What issues can clear aligners fix, and what can't they?

Written by Chris Pearson GDP Registered Dentist

If you want straighter teeth, and you’re thinking about clear aligners, it helps to know more about what problems they can fix and what they might not be able to improve.

Clear aligners are a great choice for many people. They’re discreet and easy to wear, so you can use them to straighten your teeth even at work or at the bar. Nobody will see that you’re wearing clear aligners, and they can be removed when you’re eating and drinking so you can maintain good dental hygiene. Most clear aligner treatment takes place at home, so you can save time and don’t need to keep driving to clinics.

Many people are happy with their clear aligners and the results of their treatment. Do you want to join them? Keep reading to learn more about the problems clear aligners can fix.

What can clear aligners fix?



An overbite is one of the most common dental problems people face. About 70% of US adults have some type of overbite. A mild overbite isn’t too much of a problem. If your overbite is more severe, you might experience pain and trouble eating.

If you have an overbite, the teeth on the top row are positioned in front of the bottom row. When you close your mouth, there will be a gap between your teeth. Instead of meeting, your top teeth could be some distance in front of your bottom teeth. This can affect your smile, but also affect other elements of daily life.

Everyone loves pizza. If you have a severe overbite, there’s a chance that you can’t bite a pizza using your front teeth. The pizza would slip right through the gap. Instead, you might have trained yourself to take bites using teeth at the side. An overbite can mean that your lips don’t close properly. It could make you unhappy with your smile. An overbite can also affect your speech, if it’s severe enough.

Overbites fall into two categories

Skeletal overbites are harder to fix because they’re caused by the shape of your jaw. A skeletal overbite is usually genetic. Many of these overbites are hard to fix, often needing some type of surgery.

Dental overbites are problems with the teeth and not the jaw. They might occur naturally, but could be made worse by behavior. You might have an overbite if you chew objects like pencils when you’re distracted. You might have used a pacifier once adult teeth started to develop, or could be the type of person that sucks their thumb or bites their nails. All these habits and behaviors can lead to dental issues. Fortunately, dental overbites are easier to fix with clear aligners.



The opposite of an overbite, an underbite is a less common problem people face. This is where your bottom row of teeth rests further forward than your top row.

Just like with an overbite, your teeth won’t meet if you close your mouth and have an underbite. You might have the same problems eating and speaking. You might find that you can close your mouth fully. You might be unhappy with the way you look in photographs.

Mild underbites aren’t much of a problem. In more severe cases, a clicking jaw might be a sign that things aren’t right. You might also experience related pain, like regular headaches or earache.

Severe underbites, especially skeletal ones caused by the shape of the jaw, may need to be fixed with surgery.

Skeletal underbites are typically genetic, caused by your natural face shape. These are the hardest underbites to fix, since there’s an underlying problem.

Dental underbites can usually be fixed with braces or clear aligners. These happen when your jaw’s the right shape, but your teeth aren’t fully aligned.



If some teeth have an overbite and others have an underbite, you’re described as having a crossbite.

Clear aligners can usually fix crossbites. They can be used to manipulate individual teeth, helping to move them into line. Clear aligners are custom made, so they can easily move some teeth forward whilst encouraging others to move backwards.

Crossbites are usually a dental problem, rather than an issue with the jaw. These are especially common problems in people with thumb-sucking habits. Using a pacifier for too long can have the same effect on your teeth.

More rarely, a crossbite is genetic and caused by jaw shape and size. This might mean that your teeth don’t have space to develop in their correct positions. A crossbite might happen if baby teeth take too long to fall out, because your adult teeth have emerged too far forward or backward. As your adult teeth start to erupt, they should push your baby teeth out. If an adult tooth comes up behind your baby tooth, or emerges in front of it, there’s a chance it could settle in the wrong position. Teeth have a window of time in which they’ll need to find their final position. If your baby tooth doesn’t fall out in time, your adult tooth might settle in the wrong place.

Luckily, most crossbites can be fixed with clear aligners so you can enjoy a straighter smile. It’s very rare that a crossbite is so severe that it requires a more invasive treatment.

Open Bite

Open bite

Open bites are tricky, and not all cases can be treated with clear aligners. Many, however, can be improved without the need for traditional braces.

An open bite happens when the teeth at the back come into contact quicker than the front teeth. This means that when you close your mouth, the back teeth are closed and the front ones haven’t yet met up. You won’t be able to close your mouth further, since the back teeth are pressing together. This means that there’s always a gap between your two rows of front teeth.

Open bites can cause problems with eating, since small foods can slide right through the gap between your teeth. You might have adapted by using your side teeth to bite your food.

Open bites might also affect how you look when you smile, both with your lips open and with them closed, which may have an impact on your confidence. Treatment usually involves moving the back teeth whilst pulling the front teeth further out of your gums. Clear aligners can’t manage such complex treatment, but may be able to resolve an open bite if simply moving teeth around will be enough.

Crowded Teeth

Many people have a jaw that’s too small for the number of teeth it should hold. Often, dental overcrowding needs to be fixed with tooth extractions. Sometimes, problems can be resolved using clear aligners.

Many people have their teeth extracted but find that it doesn’t fix the problem. The remaining teeth are still crowded together, as they’ve already settled in the gums. This happens if you don’t get teeth removed until you’re well into adulthood. After extractions, you might use clear aligners to help move these teeth and fix your smile.

Overcrowded teeth will overlap. They might rub against each other, causing cavities and damaging your teeth over time. Teeth will be weaker and thinner, more likely to develop long-term problems.

Remember that clear aligners can’t make space where it doesn’t exist. If your teeth are overcrowded, there may be no room for clear aligners to use. You may need to have some teeth removed before you start your clear aligner treatment plan.

Wisdom teeth can cause overcrowding problems where they didn’t initially exist. These teeth emerge far later than the rest, so they might push other teeth out of place. Many people need to have their wisdom teeth removed, so you should check with your dentist if this is something that will be worthwhile. If your dentist suggests you have your wisdom teeth removed, this should be done before you use aligners.

Excessive Gaps

Excessive Gaps

Purely a cosmetic issue, but one that might affect your confidence, excessive gaps are a problem for some people. Many people have a jaw that’s too small for their teeth, leading to overcrowding. Excessive gaps are the opposite issue, where your jaw is too large for the number of teeth it needs to hold. Each tooth has more space than it needs, so there may be gaps between your teeth.

Excessive gaps in your teeth don’t actually need to be fixed. It’s great if you’re happy with the way that you look, since this is a dental issue that doesn’t need resolving. But, if you’re unhappy with the gaps, clear aligners can usually help.

Gaps might have existed since your adult teeth emerged, or could have been caused by a tooth extraction leaving a space in your mouth. Whatever the cause, clear aligners can move your teeth to close any visible gaps.

Children’s Dental Issues

Many providers of clear aligners will refuse to treat children. Most will only provide aligner treatment if you have all your permanent teeth. In rare cases, providers like Invisalign will help with children’s dental issues.

Children’s teeth are growing, shifting and changing until they reach adulthood. This means that you might wait and see what happens, rather than getting early treatment. But, it’s worth noting that early treatment can prevent bigger problems later. If your child’s teeth are already misaligned, this could lead to lifelong bite problems and a need for more invasive treatment. If you’re having concerns, talking to a dentist can help. A dentist may tell you if your child’s smile could benefit from early intervention.

If your child uses clear aligners, this won’t be a magic resolution. They’re likely to need further teeth straightening once they’ve reached adulthood. However, earlier treatment can improve their confidence through those important teenage years. Early treatment can also reduce the dental work that’s needed once your child has grown up.

Aligner treatment may be available for children as young as six. It’s often easy to tell, even at this age, if there are dental problems to keep track of. As your child gets their first few permanent teeth, you’re likely to notice any issues with teeth appearing in the wrong places. Some problems will resolve themselves as a few more adult teeth show up, but a history of dental problems in your family could be a sign that they won’t.

What clear aligners cannot fix?

Clear aligners aren’t a magic solution for all of life’s teeth alignment problems. They can only be used for mild to moderate dental malocclusion. More severe problems will need to be resolved with surgery or more invasive, more closely-monitored treatments.

Problems that clear aligners can’t fix include:

Gum Disease and Cavities

Gum disease can only be resolved with a good dental hygiene routine. If dental hygiene is left unchecked, it can lead to more serious disease and problems with your jaw bones. It can also lead to cavities.

Clear aligners can’t fix gum disease and cavities, but also can’t be used if you’re already having these problems. Before you start treatment, resolve the gum disease and check that any cavities are filled.

Problems with Wisdom Teeth

Clear aligners only move the visible teeth in your mouth. They shift the teeth that people can see when you smile. They don’t reach the back teeth, so they can’t help with any problems that you’ve got with your wisdom teeth.

Many people have wisdom teeth problems. If yours are causing pain or discomfort, your dentist might recommend extraction. If you’re planning to use clear aligners, but have existing wisdom teeth problems, it’s usually best to get wisdom teeth removed before treatment to give your mouth some healing time.

Tooth Shape

Clear aligners can’t change the shape of your teeth. They can move your teeth, but can’t change your smile if you don’t like how large, small, pointy, rounded or chipped your adult teeth are.

Preparing for Clear Aligners

Most providers of clear aligner treatments will require you to have all your adult teeth in place. If you don’t have all your adult teeth, you can choose to wait or find a provider that’s happy to treat children. Remember that most providers ask you to wait for good reason. Until you have all your permanent teeth, your smile could still be changing and shifting. If you spend time and money on a straighter smile, you’d be disappointed if a new tooth came along and ruined your hard work. Treatment is more effective and long-lasting once your permanent teeth are all in.

Make sure that your mouth’s in the best possible condition before you try to get clear aligners. Gum disease, cavities and problematic wisdom teeth can all be reasons for rejection. To stand the best chance of being a suitable candidate, stick to your routine dental checkups and great dental hygiene.

Before you begin, your clear aligner provider should show you an in-depth treatment plan. This should show the expected results of the treatment you’re about to undertake. Be realistic about your expectations, as more severe dental malocclusion can’t easily be fixed with clear aligners. If you’re concerned, find a provider that offers a results guarantee. If you’re not a suitable clear aligner candidate, don’t worry. Your dentist may be able to offer alternatives, like traditional braces or another type of dental treatment.

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