Invisalign is a wonderful way to straighten your teeth and achieve the beautiful smile you have always dreamed of having. Patients using Invisalign to move the teeth are responsible for wearing the aligners at least 22 hours every day during treatment. The aligners are clear plastic and cover all of the exposed teeth to the edge of the gums.
One of the “cons” that Invisalign shares with traditional braces is an increased risk for cavities and gum disease. While the risk is lower in Invisalign because the aligners are removable for great oral hygiene, the barrier of plastic does prevent saliva from reaching the teeth and gums. Saliva is good for the teeth and protects them against attacks of cavity-causing bacteria and the bacterial buildup that leads to gum disease.
In some patients, aligners can also increase the risk of TMJ problems. The thickness of the aligner plastic slightly changes the way the teeth bite together. This does not affect the joints in most patients, but in those with a risk for TMJ dysfunction, even the aligners’ thin plastic can be enough to impact the joint.
So what can you do to make sure your mouth, teeth, gums and jaw joints stay healthy while you undergo Invisalign treatment?
It is always important to have great oral hygiene routines at home. When you are wearing Invisalign aligners, it becomes even more important. This is because you lose the protective effect of saliva washing over the teeth and gums throughout the day. The barrier of aligner plastic keeps the saliva from reaching the teeth to re-harden enamel and fight bacteria.
Because of the elevated risk for cavities and gum disease, you must commit to practicing great oral hygiene during your Invisalign treatment. This means brushing twice daily (three times if you are able to brush after lunch). We usually recommend brushing after your breakfast before you place your aligners in for the day, and before bedtime. Make sure you are using the proper brushing technique in which the bristles lightly graze the gum lines in gentle circular motions.
Flossing is a must! It is the only way to remove plaque and food debris from between the teeth. Not flossing is even more dangerous when you wear aligners because the aligners “trap” the plaque or food debris in place.
Most patients undergoing Invisalign treatment see the dentist every four to six weeks for evaluation of their progress. However, these visits may mask the fact that you have not had a professional teeth cleaning or full dental check-up. We know you are seeing the dentist regularly. It is important that you see your dental hygienist, too!
At these cleaning & evaluation visits, your dentist will monitor more than just the movement of your teeth. He or she checks for any warning signs of changes in your oral health and makes recommendations to lower disease risk as you continue treatment.
The good news is that you get accustomed to wearing plastic aligners over your teeth relatively quickly. The bad news is that you can almost forget the aligners are in your mouth, which could lead you to drink beverages while they are in place.
The liquid of our various beverages does seep underneath the aligners to contact the teeth. Unless this liquid is water, this is a bad thing. Anything that is acidic or contains sugar should never contact your teeth under the aligner where saliva cannot counteract it. The simple rule is that you should only drink plain (not sparkling) water while wearing your aligners. The more sugar a drink contains or the more acidic a beverage is, the worse it is for your teeth.
Ideally, you should clean all of the plaque and food debris from your teeth before placing the aligners over the teeth. However, we understand that this is not always an option. Maybe you are out to lunch for an important business meeting, or at someone else’s house for dinner. In these cases, we do not want you leaving the aligners out until you can get to your toothbrush and floss. You should swish your mouth vigorously with plain water (again, NOT sparkling) to remove any loose plaque or food debris before re-inserting your aligners.
Then, once you have reached the office or home, you can remove them to brush. As we said, it is not ideal. Nevertheless, it is better than leaving them out for hours at a time.
When your dentist assesses your risk for cavities and/or gum disease, he or she might recommend certain oral hygiene products for you to use during your Invisalign treatment. Using these products as directed can help you protect your teeth and gums in their slightly more vulnerable state.
Most commonly, these will include a fluoride mouth rinse to use after brushing and flossing. By swishing with a fluoride mouth rinse before you insert your aligners, you can “trap” fluoride on the teeth, which strengthens and hardens the teeth.
Some patients will receive a prescription for a special toothpaste or gel to use when cleaning the teeth at home. Whatever the recommendation, its purpose is to keep your teeth and gums healthy throughout your orthodontic treatment. Following instructions closely will help you maintain your oral health while you straighten your teeth.
This will not be a concern for every Invisalign patient, but every patient should know what signs and symptoms to watch for during aligner treatment. If you notice any of these symptoms occurring, notify your dentist at once so that steps can be taken to keep your joints healthy.
If you notice that any of these symptoms seem worse when the aligners are on your teeth, stop wearing the aligners. You can try wearing just one (either just the upper or just the lower aligner) at a time to see if the symptoms improve. Some patients with severe TMJ problems may need to use traditional braces instead of clear aligners.