Orthodontist in Suwanee Answers: Why Your Invisalign Not Working?

(Atlanta-Suwanee, Johns Creek, Cumming, GA) Invisalign, as you know, is an esthetic alternative to the standard metal braces we all know and love. It moves teeth by wearing a sequential series of removable, clear aligners, each with small increments of tooth movement incorporated into each one, for a specified period of time. They must be worn for a minimum of 22 hours per day to achieve the desired results. Desired results will not be achieved if the aligners are not worn as instructed, requested tooth movement is too difficult for aligners to achieve, improper placement of the attachments, or improper treatment planning. What happens to my aligners if these issues occur???

Tracking errors start to show themselves as treatment progresses and is therefore compounded with each new aligner…in other words, it gets worse with each new aligner. Properly tracking aligners should fit perfectly throughout the treatment process (“like a surgical glove…as I tell my patients)

A “tracking” error is simply where the aligner plastic is losing contact with the teeth/tooth resulting various levels of “poor” fit or adaptation (See Figure). Tracking errors can range from very mild to severe…the more severe, the more obvious will be the ill fitting nature of the aligner and the lack of tooth movement.

The Following are Indications of Possible Tracking Errors:

1. Gaps or spaces are seen between the biting surface of the teeth and the aligner.
2. Aligner is not fitting over one or more teeth
3. Aligner is not adapting to or fitting over one or more “buttons” or attachments
4. Aligner is not staying in place or loose (obvious)
5. Teeth are not moving or following the staging shown in the ClinCheck video
6. Aligner “rocks” or pushes-up on one side while the other side is seated

The above are all possible indications to “reboot” or take new impressions to submit to Invisalign for a new series of aligners to be made. This is referred to as a Mid-Course Correction or a Refinement. One or more (Submissions) of these are usually available (included in fee) if you are being treated with Invisalign Teen or Invisalign Full. With other products such as Invisalign Express 10 or Invisalign Express 5, refinements can be purchased separately.

By Matt T. Walton, DMD – Walton Orthodontics