Braces without wires, known as clear aligners, are a modern orthodontic alternative to traditional fixed appliances. This technology involves a series of custom-made, transparent trays fabricated from plastic. These trays apply gentle, consistent pressure to gradually guide the teeth into a desired alignment. Clear aligners offer a discreet method for achieving a straighter smile, as they fit snugly over the teeth and are virtually unnoticeable. The entire treatment process is digitally mapped from the beginning, allowing for precise control over the planned tooth movements.
How Clear Aligners Move Teeth
Clear aligners straighten teeth using a series of trays, each designed to achieve a small, precise amount of movement. The process begins with a three-dimensional digital model of the patient’s teeth, which an orthodontist uses to map out the entire treatment path. This digital plan is broken down into numerous stages, with a corresponding aligner tray created for each stage.
Unlike traditional braces that use a continuous pulling force from a wire, clear aligners use a pushing force distributed across the entire surface of the tooth. When a new aligner tray is seated, it applies a subtle pressure where the current tooth position slightly mismatches the new, desired position built into the tray. This controlled force initiates the biological process of bone remodeling, where bone tissue is broken down on the pressure side and rebuilt on the tension side, allowing the tooth to shift.
For more complex movements, small, tooth-colored attachments are bonded to specific teeth. These attachments act as anchors, enhancing the aligner’s ability to grip the tooth and apply directed force, particularly for rotating teeth or moving them vertically. Without these auxiliary elements, the smooth plastic struggles to achieve the necessary leverage for challenging movements. The use of attachments and the staged movement process allows the treatment to be both effective and highly predictable.
What Conditions Can Be Treated
Clear aligners are effective for correcting a range of mild to moderate malocclusions. They are frequently used to treat general crowding, where there is not enough space for the teeth to fit normally. Aligners also work well for closing minor to moderate gaps between teeth, known as spacing.
Minor bite discrepancies, such as a mild overbite, underbite, or crossbite, can also be successfully managed with clear aligner therapy. The customized trays and the addition of attachments or elastics help guide the upper and lower jaws into a more harmonious relationship. The clinical suitability of a case depends on the complexity of the required movements and the overall severity of the malocclusion.
Clear aligners have limitations and are not suitable for every condition. Cases involving severe crowding, large skeletal discrepancies, or significant rotations often still necessitate traditional fixed braces. The decision to use aligners versus traditional braces is a clinical one, determined by the orthodontist based on the specific anatomical challenges and the degree of tooth movement required. Moving a tooth bodily, where the root and crown move together in a straight line, is more challenging for aligners than simple tipping movements.
Daily Life During Treatment
Patient compliance is the most significant factor determining the success of clear aligner treatment. For the teeth to move consistently according to the treatment plan, the aligners must be worn for 20 to 22 hours every day. Removing the aligners for longer periods prevents the application of the necessary force, which can delay progress or cause the teeth to regress slightly.
The trays must be removed for all eating and drinking, with the exception of plain water. This prevents staining of the clear plastic and avoids trapping sugars and acids against the tooth surface, which could lead to decay. Following a meal, it is important to brush the teeth before reinserting the aligners to maintain oral hygiene.
A new set of aligners is typically introduced every one to two weeks to continue the progression of tooth movement. Cleaning the aligners involves gently brushing them with a soft toothbrush and mild soap or using specialized cleaning crystals or tablets. This routine prevents the buildup of plaque and bacteria on the trays.