Clear aligners · what to expect
What happens when you have clear aligner treatment?
It starts with an assessment, x-rays and a scan, then a plan you should be walked through before you agree. Most cases need small tooth-coloured attachments on some teeth, and some need a little space made between teeth. Then a sequence of trays, reviews along the way, and retainers at the end.
What happens before treatment starts?
An examination first, because moving teeth through decay or unhealthy gums makes both problems worse. Anything that needs treating gets treated before movement is planned, and that is not a delaying tactic.
Then the records the plan is built from: x-rays, photographs and a scan of your teeth. The scan is a small camera moved around your mouth over a few minutes, and it replaces the impression trays people remember.
From those, a plan. You should be walked through what movement is proposed, roughly how long it would take, and whether aligners are genuinely the right tool for your case. If they are not, you should be told that at this point rather than after you have paid for something.
What are attachments, and will you need them?
Most cases do, and they are the thing people are least expecting. Attachments are small tooth-coloured bumps bonded onto some teeth, and they give the tray something to push against so it can move a tooth in a particular direction rather than just squeezing it.
Putting them on does not need an injection and removes nothing from the tooth. They stay on for the length of treatment and are polished off at the end.
They are more visible than the trays are, which surprises people who chose aligners for discretion. Ask to see where yours would go before you start, rather than finding out on fitting day.
Will any tooth be trimmed to make room?
Sometimes, and you should be told before you agree rather than on the day it happens. Where teeth are crowded and there is nowhere for them to go, a very small amount of enamel can be polished from between two teeth to create space. It is a fraction of a millimetre between the contact points, not a reshaping of the tooth, and it is done with a fine strip or disc rather than a drill.
It is still enamel, and enamel does not grow back, so it belongs in the same conversation as everything else on this site that removes tooth. Ask which teeth, how much, and whether there is a version of the plan that avoids it. Sometimes there is. How much tooth is removed sets out why we treat that question as the important one.
What is wearing them actually like?
The first few days of each new tray are the noticeable ones: tightness and pressure, which is what movement feels like, easing over a day or so. Speech is slightly different for the first week and then your tongue stops caring.
They come out to eat and to drink anything other than water, and your teeth are cleaned before the trays go back in. That is the part that reshapes your day, more than any discomfort. People who snack often find it harder than people who eat at set times, and it is worth being honest with yourself about that before starting rather than after.
Trays are worn as instructed, which is most of the day and night. Time that is lost cannot be recovered, though the plan can be adjusted, which is what the reviews are for.
What happens at the end?
Attachments are polished off, the result is checked against the plan, and some cases need a short extra series to finish properly. Ask at the quote stage whether that is included, because it is a common gap between quotes.
Then retainers, which are not an optional extra. Teeth drift back towards where they started throughout life, and retainers are what holds what you paid for. Living with aligners and retainers covers the day to day of both.
Treatment is provided by principal dentist Dr Fatima Kurnaz, a general dentist rather than a registered specialist, who does the assessment, plans the treatment and sees you at the reviews.
Other questions people ask
Does the scan hurt?
No. A small camera is moved around your teeth to build a three-dimensional model. It takes a few minutes, there is nothing sharp, and it replaces the tray of impression material people remember from years ago.
Will people see the attachments?
They are tooth-coloured and small, and most people have to be looking for them. They are more noticeable than the trays themselves, which catches some people out, so ask to see where they would go before treatment starts.
Do the trays hurt?
Pressure and tightness for a day or so after changing to a new one, which is the teeth being moved. Ordinary pain relief covers it. Sharp pain, a tray that will not seat, or a tooth that feels loose beyond the usual are reasons to ring rather than push on.
Will it affect my speech?
For a few days, slightly, and then your tongue adapts. Most people notice it more than anyone listening does. If you have a lot of speaking to do in the first week, it is worth knowing that in advance.
What if I cannot get a tray out?
Work from the back teeth forward rather than pulling at the front, and do it over a basin. If one genuinely will not come out, ring us rather than forcing it.
How often will I be seen?
At intervals set by your plan, and the appointments are usually short. They exist to check that teeth are moving the way the plan said they would, which is the thing that cannot be done remotely.