Contraindication of aligners are as follows-Clear aligners creating a mild pressure on teeth they slowly push the teeth in the desired position. There are some complex cases which can be difficult to get it treated with clear aligners here are some of them listed below:

a) Crowding and Spacing over 5mm: Large spaces that require the back teeth to be moved forward more than 5mm e.g.: Molar extraction spaces
Spaces within 5mm can be treated with aligners. Similarly severe crowding cannot be resolved with the help of aligner.

b) Severely Rotated Teeth: Teeth which are rotated up to 20 degrees can be treated with the help of aligners but more than this cannot be treated with aligner treatment.

c) Open Bite that need to be closed: Open bite cases are rare type of malocclusion. When your upper and lower teeth don’t touch or occlude with each other when you close your mouth this is called open bite. It cause difficulty to bite and chew for e.g. apple. Such cases are difficult to be treated with aligner treatment.

d) Extrusion of teeth: Extrusion of teeth is displacement of teeth out of its socket. We should understand that in extrusion cases we need to move the bone and the gum together with the root. Such as impacted teeth ( high canines) which require orthodontic traction and as aligners are built in tray pattern hence extrusion cannot be done with aligners.

e) Severely Tipped Teeth: Teeth tipped more than 45 degrees such cases are not recommended as it becomes difficult to treat with aligners.

f) Dental expansion required for blocked teeth

g) Arch with multiple missing teeth:
Generally it’s not a problem if there are one or two missing teeth in an arch but if there are multiple missing teeth more than two it becomes difficulty in removing and placing the aligners for the patient.

h) Teeth with short clinical crown height:
As aligners are built in tray pattern which are customised for every individual according to their arch shape and teeth and are fixed on your teeth. But if there is no sufficient crown height of the teeth so that the tray will grab on to it, it becomes difficult for the tray to fit properly hence such cases are not recommended for aligner treatment.

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