How to Maintain Healthy Teeth and Gums While Undergoing Invisalign Treatment

Clear aligners are removable, which is their great advantage over fixed braces and also the source of the one real hygiene problem they create. If you are still choosing a treatment, read our clear aligners versus traditional braces comparison.

An aligner sits tightly against your teeth for most of the day. Anything on those teeth when you put it in - sugar, acid, plaque - is held there against the enamel with no saliva washing it away. Saliva normally neutralises acid and helps remineralise enamel; an aligner blocks that. This is why the routine below matters more during aligner treatment than at any other time.

The routine that matters

• Brush after eating, before the aligners go back in. This is the whole game. Carry a brush. If you genuinely cannot brush, rinse thoroughly with water - better than nothing, not as good as brushing.
• Clean between the teeth daily. Floss or interdental brushes. Aligner treatment often moves teeth into tighter contact, which makes this both harder and more important.
• Only water while wearing them. Anything else - tea, coffee, juice, fizzy drinks - sits trapped against the enamel. Hot drinks can also distort the plastic.
• Rinse the aligners whenever you take them out. Dried saliva is what makes them cloudy.
• Clean them properly once a day with a soft brush and cool water, or a cleaning tablet made for aligners. Not toothpaste - most are abrasive and will scratch the plastic, making it cloudy and easier for bacteria to cling to.
• Never use hot water. It warps them, and a warped aligner does not fit.
• Store them in the case. Not a napkin. Aligners wrapped in tissue get thrown away constantly.

Wear time, and what happens if you slip

Aligners work by applying gentle continuous pressure, which means wear time is not a suggestion - it is the mechanism. The usual instruction is 20 to 22 hours a day, out only for eating, drinking anything other than water, and cleaning.

If you fall short consistently, teeth drift back between wears and the next aligner stops fitting properly. That usually means going back a stage or having a new set made, which adds months.

New aligners often feel tight for a day or two. That pressure is the treatment working. Switching to a new set in the evening means sleeping through the tightest part.

If an aligner cracks or is lost, contact the clinic rather than skipping ahead to the next one on your own.

Common problems, and what to do

• Bad breath or cloudy aligners. Almost always cleaning frequency. Increase it before assuming something is wrong.
• Sore gums. Usually a rough aligner edge, which the clinic can smooth in minutes.
• White marks on teeth after treatment. Early decay from plaque held against enamel - the specific risk this routine exists to prevent.
• Bleeding gums. Inflammation from plaque, not the aligners themselves. Worth a professional clean.
• Dry mouth. Common with aligners, and it reduces the saliva that would otherwise protect teeth. Drink water regularly.
• Sensitivity. Some is normal as teeth move. Persistent sensitivity should be checked.

Attachments, refinements and retainers

Three parts of aligner treatment that surprise people:

Attachments are small tooth-coloured bumps bonded to some teeth, giving the aligner something to grip so it can apply the right force. They stay for most of treatment and are removed at the end. They make cleaning around those teeth a little more fiddly - a soft brush angled around each attachment does it.

Refinements are a second series of aligners made after the first course, because teeth rarely move exactly as predicted. Needing them is normal rather than a sign anything went wrong.

Retainers are not permanent - a retainer typically lasts five to twenty years and is then replaced - but wearing one is long-term. Teeth have a strong tendency to drift back towards their old positions, and that tendency does not expire. Most people wear a retainer nightly, indefinitely. Not wearing one is the single most common reason orthodontic results are lost.

Eating and drinking during treatment

• Take the aligners out for everything except water - no exceptions for "just a quick coffee"
• Aim to eat at set times rather than grazing; every snack costs you wear time and a brushing
• Rinse after acidic drinks and wait before brushing, so you are not brushing softened enamel
• Cut hard food into pieces rather than biting into it, particularly if you have attachments on the front teeth
• Sugar-free gum is out while aligners are in

Finishing treatment with healthy teeth and gums

Aligner treatment is straightforward to keep clean, but only if the routine holds: brush before they go back in, water only while they are on, clean them daily with cool water, and wear them the full 20 to 22 hours. Get through treatment with healthy gums and no white spots and you get the straight teeth without a new set of problems.

If you are having aligner treatment at Mahavirai Dental and Medical Care in Sector 48, Sohna Road and something is uncomfortable or not fitting properly, tell us early - most issues are quick to sort.