An alternative to braces, clear aligner therapy has been growing in popularity over the last two decades. It consists of a series of clear, plastic, removable trays that incrementally move teeth into a desired position. The trays, called aligners, are typically changed every 1-2 weeks depending on your orthodontist’s instructions. The most popular brand that manufacturers clear aligners is Invisalign, but there are others, such as Reveal, ClearCorrect and Smile Direct Club.
To effectively move teeth, clear aligners have to be worn at least 20-22 hours every day. There are a few other adjuncts that are commonly used with clear aligners:
Attachments
Tooth colored attachments or engagers, may be bonded to your teeth for the duration of treatment. They serve as handles that allow the trays to grab your teeth better. Many teeth are small and conical in shape, so without these attachments aligners just slip off them lacking proper engagement. Sometimes clear or metal buttons can be added as well.
Interproximal reduction
Interproximal reduction, also called slenderizing or filing, is a process of stripping down enamel between adjacent teeth by using a rotary disk or strips that resemble fine sandpaper. The amount of enamel removed is minimal and typically doesn’t negatively impact your teeth. However, some sensitivity afterwards is possible, especially if your teeth are already prone to sensitivity. The purpose of the filing is to create space for crowded teeth and to lighten tight contacts.
Elastics
Elastic rubber bands can be used with clear aligners in the same way they are used with braces. Elastics help to improve the bite by bringing upper and lower teeth together into a better relationship. Clear or metal hooks and buttons maybe cemented to your teeth to attach the rubber bands.
Advantages of Clear Aligners
- Preferred by many adults an teenagers
- Virtually invisible. Transparent aligners have no metal parts and are even less noticeable than clear braces. The attachments cemented to the teeth are tooth colored.
- Better for periodontal health. Because the aligners can be removed for brushing and flossing, oral hygiene is not compromised. If you are prone to periodontal disease, including gum inflammation, clear aligners therapy maybe preferable to conventional braces.
- Less irritation. Because there are no metal brackets or poky wires, clear aligners may cause less irritation and cuts to the cheek and gum tissues. Aligners also have lower profile than braces, so they are more comfortable overall.
- Easy to eat. You can take your aligners out for eating and drinking, so you can chew normally with your teeth without worrying about food getting stuck in appliances.
- Fewer appointments. Your orthodontist may give you three or more sets of aligners at a time, so that the time between visits can be 6-10 weeks, instead of 4-6 weeks needed for braces.
Disadvantages of Clear Aligners
- Limitations
The main drawback of clear aligner therapy is the limitations of what can be corrected. Many systems only align the front teeth, but even the more advanced ones like Invisalign are limited when it comes to bite correction. Problems like excessive overbite, underbite, narrow constricted upper arch, severe crowding requiring extractions of teeth, and other complex cases are best treated with braces. Your orthodontist will discuss the options with you and recommend the most effective treatment.
- Inconvenience of having to remove trays.
Being able to remove the trays can be an advantage and a disadvantage. It is true that without the trays it is easier to brush and floss your teeth, and eating is more enjoyable. But you have to be disciplined enough to remember to put them back in right after you are done. If you don’t wear your aligners 20-22 hours per day, the treatment will not be effective. And removing aligners for eating and drinking anything other than water is not optional, so you have to always carry your storage case with you.
- Cost
Some do-it-at-home clear aligner systems cost fraction of what a comprehensive treatment administered by an orthodontist would cost. But they are very limited in what they can correct. More advanced systems, like Invisalign, tend to be a little more expensive than braces. But keep in mind that even Invisalign has limitations. So conventional braces are the most cost effective option, because you get a more ideal result and more comprehensive correction than clear aligners.