Removable orthodontics
Clear Aligners
Orthodontic treatment using a series of removable transparent trays instead of fixed braces, for cases where the movements suit them.
How they work
Clear aligners are thin transparent trays made to fit over the teeth. Each one is shaped very slightly differently from the position the teeth are currently in, so wearing it applies gentle pressure and moves them a small amount. You work through the series in order, each tray for a set period, and the teeth arrive in stages at the planned position.
Small tooth coloured shapes, called attachments, are often bonded to some teeth so the tray has something to grip and can deliver the right kind of force. Some movements, particularly rotating a round tooth or moving a root rather than tipping a crown, are harder to achieve with a tray than with a fixed wire, which is why aligners suit some cases and not others. An assessment is what settles which one you are.
At the appointment
Treatment starts with records: an examination, X rays, photographs, and impressions or a digital scan. Those are used to plan the sequence of movements and produce the trays. Before anything is fitted you should be told what the plan is trying to achieve, roughly how many stages it involves, and what the alternatives are, including fixed braces and doing nothing.
The fitting appointment covers bonding any attachments, seating the first tray and showing you how to put them in and take them out. After that, visits are short reviews to check that the teeth are tracking against the plan. If they are not, the plan is revised, which is a normal part of aligner treatment rather than a failure.
Visits, Recovery and When to Call
Visits and timing
Overall length depends entirely on how far the teeth have to move, and varies widely from case to case. Review appointments are usually several weeks apart and short. You change trays yourself between visits on the schedule you are given.
Afterwards
Each new tray brings a couple of days of pressure and tenderness. Speech is slightly affected for the first few days and then adapts. Aligners must be taken out to eat and to drink anything other than water, and the teeth brushed before they go back in, or you are holding sugar and acid against the enamel.
Call sooner if
A tray no longer seats fully, an attachment comes off, a tray cracks, or you have lost one. Continuing out of sequence or skipping ahead pushes the teeth away from the plan. Also call if a tooth becomes loose or painful in a way that is different from the normal ache after a change.
Wear time is the whole treatment
Because they come out, aligners only work for the hours they are actually in. Typical instructions are in the region of twenty to twenty two hours a day, out for meals and cleaning only. Treatment that falls behind almost always falls behind for this reason. And as with any orthodontic treatment, a retainer afterwards is what stops the teeth drifting back.
Keep reading
Questions About Clear Aligners?
Describe the problem on the phone. That conversation is usually enough to work out the first appointment. Mandarin, Taiwanese, English and Japanese are spoken.