an orthodontist or dentist experienced in teen aligner cases is typically the best way to determine the right fit. Our Invisalign vs Smile Direct comparison is now historical: SmileDirectClub said it would “wind down its global operations, effective immediately” in December 2023. The FDA page on clear dental aligners, current as of September 9, 2026, says: “The FDA has not authorized clear aligners that are sold directly to consumers without a prescription and supervision by a dentist or orthodontist.”