Aligners work by applying gentle pressure on your teeth, making them gradually move to their normal position. The pressure applied is then transferred from the roots to jaws. Jaw bone further reacts to the forces applied and moves the socket around the teeth to desirable direction.

From basic understanding, one might think that they just need to put on the aligners and teeth begin to move. However, that’s not entirely true. Since aligners are not directly attached to the tooth, we need to prepare small pressure points on teeth in some cases, called as attachments. Those are little tooth coloured bumps bonded on tooth surface during the treatment, their position and shape completely depends on the desired movement required.

     Attachments are not usually needed in each and every case for movement of teeth, only  cases with severe rotation and for moderate tooth movements might need few attachments.

The length of aligner treatment mainly depends on severity of each case. It can take as short as three weeks or as long as 10-12 months. Mild to moderate cases take few weeks to 6 months whereas some of the severe and complicated cases need 10-12 months for complete alignment of teeth.

Typically, you will be required to wear aligners for 22hours per day throughout the process, only removing them to eat, brush or floss.

One of the great things about aligners is that- you will begin noticing the changes within just a few weeks of treatment. Initially, there might be the minimal, change, but you will definitely see noticeable changes within 4-6 weeks of starting your treatment.

Aligners have various advantages over braces:

a) They are removable, so one can easily floss or brush their teeth after meals.

b) They can be easily cleaned so oral hygiene is maintained.

c) More comfortable than braces and are painless.

d) Unlike traditional braces, aligners doesn’t irritate gums and cheeks.

e) They can prevent loss of tooth material which happens due to grinding of teeth.

      f) Reduced dental visits.

      g) They are invisible and looks aesthetic.

      h) Treatment duration is comparatively less than braces.

      i) Fits smoothly on teeth.

      j) No food related restrictions, unlike braces in which are advised not to have chewy or sticky or hard foodstuff.

     k) Aligners are more predictable, it gives you the preview of how your teeth will look after the treatment, prior to starting the treatment.

     l) They are uniquely customised according to the individual’s teeth.

Usually we suggest to wear aligners 22hrs a day and changing each aligner set every 2 weeks in order to give your bone and tissue time to heal and fill in as your teeth shift to new position.

Some notice that their trays become loose after 7-10days, in that case it is okay if you change them earlier. However this should be done only after consulting your orthodontist.

Every treatment is planned on movement that you wear each of your aligner tray for minimum 2 weeks which is obtained when you wear aligners for 22hrs a day.

If movement is forced or too fast, it doesn’t allow your bone to remodel completely and might end up with negative consequences.

Even after 2 weeks of usage, if you feel like your aligners are still tight, consult your dentist, he might ask you to wear them for one additional week before switching to next set.

You can always consult your orthodontist before you make any changes to your treatment plan.

Aligner is comparatively painless as compared to traditional braces. Few reasons for this are-

a)  The amount of tooth movement done for each set of aligners is minimal which doesn’t exceed beyond 0.25mm unlike braces where movement is comparatively faster.

b)  The force applied during aligner treatment is low and is distributed all over the tooth surface.

Aligner treatment is generally less painful than traditional braces but patients often experiences slight pain or discomfort during starting of treatment. In most cases, discomfort is felt when aligners are first-fitted and when aligner set are changed after every 2 weeks.

It is important to understand that aligners cause teeth movements which do cause some pain. They help bring your teeth in alignment and this is done by applying pressure on your teeth. This pressure then leads to changes in bone which makes your teeth sore and a bit painful. But this is usually mild and temporary, once you get accustomed to it, pain and soreness becomes less pronounced.

There are some specific treatment procedures you can do while undergoing aligner treatment like-

Teeth whitening,

Fluoride application,

Teeth cleaning and polishing,

Anti-sensitivity treatment.

Above mentioned procedures are possible because they do not involve any change in structure of your tooth. Any procedure which tends to change shape of your teeth cannot be done while aligner treatment is still going, it might alter your treatment plan.

Procedures which cannot be done are-

Root canal treatment,

Crowns and bridges,

Laminates and Veneers,

Restorations,

Implants.

The results are permanent with aligner treatment.

You will need to wear retainers after the treatment because your teeth will gradually start to shift to their original position.

It is normal for your teeth to slightly shift once you stop wearing aligner. This is result of everyday wear and tear of your teeth which happens as you chew, bite down, speak and swallow. The retainer is fabricated to prevent the noticeable changes so that you can maintain beautiful smile.

Your teeth are held in their place by surrounding jaw bone. During aligner treatment, bone becomes soft so teeth could move into their final position. Hence it is recommended to wear retainers after you stop wearing aligners so that teeth are held in place while new bone is being deposited. It usually takes 8-12months for your body to build up enough bone to stabilize teeth.

Aligners usually have minimal side effects, in very rare cases, following effects can be seen:

Dry Mouth:

Wearing aligners whole day can really dry out your mouth. The best remedy is to drink more water during the day which is excellent habit anyways. Keep yourself hydrated.

Initial Pain:

Mild pain in the beginning when putting in new aligners is normal. It should go away with time once you get used to of it. Taking over the counter pain relief will give you relief.

Speech Trouble:

Few cases of aligners have noted unfamiliar and unintended speech patterns for initial few days, but this should get better eventually once you get accustomed to it and disappears after 7 days.

Allergic Reactions(less common):

This is a very rare side effect. It is possible for some patients to have allergic reaction for plastic material of which aligner is made up of. Some may not realize if they have plastic allergy, but if there is any doubt you can consult your orthodontist.

There is no specific age limit for aligner treatment. Whether they are teenagers of age 13-18 or adults, you will find aligners as an option with various advantages- since they are clear, they are practically invisible. You won’t have to worry about peer opinions, and it may be more comfortable for them in social situations.

If you are an older adult, aligners are the ideal option for a single reason- convenience.

For adults, if they want to maintain their professional appearance, aligners is the best option. Unlike braces, you don’t have to worry about:

Flashing metallic smile for corporate shoots or any other social situation,

Eating dinner and having to remove food from braces,

Conversing with colleagues or clients while hiding your smile.

Yes, you can definitely go for aligners if your teeth are forwardly placed.

Aligners are series of tight-fitted custom made trays which perfectly fit on your teeth. They gradually make your teeth shift to the final position and straighten your smile.

This happens when you switch from your 1^st aligner set to the other and so on till you get proper alignment.

So what happens is when you change your aligner sets, gradually the teeth starts to shift in backward direction so that proper bite is acquired and alignment is achieved.

Yes, we can correct deep bite by aligner treatment.

Deep bite is excessive vertical overlapping of lower front teeth by upper front teeth. Your upper front teeth come too far over your bottom front teeth when you close your jaw. This can cause problems from wearing off of your teeth to pain in your jaw.

Aligners could be a great option for this.

Treatment can be done by using 2 methods:
A) Your front teeth are pushed inside the jaw(anterior intrusion)

B) Your back teeth are pulled slightly outside the jaw (posterior extrusion)

These complex tooth movements are easily carried out with the help pf aligners because we have provision of giving attachments and including biteramp in the sets of aligner.

There can be many reasons for gaps between teeth:

Mismatch between jaw size and teeth size,

Missing or small-sized teeth,

Habits like thumb sucking can pull your teeth forward and create gaps,

Due to improper swallowing movement. Normally when you swallow, your tongue should press against roof of your mouth, but some have tendency to push their tongue forward against front teeth which causes the front teeth to move and creating gaps between them,

Gum diseases causes your jaw bone to weaken which ultimately makes teeth loose and spaces start to grow.

Aligners poses to be the great option in such cases. It corrects your smile with the series of clear plastic aligners that are customized according to your teeth and gradually correct the misalignment.

The treatment duration varies based on the size of gap. Small gaps take as less as 6-7 months whereas spacing more than 6mm might take 12-24months for correction.

During your first visit complete examination and impressions of your upper and lower teeth is taken. Later we generate virtual 3D model of your teeth using CAD-CAM technology. Then a custom treatment plan is made after examining 3D scan.

This digital treatment plan shows you exactly how your teeth will move and how long it will take to reshape your smile. This shows your new smile before aligners are created. These are then sent to digital treatment facility where casts are made out of those impressions and series of aligners is staged.

The digital plan is then sent to your dentist to review and approve. Once approved, aligners fabrication starts. They are then sent to your dentist and further delivered to you.

Firstly, a zero stage aligner is given which should be used for about 2 weeks to check for proper fit and getting accustomed to it. Once you are done wearing this, then 1^st set of aligners are given from where the actual treatment starts.

The process of receiving 1^st set of aligners usually take 3-4 weeks.

It takes such long time because after taking impressions or scan of your mouth by your dentist, desired amount of aligners trays are decided which are sent to your dentist for approval and any modification they want to do.

Once these changes are done, then aligner are fabricated and sent to your dentist which are then further delivered to patient.

Most of the aligner cases are done without extractions, only few cases might need extractions.

If crowding of teeth is your issue, then aligners may expand your arch and allow teeth to move into their proper position. If this happens, you may not need tooth extraction.

Some patients, those with severe crowding, may need to have their teeth trimmed a bit to make space for alignment of teeth. It involves trimming one or both sides of a tooth or multiple teeth. This procedure is quick and results are immediate, and most important is it can eliminate the need for tooth extraction. But tooth trimming alone is not a solution for overcrowding. This procedure along with aligner treatment can help you avoid extractions.

On your first visit to dentist, he properly examines your teeth and takes impression of your upper and lower teeth. Once these impressions are sent to the lab then it is made into virtual model using CAD-CAM technology.

Also a series of videos are made which includes gradual tooth movements needed to straighten your teeth.

These videos are then sent to your dentist who reviews it and makes any changes he wants to. These videos are then showed to patients where they can see the outcome of their treatment even before starting it. This is one of the greatest advantages of aligners that it gives you a preview of your look even before starting the treatment.

When you come in for your consultation, your teeth are examined and a digital 3D scan of your teeth is made. This is done to show you the preview of your smile outcome at the end of treatment.

If you are ready to get started with aligners, your dentist will work to make some specific tooth movements that are needed to create beautiful smile, then this digital scans are sent to lab and your clear aligners manufactured.

After 2-3 weeks yours trays will arrive, you are now on your way to a healthy, beautiful smile with aligners.

Consultation:

When you first visit to your orthodontist, he does proper checkup of your teeth and explains you what corrections you need in your case and best treatment option for it.

Treatment plan:

Once you have decided to go for aligners, we take x-rays, intraoral and extra oral photographs and impressions of your teeth.

These records are then sent to lab along with the instructions told by dentist for how the teeth will move. Those technicians put information in computer to create a 3D model of your teeth and how they will move to their desired position.

Videos:

After computer model is made, these videos are sent to your dentist. Once he has gone through it and made any changes he want, they are sent to patient. It gives them idea of how their teeth will look after the treatment.

Some people might need to create some space for alignment of teeth, for that slight trimming from one or both sides is done. Impressions are taken again and sent to lab.

Aligner fabrication:

Once you are satisfied with the results, aligner fabrication process starts. This will take at least 2-3 weeks because there are many sets of aligner tray so it may take little longer time.

Aligner delivery:

Aligners are then given to you and explained about how to use them and maintain them. They are meant to be worn in specific order and each set for 2 weeks for 22 hours per day. As you switch with your next sets of aligner you will notice your teeth getting aligned gradually.

Maintain your smile:

After your complete treatment is done, you will need to wear retainers so as to give your bones time to solidify around your new teeth positions. They should be used for 10-12 months.

Are you thinking of straightening your teeth, aligners is the best option since it is nearly invisible and easily removable.

However, most people nowadays have dental work and restorations, like veneers, crowns and bridges and implants.

Crowns are placed over the teeth for cosmetic and structural reasons. For example, if you have discolored teeth, a crown can help improve your tooth appearance. If tooth is severely decayed, the decay is cleaned, natural tooth sealed and a crown is placed to help give extra tooth support.

Since they are placed over the tooth and not embedded into the jaw, teeth with crowns can be moved as easily as teeth without crowns. Aligners are also custom-fitted to your teeth, which means if you already have crown, the impressions taken of your teeth to fabricate your aligners will include the space needed for your crowns.

Also as there is no bonding associated with aligners, this means that if you have crown on front teeth, nothing will be stuck to them in order to move your teeth to final positions, which reduces the potential of damage to finish of your crown.

Biggest advantage for aligner wearers is convenience. Patients love the flexibility and freedom of removing their aligners for short period of time, whether during meals or while brushing and flossing.

Those who wear them for less than 22 hours a day will see slower results, but if not worn for more than 6 days can delay your treatment for more few weeks.

If you haven’t worn your aligners for more than 6 days, you aligners might not fit well like they used to before and feel uncomfortable. You should never force the aligner into the mouth. Using a mirror, insert the aligner from one side of mouth. If it fits in easily and there is no discomfort, you can insert other side then.

But when it is too painful or impossible to sit the trays, try the previous set of aligner. In most instances, this previous tray will fit more comfortably and will allow to reboot the orthodontic process. This could take a few weeks since teeth have moved to their original position. Once you start feeling this tray loose, then again shift to the set which was not fitting. Use it for another 2 weeks and then switch to next set.

Yes, you can do teeth whitening even before treatment, while undergoing aligner treatment or after the treatment.

Brightening your teeth while realigning them would be the most efficient way of achieving a perfect and healthy smile.

As aligners can be easily removed, you can remove them get your teeth whitened and simply put them back on. Some of you might think that your aligner set can act as a tray for teeth whitening material, but no you need another tray of different material for that. If you use aligner tray, it can cause irritation to your gums and surrounding tissue.

You can also use toothpastes or mouthwashes that are specially formulated with whitening agents. These agents help dissolve surface stains, and tiny particles with abrasive properties which help polish the teeth’s surface.

A properly fitting aligner should cover the teeth and fit tightly on your teeth. It might be tight initially but then after continue usage, it gets comfortable.

You need to keep following things in mind while sitting your aligner:

•       Aligners should usually cover your gums by at least 0.2mm.
•       There should be no gap between aligner and tip of teeth.
•        Aligner should fit snugly till the last teeth up to which aligner is extended.

If you feel your aligner is not fitting properly, can try following methods for placing it:

• Use chewie to seat aligner properly
• Use aligner for maximum amount of time
• Before switching to next set consult your orthodontist.

If you end up determining that your aligners doesn’t fit properly- don’t worry there are various inexpensive and easy ways to correct the fit of your trays and lower any sort of discomfort. One of them is Chewie.

These are made up of soft, durable material just like foam which looks like a cotton roll. To use it, just place it between your teeth and bite down for at least 5-10 seconds before releasing. Then move it from one end of your mouth to another, continuing this till you have bitten on all your teeth. The pressure from biting will then force your aligner to fit onto teeth even if they are tight. You can wash them after each use using any mild soap and water and then reuse them till they lose their elasticity.

You should use chewie every time you switch to a new set of aligners as it will help the aligners to seat well on your teeth and help achieve proper tooth movement since aligners exert even, gentle pressure on your teeth once they have been seated properly over your teeth.

Some patients might feel difficulty in removing aligners, mainly because they are not used to it.

Some find it uncomfortable placing their fingers in their mouth to remove the aligners. They feel like they cannot find a place to hold grip onto the aligner for easy removal from the mouth.

Solution for this is – Aligner removal tool.

This is double sided instrument which has one end with a U-shaped hook designed to engage the edge of aligner at the level slightly below your gum line and remove it with a pulling motion that is down and off (don’t pull it outwards). You may loosen aligner in one or more places before pulling it off. This end is used to remove upper aligner.

Other end has lever which helps pushing off your lower aligner. Engage the lever end between your aligner and teeth and push it up and off (don’t pull outwards).

This tool safely and easily removes aligners thereby preventing unwanted aligner tears and does not damage or break fingernails while removing it.

One of the largest benefits of aligners when compared to traditional braces is that they can be removed. This enables patients to enjoy food without any restrictions and makes it easier to maintain good oral hygiene. But if you forget to put them back in or aren’t using them regularly, it can affect your treatment progress.

Normally aligners are intended to be worn for 22 hours a day, any less than that can increase your treatment duration as teeth begin to shift to their previous position. If you miss a day, that’s considerable but more than that can delay your treatment.

After missing few days of aligners, if you re-insert the aligner again and it fits perfectly then you are good to go. But if there is difficulty in placing, don’t forcibly insert it, can injure gums and tissue, and instead just revert back to the previous set of aligner. Use it for next couple of days, consult your orthodontist and then switch again to the set which wasn’t fitting before.

The length of aligner treatment and number of aligners required depends on the severity of the case.

As you might expect, patients with more alignment issues will have longer treatment time and more sets of aligners (up to 50) than people with minor issues and less sets of aligners (20-30).

You might be thinking how to identify the set number?

U for upper and L for lower aligner is marked and number next to that signifies the number of aligner. For example U 13 is the 13^th upper aligner.

The number of aligner out of total provided is shown on the front of each packet as well as on each individual aligner.

Additionally, if your case needs refinement sets of aligners (to give final tweaks to your teeth) they are designated as R and next to it is number of refinement aligner. For example- U-R1 is the upper 1^st refinement aligner.