Invisalign has become an increasingly popular alternative to traditional metal braces for adults looking to straighten their teeth. The clear plastic aligners are practically invisible, removable, and comfortable. However, not every dental case is suited for Invisalign treatment.
There are certain dental situations where traditional braces would work better than Invisalign aligners. In general, the limitations of Invisalign come down to the type of movements that are required to straighten the teeth. The Invisalign company itself states that only about 70% of orthodontic cases are candidates for Invisalign.
Teeth that are severely crowded or rotated
One of the main limitations of Invisalign is in cases of severely crooked, crowded or rotated teeth. The aligners are only able to produce gentle forces to move teeth into alignment. They work best when teeth need to be tipped or slightly rotated into position.
With metal braces, the orthodontist can apply stronger forces and torque to severely twisted or crowded teeth. The braces can even create extra space in a crowded jaw by expanding the dental arches. Invisalign is limited in the amount of expansion it can achieve.
Example of crowded bottom teeth
Here is an example of very crowded bottom teeth:
As you can see, the bottom teeth are very crowded and rotated. There is simply not enough room to fit all the teeth. Attempting to move these teeth with Invisalign aligners alone would be extremely challenging. Braces are better suited to make space and properly align these crowded bottom teeth.
Example of severely rotated tooth
This is an example of a severely rotated tooth:
You can see how the incisor is almost perpendicular to the other frontal teeth. The plastic aligners would have difficulty producing enough rotational force to properly align this tooth into the arch. Traditional braces can apply stronger torque and rotation to straighten out the tooth.
Teeth with short clinical crowns
Clinical crown refers to the visible portion of the tooth above the gumline. Teeth with shorter clinical crowns can present a challenge for Invisalign treatment. The aligners need a certain amount of surface area on the teeth in order to grip and apply orthodontic forces.
Example of short clinical crowns
Here is an example of teeth with short clinical crowns:
You can see how the gumline extends further down the teeth, resulting in less visible enamel for the aligners to grip. This could compromise the ability to move these teeth without braces.
Teeth with old dental work
Teeth that have old fillings, crowns, or veneers can also be problematic cases for Invisalign. The plastic aligners need to grip the surface of the enamel in order to move teeth. They may not get adequate grip on old restorations.
Additionally, moving teeth with old dental work runs the risk of damaging those restorations. The pressure placed on them by Invisalign could debond or crack the material. In these situations, braces may be the safer option.
Examples of old dental work
Some examples of teeth with old restorations that may not work well with Invisalign:
- Large silver amalgam fillings
- Porcelain fused to metal crowns
- Old veneers with compromised bond strength
Consulting with an orthodontist is recommended to see if Invisalign is possible with old dental restorations.
Teeth with braces as a teenager
In some cases, people who had braces as a teenager may require additional orthodontic treatment as an adult. Perhaps they did not wear their retainers and their teeth have shifted, or they require minor tooth movements to perfect their smile.
Having braces previously as a teenager does not necessarily preclude someone from being an Invisalign candidate. However, their specific case needs to be evaluated.
If significant movement is required, traditional braces may work better than Invisalign aligners. Braces can apply stronger forces to recalcitrant teeth. Discuss the pros and cons with your orthodontist.
Jaw alignment issues
Correcting more significant jaw alignment issues is another limitation of Invisalign treatment. For example, correcting an underbite, overbite or overjet may be beyond the capabilities of Invisalign alone.
Here are some examples of orthodontic cases that involve the jaw and may require traditional braces:
- Severe underbite
- Severe overjet
- Crossbites requiring expansion of the dental arches
- Opening a closed bite
- Surgical orthodontics
Invisalign works best when minor tooth alignment is needed. Jaw misalignment often requires complex orthodontic techniques only achievable with braces.
Teens and children
Invisalign can be used in teenagers, especially older teens. However, braces are usually recommended for children, tweens and younger teens for several reasons:
- Permanent teeth are still developing and erupting
- Jaw growth is still occurring
- Compliance with treatment may be lower
- Teens tend to eat and snack more frequently
Younger teens may not be as diligent about wearing the aligners for 22 hours per day. Braces are fixed in place and cannot be taken out. Orthodontists usually recommend Invisalign for ages 14-15 and up.
Conclusion
While Invisalign aligners offer an excellent alternative to traditional metal braces for mildly crooked teeth, there are some limitations. Teeth that require complex movements, have old dental restorations, or cases involving jaw misalignment may be better suited for braces.
Every patient needs a thorough evaluation by an orthodontist to determine if they are a candidate. Speak to your dentist about whether Invisalign or braces would work better for your specific dental situation.
Frequently Asked Questions
Can Invisalign fix severely crooked teeth?
Invisalign is not well-suited for severely crooked, crowded or rotated teeth. The plastic aligners can only apply gentle forces, unlike braces which can move teeth into place even in very crooked cases. An orthodontist can best evaluate if your teeth can be straightened with Invisalign alone.
Can Invisalign correct an underbite or overbite?
Invisalign is limited in its ability to correct more significant jaw alignment issues like underbites, overbites and crossbites. Mild cases may be possible, but more severe anteroposterior discrepancies usually require the complex tooth movements only achievable with braces.
Can Invisalign work if I had braces as a teenager?
Yes, Invisalign may still be an option if you had braces previously as a teen. Much depends on how extensive the tooth movement needs to be. Minor adjustments may be feasible with Invisalign aligners, while major movement likely requires braces again.
At what age can you get Invisalign?
Invisalign can be an option for teenagers, usually age 14-15 and older. Younger teens and children are typically better suited for traditional braces. Invisalign requires compliance with aligner wear that may be challenging for younger patients.
Can Invisalign fix teeth with dental bonding or veneers?
Invisalign aligners may have difficulty gripping to teeth with old bonding material or veneers on them. Smooth porcelain can cause issues. New dental work is not a problem, but orthodontic movement of teeth with old restorations should be evaluated.
Additional Facts About Invisalign Limitations
Invisalign material
Invisalign aligners are made from clear plastic called polyethylene terephthalate glycol (PETG). The thin, smooth material is comfortable but has limitations in the amount of force it can exert on teeth.
Average treatment time
The average treatment time with Invisalign is 12-18 months. More complex cases often take longer to complete. Some teens choose Invisalign over braces thinking treatment time will be quicker, but that’s not always the case.
Number of aligners used
On average, an Invisalign patient will go through 18-48 aligners over the course of treatment. Aligners are swapped out for new ones as teeth move. More aligners are often needed for difficult tooth movements.
Invisalign cost
The average cost of Invisalign ranges from $3,000 to $8,000 for the complete treatment. Costs depend on how many aligners are needed and treatment duration. Invisalign costs more upfront than traditional braces.
Advantages of braces
While Invisalign is popular for its aesthetics, traditional braces have advantages like:
| Braces | Advantages |
|---|---|
| Apply stronger forces | Move teeth more quickly |
| Fixed in place 24/7 | No compliance issues |
| Effective for complex cases | Jaw and bite issues |
| Less emergencies or unexpected issues | Progress is easier to monitor |
Clear aligner alternatives
In addition to Invisalign, there are some other clear aligner brands such as:
- ClearCorrect
- Align Technology
- ClearPath Orthodontics
- Angelalign
While each has some differences, in general these clear aligner systems have similar treatment capacities and limitations as Invisalign.
Answering Additional Questions
Here are some additional questions patients often ask about Invisalign limitations:
Can Invisalign fix gaps between teeth?
Yes, small gaps between teeth can often be closed with Invisalign aligners. As long as the gaps are not due to missing teeth or skeletal jaw issues, the plastic trays can gently bring teeth together to close gaps.
Does Invisalign hurt?
Invisalign is relatively comfortable and does not cause much pain in most cases. Unlike traditional metal braces, there are no sharp brackets or wires digging into the mouth. Some mild soreness adjusting to new aligners is normal.
Can Invisalign fix overbite?
Invisalign has limited ability to fix more severe overbites by itself. Mild overbite cases of 1-3 mm may be possible. Larger bites often require braces or orthodontic appliances to help align the jaw position.
How old do you have to be for Invisalign?
The recommended minimum age for Invisalign is between 14-15 years old. Invisalign requires compliance with aligner wear that may be challenging for younger teens and children. Braces are usually better for orthodontic treatment under age 14.
Can Invisalign be used for bite issues?
For minor bite alignment issues, Invisalign may be sufficient. But traditional metal braces are usually required for overbite, underbite, crossbite and open bite correction. Jaw positioning is very difficult to fully correct with Invisalign alone.
Is Invisalign painful?
Compared to traditional metal braces, Invisalign does not cause significant pain in most cases. Some patients report mild discomfort or soreness when they switch to a new aligner as teeth are moving. But Invisalign is generally considered more comfortable and pain-free.
In Conclusion
Invisalign clear aligners provide an excellent option for mild to moderate orthodontic cases. Improvements in the technology have expanded the types of tooth movements possible with Invisalign.
However, traditional metal braces are still required for certain complex orthodontic treatments, especially those involving the jaw and bite alignment. An experienced orthodontist can best evaluate your specific dentition and determine the most effective treatment options.
With a proper evaluation, Invisalign may be possible and allow you to achieve a beautiful smile without conspicuous metal braces. Consult your dentist to discuss your options.