12 Questions About Orthodontic Treatment Without Braces

Straight teeth not only provide a beautiful smile but also significantly benefit overall health. This is because crowding and poor dental occlusion can create chewing problems and pave the way for periodontitis, which in turn increases the risk of other issues.

However, many people do not wish to wear conventional orthodontic appliances (braces), either because they are highly visible or because they feel constrained by them.

In such cases, an effective alternative solution is clear, removable aligners, which are used for a few days and then replaced.

Dr. Katerina Douma-Michelaki, DDS, PhD, Specialist Orthodontist for Children & Adults and General Secretary of the Hellenic Society of Orthodontic Aligners (EEON), answers the most common questions about these aligners.

1. What are clear, removable aligners?

They are a series of “membranes” custom-made for each patient to gradually straighten the teeth without the need for braces and wires. These membranes are made of a special, flexible plastic that is shaped to fit the patient’s teeth. To create them, the orthodontist sends the manufacturing company a hologram of the teeth or a special model, which is digitized and processed by the orthodontist. Once the doctor completes the necessary therapeutic changes, a numbered series of aligners is produced using advanced 3D technology. The patient wears the aligners one by one in order. Each aligner should be used for about one week before being replaced by the next.

2. How do they work?

The aligners move the teeth millimeter by millimeter by applying pressure to specific areas. The pressure points are not the same throughout the series of aligners but change gradually to progressively guide the teeth into the desired position.

3. Is the process painful?

Orthodontic treatment with clear aligners applies very low levels of force, so any discomfort is minimal. If needed, during the first 24-48 hours, a simple pain reliever can be taken, but most of the time, this is unnecessary.

4. How many hours a day should I wear them?

Since the aligners are removable, they can be taken out for eating or brushing teeth. However, for the rest of the day and night, they should be worn; otherwise, orthodontic treatment may be delayed.

5. How often should the orthodontist check the progress of the treatment?

Usually every 4-6 weeks, but this depends on the progress of the treatment and its complexity.

6. Can someone who previously wore braces use aligners?

Usually yes, but it depends on how effective the previous treatment was and what the current issue is.

7. Who are suitable candidates for this treatment?

Clear removable aligners are typically suitable for correcting tooth crowding in teenagers and adults. However, if there is a severe bite problem, conventional braces may be required, which can also be clear or “invisible” (placed on the inner side of the teeth). An orthodontic evaluation will determine whether a person is a good candidate for this treatment.

8. Are there any restrictions during treatment (e.g., with food)?

Since the aligners are removable, there are no dietary restrictions. However, chewing gum should be avoided because it sticks to the aligners, and smoking should be avoided because it can discolor them, making them less transparent. Additionally, highly pigmented substances (such as red wine) may also cause discoloration.

9. What happens if an aligner is lost?

It depends on how long the aligner had been worn before being lost. If the patient had worn it for a sufficient period, the orthodontist may recommend moving on to the next one in the series. Otherwise, a replacement aligner may need to be ordered. In that case, the previous aligner should be worn until the new one arrives.

10. Do aligners affect speech?

The impact on speech is minimal and temporary. Most people adapt within a day or two, and their speech returns to normal.

11. Are all clear aligners the same?

Not at all. There are significant differences between various manufacturers that greatly affect the cost. Some companies produce aligners capable of effectively treating even more complex cases, while others have shown results primarily in milder cases. Thus, the cost varies accordingly.

12. What is the most important thing I should know as a patient?

The most important thing to know is that treatment with clear aligners is constantly advancing thanks to technological developments. However, it is the expertise of the specialized orthodontist that makes the real difference. Technology is a tool for knowledge, not a substitute for it. The orthodontist is solely responsible for the outcome of the treatment. Even in the most advanced systems, the doctor guides the movement of the teeth. Only they have the in-depth knowledge to determine whether what appears digitally can actually be achieved in reality.

The excellent relationship between specialists and patients, with absolute respect for biological processes, is the key to success in any therapeutic approach, including the exciting new world of digital orthodontics.