Clear aligners
Treatment with clear, removable aligners under the orthodontist’s regular supervision.
Does this sound familiar
Patients most often come for this with these words:
I want invisible treatment
My teeth are slightly crowded or spaced
My teeth have moved again after braces
I do not want braces because of my work or social life
I am thinking of ordering aligners online, but I am not sure
Aligners are clear, removable trays that gradually straighten the teeth. Each new aligner moves the teeth a small distance planned on a computer. They are almost invisible and are removed for eating and brushing. According to systematic reviews, aligners are effective for many movements, while for some movements braces are more precise. That is why we choose the method after diagnosis.
Who aligners suit
- Teenagers and adults who want invisible treatment
- When there is mild to moderate crowding or spacing
- When there is minor relapse after previous treatment
- Those ready to wear aligners for the recommended hours a day
- Cases where tooth movement is predictable with aligners
Strengths and weaknesses of aligners
| Movement | With aligners |
|---|---|
| Aligning the teeth | Good |
| Closing small gaps | Good |
| Some movements of the front teeth | Good |
| Lengthening teeth | Difficult, extra tools may be needed |
| Rotating round teeth | Difficult |
| Precise root control | Braces are more precise |
For difficult movements I bond small attachments to the teeth, add elastics or mini-screws, and sometimes suggest braces. A detailed comparison: braces or aligners.
How treatment goes
- Consultation, photographs, X-rays and a gum check
- A digital or conventional impression of the teeth
- Preparing the computer plan and my adjustments to it
- We go through the plan together: how the teeth will move and what the result will be
- Handing over the aligners and bonding attachments if needed
- Regular check-up visits
- Adjustments with additional aligners if needed
- Retention
The orthodontist, not the aligner, leads treatment
Planning tooth movement on a computer is one thing, following how that movement happens in real life is another. During treatment the teeth may not move at the same speed as planned, and sometimes the plan has to be revised. That is why regular orthodontic supervision matters in aligner treatment too. About aligners ordered online: can you order aligners online.
Daily rules
- Wear the aligners for the recommended hours a day, remove them only for eating and brushing
- Drink only water with aligners in, remove them for sweet and coloured drinks
- Brush your teeth before putting the aligners back in
- Clean the aligners every day with cold or lukewarm water, do not put them in hot water
- Keep the aligners in their case, do not wrap them in a napkin: that is how they often get lost
- Move to the next aligner only at the stated time
Risks
- When aligners are worn too little, the teeth do not follow the plan and treatment takes longer
- Sugary drinks with aligners in increase the risk of decay
- When teeth fall behind the plan the aligners do not fit and extra aligners are needed
- Without retention the teeth can move back. See: retention
What the science says
- Systematic review (2015): aligners are effective for alignment, while lengthening teeth and rotating round teeth are harder to control.
- Comparative review (2019): both methods are effective; braces are better at the bite relationship and root control.
An aligner is just a tool. The orthodontist, not the aligner, must lead the treatment.
How aligner treatment is monitored
At every visit I check how tightly the aligners fit the teeth, the condition of the attachments and where the teeth are compared with the plan. If a gap is visible between an aligner and a tooth, the tooth has fallen behind the plan. In that case I either recommend wearing the aligner a little longer or we order additional aligners. These adjustments are normal and part of treatment.
Frequently asked questions
How many hours a day should I wear aligners?
Almost all day, removing them only for eating and brushing. I tell you the exact rule according to your plan.
Is it hard to speak with aligners?
Some sounds may come out differently for the first few days, then you get used to it.
How long does aligner treatment take?
It depends on the complexity of the case and how much the aligners are worn. I give the approximate duration once the plan is ready.
I live abroad. Can I have aligner treatment?
Yes, we plan visits around your travel schedule. See: [patients living abroad](service:patients-abroad).
What should I do if I lose an aligner?
Put the previous aligner back in and message me. We decide the next step together according to the state of the teeth.
Can children wear aligners?
In some cases yes, but growth-related problems are often better solved with other appliances.
Are the attachments visible?
Attachments are made of tooth-coloured composite and are slightly visible up close, but almost unnoticeable from a distance.
Read more
Scientific sources
The information in this article is based on the following peer-reviewed scientific articles and systematic reviews.
- Rossini, G., Parrini, S., Castroflorio, T., Deregibus, A., & Debernardi, C. L. (2015). Efficacy of clear aligners in controlling orthodontic tooth movement: a systematic review. The Angle Orthodontist, 85(5), 881-889. [PMID: 25412265] | [DOI: 10.2319/061614-436.1]
- Ke, Y., Zhu, Y., & Zhu, M. (2019). A comparison of treatment effectiveness between clear aligner and fixed appliance therapies. BMC Oral Health, 19(1), 24. [PMID: 30674307] | [DOI: 10.1186/s12903-018-0695-z]
- Martin, C., Littlewood, S. J., Millett, D. T., Doubleday, B., Bearn, D., Worthington, H. V., & Limones, A. (2023). Retention procedures for stabilising tooth position after treatment with orthodontic braces. Cochrane Database of Systematic Reviews, 5(5), CD002283. [PMID: 37219527] | [DOI: 10.1002/14651858.CD002283.pub5]