What's possible with clear aligners?

Are you considering clear aligners? Almost invisible and very discreet, clear aligners are an alternative to traditional braces. You can use clear aligners to straighten your teeth, with most treatment taking place at home.

Around the world, millions of customers are happy with their clear aligner treatment. Could you be amongst those that have already used companies like Invisalign and Smile Direct Club?

Today, find out more about clear aligners and what they can and can’t do.

Problems that clear aligners can't fix

Clear aligners are a fast, effective and discreet way to solve many dental malocclusion problems. But, they can’t fix every issue. Severe dental problems need a different approach, with treatment overseen during regular appointments. In some cases, surgery may be needed. In others, your treatment might involve tooth extraction.

Problems that clear aligners can’t fix include:

The shape of individual teeth

Some people find that they don’t like their smile not because of the position of the teeth, but because of their shape. Clear aligners can’t help to change the shape of teeth that are too pointy, have chips, or are too large or too small.

Poor dental health

Clear aligners are only for malocclusion issues – poor alignment of the teeth – and can’t resolve any other dental problems and concerns. Other issues should be resolved before you begin your clear aligner treatment. You’ll need to be free from cavities and gum disease. Receding gums can lead to other dental problems. They may mean that you’re not a suitable clear aligner candidate.

Developmental issues with Wisdom teeth

Many people find that their back molars and wisdom teeth grow through at the wrong angle. Clear aligners can’t help with these issues, so you’ll need to speak to your dentist.

Aligners only move the visible teeth – the ones that you can see when you smile – and don’t extend all the way to the back of your mouth.

Problems that can be fixed

Teeth with an underbite

An underbite, as you might expect, is the opposite of an overbite. It’s a less common issue, but still something that affects many people.

An underbite happens when the bottom row of teeth naturally sits further forward than the top row. This means that the two don’t meet, when you close your mouth. An underbite can affect speech and eating. You might find that your mouth doesn’t close properly, or that you can’t bite foods easily using your incisors.

Severe underbites may lead to pain, a clicking jaw or chronic headaches. The most severe cases will need to be fixed with jaw surgery. These are often skeletal underbites, caused by an underlying issue with the shape of the jaw. Less severe underbites can be fixed with clear aligners. These are typically dental overbites, where the teeth are misaligned but the jaw itself isn’t far out of alignment.

Teeth with an overbite

An overbite happens when the teeth on the top row hang in front of the teeth in the bottom row. This means that when you close your mouth, the teeth don’t connect. In mild cases, an overbite won’t make much difference to your day-to-day life. In more severe cases, your overbite can have a more considerable impact.

A severe overbite can make you unhappy with the way you look in photographs. It could mean that when you close your mouth, there’s still a slight gap between your lips. A severe overbite might also affect the way you eat. If you have an overbite, you could find that biting down on thinner foods (like a slice of pizza, for example) is impossible with your front teeth. You may be forced to use the side teeth to tear food, though these are the teeth that are usually used for chewing.

Some overbites can only be fixed with jaw surgery. These are typically skeletal overbites, caused by the top and bottom jaws being misaligned. Skeletal overbites are usually genetic. Dental overbites are caused by the teeth being misaligned, and these are the overbites more easily fixed with clear aligners. Dental overbites can happen naturally, but are more likely to be exaggerated by using a dummy once adult teeth are developing, or by habits like thumb sucking, nail biting or chewing objects like pencils.

Overbites are common. In fact, up to 70% of people have some level of overbite.

Open Bites

An open bite may occur when the teeth at the back of your mouth are larger or better positioned than the teeth at the front. This means that the top and bottom teeth come into contact, stopping your mouth from closing further, whilst the front teeth still haven’t met up. With an open bite, your front teeth never close together and connect.

An open bite can cause problems with eating. Smaller foods may fit through the gap that remains when your mouth is closed. As a result, you might not be able to bite foods with your front teeth. It’s likely that you’ve adapted by using your side teeth to bite.

Open bites can be harder to treat, but some clear aligner providers will take on this challenge. Treatment usually involves moving the front teeth down, further out of the gum, and moving the back teeth so that they don’t meet so quickly.

Problems with crossbites

A crossbite is where some teeth have an overbite and others have an underbite. At the front of your mouth the top teeth may protrude over the bottom teeth, whilst at the back the bottom teeth may be further forward than the top ones.

Many things can cause the development of a crossbite. They’re common in children that used a dummy a lot, or have a habit of sucking their thumb.

Crossbites can also occur when baby teeth don’t fall out as the adult teeth push through, leading the adult teeth to grow behind (or in front of) their intended position. If the baby tooth doesn’t fall out as the adult tooth grows, there’s a chance that the adult tooth will settle in the wrong place rather than filling the gap. When the baby teeth does eventually fall out, the adult tooth will be positioned too far forward or back.

Crossbites can be genetic, like underbites and overbites, caused by the shape of the jaw. Dental crossbites and mild cases can usually be fixed with clear aligners.

Teeth that are too close together

We all have different jaws. If your jaw is too small for the number of teeth within it, or if some teeth have grown at the wrong angle, you might find that your teeth are overcrowded. Overcrowded teeth will often overlap, so that one sits on top of another. Some teeth may be pushed backwards, whilst others might be pushed forwards.

Overcrowded teeth aren’t just a cosmetic problem. Much like the Earth’s tectonic plates, your teeth will slide against one another. There’s friction and pressure, and this can cause your teeth to erode over time. Your teeth will become weaker and cavities are likely to develop.

As they grow, teeth find their place in your mouth. If there isn’t enough space available, they’re likely to fit where they can.

To fix overcrowding, you might need to have one or more teeth removed. This should be done as soon as possible, so that other teeth can grow into their correct positions. If overcrowding isn’t dealt with until long into adulthood, the existing teeth won’t adjust to the space that’s now available. Braces or clear aligners may be needed.

Clear aligners can’t create space where it doesn’t already exist. If there’s no room for your teeth to move, aligners won’t make things any better. Before you start aligner treatment, you may need to have some of your teeth taken out.

Overcrowded teeth are often a problem after wisdom teeth erupt. These have to find an almost non-existent space at the back of your mouth, and will usually push all your other teeth together. Many people need to have their wisdom teeth removed. If your dentist thinks your wisdom teeth should be removed, this should be done before you start any clear aligner treatment.

Teeth that are too far apart

Whilst many people struggle with overcrowded teeth leading to different dental problems, there are some patients that are dealing with the opposite issue. If you have an excess of space, you might find that there are gaps between your teeth. Gaps are more of a cosmetic problem, less likely to lead to ongoing pain or dental hygiene issues, though it’s certainly true that a gappy smile can have an impact on your confidence.

Gaps may happen because some of your adult teeth are missing. They may not have grown, or may have been removed for some reason. You might also have gaps if your jaw’s large and your teeth are small. Gaps can be natural, or may have been caused by previous dental treatment.

Clear aligners can be used to shift your teeth and close any gaps that exist. This might help you to feel more confident, if you don’t like the way your smile looks now.

Problems with children's teeth during development

Very rarely, aligner providers will work with younger children. Invisalign is one option, providing clear aligners for children as young as six. It’s usually clear, as children start to lose their baby teeth, that problems are going to exist.

As soon as young children start to get their adult teeth, it may be seen that they’re not properly aligned. Some problems will fix themselves as more baby teeth are lost. Adult teeth may move into position if they have the opportunity. But, if there’s a family history of dental issues then you may notice the signs early.

Most providers of clear aligners will only work with patients that have all their permanent teeth. Some, though, will help you get an early head-start. A gentle treatment for a younger child can stop issues from developing further, reducing the risk of more severe problems in adulthood.

Clear aligners won’t fix everything for a young child. Further treatment will be needed in adulthood, as more adult teeth will have grown and affected the smile, though often these children grow to have fewer problems and may avoid the risk of lifelong issues.

What to do before you start clear aligner treatment

Many providers of clear aligner treatment won’t accept you as a candidate until you have all your adult teeth.

It can be tempting to start treatment as soon as possible, but remember that waiting is for your own safety and that it’s required for good reason. Instead of rushing to find someone that will take you as a patient before you’ve got all permanent teeth, consider that waiting will make treatment more effective and lead to longer lasting results. If you spent time and money going through treatment, you’d be disappointed if teeth emerged later and shifted your smile once again.

If you are younger and you’re accepted for treatment, there’s a good chance that you’ll need further teeth straightening treatment in future. See your treatment as a temporary fix, and something that might help you avoid the worst misalignment problems when you’ve reached adulthood.

Use reputable providers of clear aligner treatment, realistic about expectations. A quality provider will assess every candidate to make sure that they’re suitable. Your provided treatment plan should show you what to expect. Check your treatment plan so you can decide if you’ll be happy with your smile at the end. If you’ve got any questions or concerns, make sure they’re answered before you start treatment. Check if your provider has any guarantee, in case results don’t match their predictions.

If you’ve contacted a couple of aligner providers and they’re not happy to treat you, there will be good reason for their decision. After all, they’d really prefer to get you (and your money) on board! If you’d like a straighter smile but clear aligners aren’t suitable, don’t feel that you’re completely out of options. Your usual dentist should be able to help. Treatment may take longer, be more expensive or require many more appointments, but very few people are completely out of options if they’re unhappy with their teeth.