Since clear aligners came about in 1997 (invented by a Stanford University student who started Align Technology and the fabrication of Invisalign clear aligners), the product has continuously evolved in materials, processes and the ability to efficiently and effectively move teeth through bone. Now there are several clear aligner companies, some of which deal directly with the patient/consumer with no dentist or orthodontist providing any hands-on treatment (not advised due to possibilities of causing bony, TMJ, tooth nerve, or bite issues when there is no direct professional supervision).
Clear aligners, in exerting a slow, light, constant force on the teeth (ideal wear time being 21-22 hours each day) are ideal for a comfortable and esthetic treatment that results in less trauma to the teeth and hard and soft tissues of the mouth than more forceful appliances or brackets and wires are capable of. Clear aligner treatment makes it possible for the bone to actually build itself up in the area where the tooth is being pushed into, which can prevent bone loss in undesired places. Slow and easy does it.
So what are the benefits to clear aligners besides straightening and making the teeth look better?
- Bite and jaw joint
- Teeth can be moved into a better position when the jaws close together, resulting in less stress on them and more harmonious function with the TMJ.
- When the bite is not ideal, it can cause the lower jaw to be pushed backward, causing TMJ pain and dislocation, and also potential airway tightness behind the lower jaw. Airway size that is too small increases risk of snoring, oxygen dropping during sleep, and sleep apnea.
- Airway enlargement
- “Expanding” the dental arches to be wider is often involved in orthodontics to provide room for the teeth to align side-by-side, but the side effect of that is that the lower jaw has more room inside the upper jaw, the tongue has more room inside the lower jaw, and the floor of the nose can widen a bit. All of these can result in airway improvement for taking oxygen into the body.
- One company called Candid has changed the standard clear aligner design in the last couple of years to achieve what it claims is more effective bony widening of the jaw bone itself, rather than just widening through the teeth. It also has the advantage of less attachment use. (Attachments are resin-bonded squares of material that are bonded to the teeth for the duration of the clear aligner treatment and commonly placed on multiple teeth to help the tooth movements express).
- When the airway is better, lots of other things can improve with the body besides more oxygen and nasal breathing and better sleep. Healthier types of oral and gut bacteria thrive (through nitric oxide dependent variables and others), and basically every bodily process is improved when oxygen levels are adequate. We cannot underestimate the value of proper breathing.
- Tooth wear
- Many patient grind or brux their teeth for decades, often during sleep. Evidence of tooth wear shows in two year olds, 18 year olds, and 70 year olds, in varying degrees depending on the patient’s airway, bite and other factors including even allergies and nutrition. Changing the position of the teeth in the mouth enables restoration of the wear areas with something as simple as direct resin bonding (done in one appointment) that is the closest thing we have to “putting enamel back on the teeth” where it has been rubbed away. This covers the soft dentin layer under the enamel that has been exposed by tooth wear, which improves sensitivity, prevents further chipping of teeth edges, and looks amazing. (Porcelain is an option to restore the teeth as well, if there are bigger shade or shape changes to be made to the teeth.) The clear retainers that follow orthodontics serve as nightguards to keep the resin or porcelain intact and prevent further damage to the other teeth too long-term. This is a big factor in tooth longevity and prevention of mobility, cracklines, etc. that can cause premature tooth loss.
- Gum health
- Teeth that are straighter are easier to clean. When areas are more accessible, we can more regularly disrupt the bacteria that hides in the crevices of the oral cavity with Waterpik, floss, and brushes. This contributes to decreased risk of gingivitis and periodontal disease, which are both connected to overall health.