Invisalign has become an increasingly popular alternative to traditional metal braces for straightening teeth. The clear plastic aligners are virtually invisible when worn and can be removed for eating, brushing, and flossing. However, many patients are surprised to learn that Invisalign often requires attachments in addition to the aligners themselves. These small bumps or buttons help the aligners grip the teeth and apply the proper force to move them into place. Patients may wonder if they can request no attachments with Invisalign treatment.
What are Invisalign attachments?
Invisalign attachments are tiny tooth-colored bumps or buttons that are bonded to the teeth with a dental adhesive. They are usually placed on the front and/or back of the teeth and serve as anchors for the clear aligners. Attachments give the aligners something to grasp onto and help direct the teeth movement. They are an important component of Invisalign treatment for the following reasons:
- Help the aligners apply targeted pressure and force to specific teeth
- Allow for more precise control of tooth movements
- Help rotate and tip teeth that need extra correction
- Prevent aligners from slipping off certain teeth
Attachments are customized for each patient’s treatment plan and placement depends on their specific orthodontic goals. Many patients will have between 5-20 attachments during their Invisalign treatment.
Can you refuse attachments with Invisalign?
While some patients are tempted to request no Invisalign attachments, refusing them is generally not recommended. Here’s why:
- Aligners may not fit or function properly. The bumps and ridges of attachments allow the aligner plastic to grip onto teeth. Without them, aligners are likely to feel loose and may not apply adequate force.
- Treatment progress will be slowed or limited. Precision movements and rotations are very difficult to achieve without the benefits of attachments.
- More aligners may be required. Lack of anchors means aligners have to work harder to move teeth. This could mean more aligner trays and longer treatment time.
- Results may be compromised. Eliminating attachments can hinder the orthodontist’s ability to properly straighten, space, and align teeth for an attractive smile.
Refusing attachments when they are recommended often results in the aligners not working as intended. Treatment time can drag on, final results may be less than ideal, and additional aligners or appointment visits may be needed. For these reasons, Invisalign experts usually do not recommend proceeding without attachments.
Can you request minimal or no attachments?
Some Invisalign providers allow patients to request removal of certain attachments if they are bothered by how many are initially placed. However, patients should keep in mind:
- 10-12 attachments are usually considered the minimum for Invisalign to work properly.
- Front teeth attachments are typically kept since they are the least visible.
- Premolars and molars often require attachments due to force needed to move them.
- Rotating teeth usually need attachments to allow for precision control.
- Requesting no attachments on certain teeth may compromise desired movements.
In rare cases, an orthodontist may approve no attachments if treatment goals are minimal, such as only closing small gaps between front teeth. But for substantial tooth movements, attachments will be required for best results.
Are attachments painful or damaging to teeth?
Patients are often concerned that Invisalign attachments will be uncomfortable or even damaging to their teeth. However, rest assured attachments do not typically cause any pain or tooth damage. Here are some facts for reassurance:
- Attachments are smooth and rounded with no sharp edges to irritate the lips, cheeks, or tongue.
- The bonding material is a safe dental adhesive that will not harm tooth enamel.
- There is generally no discomfort from attachments rubbing on the soft tissues of the mouth.
- Teeth are not at higher risk for decay or sensitivity with attachments placed.
- Attachments can be safely removed after treatment without damaging the teeth.
Proper oral hygiene and regular aligner removal for meals helps keep attachments clean and comfortable throughout treatment. Any mild irritation usually subsides within a week as the mouth adjusts.
Are attachments noticeable?
Invisalign attachments are designed to be as unobtrusive as possible. Here are some ways they are kept discreet:
- Made of a clear or tooth-colored composite resin to blend with natural teeth.
- Very small in size – as tiny as a pen tip.
- Placed on rear surfaces of teeth whenever possible.
- Shapes are rounded or sloped to avoid food/tongue irritation.
With proper placement and composite material matching the tooth shade, attachments are not very noticeable, especially at conversational distance. Clear aligner trays cover attachments, keeping them mostly hidden from view while wearing aligners.
What patients should consider when deciding on attachments
1. Aligners may not fit or function properly without attachments. They are an important component of the Invisalign system.
2. Treatment time may be longer and final results compromised if no attachments are allowed.
3. Attachments do not cause pain or dental problems when bonded properly. Any irritation usually subsides rapidly.
4. Experienced Invisalign providers can place attachments strategically to minimize visibility on front teeth.
5. While some attachments can be removed if desired, retaining 10-12 of them is recommended for proper aligner function and teeth movements.
6. Trust your orthodontist’s judgment on which attachments are necessary for your treatment plan and best outcome.
Conclusion
Invisalign attachments are an integral part of the clear aligner treatment process for most patients. While they may be an unwelcome surprise at first, refusing them outright is inadvisable. Attachments allow for predictable, efficient tooth movements and maximum results. Experienced providers can strategically place and shape attachments to minimize their appearance without compromising treatment efficacy. Trust your orthodontist to use attachments judiciously for your unique smile goals.