Have you been told “No” to clear aligner therapy?

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Orthodontic treatment with clear aligners (commonly known as “Invisalign,”) has become increasingly popular over the last few years. It is particularly desirable for adult patients because it is esthetically pleasing (no braces on teeth) and there are no eating restrictions (unlike with braces).

We commonly encounter patients who have been told that because of the positions of their teeth and/or their bite, they are not a candidate for clear aligner therapy. A common misconception is that clear aligners only work for a small subset of patients who have a very specific orthodontic issue . . . essentially very “easy” cases that don’t require complex tooth movements. This is not accurate. In truth, treating complex cases CAN be done with clear aligners when the doctor using them has the proper training and experience. The effectiveness of clear aligners depends much more on the skill and experience of the doctor using the aligners, than on the aligners themselves. Most people are unaware that clear aligner therapy is a specialization within orthodontics that is only minimally taught in orthodontic residency. Because of this, it is the responsibility of the orthodontist to seek out additional training after residency to become skilled at treating patients using clear aligners.

Teeth are tricky little devils – they move more easily in some directions than others, they move differently depending on each patient’s bone structure, they move more easily in kids than adults . . . there are so many factors to consider! There are techniques that a doctor with experience and additional training in the correct use of clear aligners knows to use that an inexperienced doctor does not. An example would be adding a tooth-colored bump of glue called an “attachment” to a tooth, which acts like a handle to help achieve a challenging movement. Only a skilled orthodontist knows where to strategically place these attachments in order to achieve the desired results. Another example is the decision to use rubber bands with aligners, to help correct a patient’s bite. Without these types of special adjustments, the patient’s teeth will almost certainly not end up in the ideal position, often causing patients and inexperienced providers to believe that “clear aligners don’t work.” By now, you can see why this is inaccurate.

My recommendation if you’ve been told “No” to clear aligner therapy is that you seek a second opinion. Be selective and do your research. Just think, a scalpel in the hands of an inexperienced surgeon is much different than the same scalpel manipulated by a skilled surgeon. A golf club held by a novice is much different than if it’s swung by a professional. The same idea applies to clear aligner therapy. I recommend that you select a board certified orthodontist who specializes in treating patients with clear aligners. With your treatment in the hands of the right doctor, you’ll likely be able to achieve the smile you’ve always dreamed about without having to wear the braces you’ve always dreaded.
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