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A woman smiling while holding her clear aligner tray.A woman smiling while holding her clear aligner tray.

Why You Might Need Aligner Attachments

By: BeSeen Team

Date: September 29, 2023

If you’ve been looking into aligner therapy, you may have seen the term “aligner attachments“ in discussions. Also known as engagers or buttons, these dental pieces affix to teeth and serve as anchors that assist aligners with certain movements. You can think of them as add-ons for treatment – not everyone needs them, but they can be incredibly beneficial for those who do.

How Aligner Attachments Help With Treatment

Clear aligners customised for attachments.
Attachments are particularly beneficial for challenging movements, like rotation.

Attachments consist of the same composite resin material that dentists use for dental fillings and other similar treatments. While they function similarly to brackets on braces, they’re much smaller and less visible. Dental practitioners use attachment materials like acid etch, pastes, and bonding agents to secure them to teeth. Once fixed, you can hook your clear aligners onto the attachments.

Aligner attachments don’t compromise the fit and general comfort of your aligners. Do you think you might need them? Here are a few ways they can help improve your orthodontic treatment.

1. They provide more control for challenging movements. 

Straightforward movements are easy to achieve with clear aligner trays only. However, more complex ones, such as rotations (turning a tooth in its socket), require clear aligner attachments.

They give the orthodontic appliance something to engage with and provide additional force for more controlled pushing, pulling, or rotating. Some malocclusion cases that might require tooth rotation include overcrowding, crossbites, and overbites. 

 2. They make progress smoother and more predictable. 

In 2023, researchers published a review of existing studies on the role of aligner attachments in effective treatment in the International Journal of Environmental Research and Public Health. They found that “[all studies] indicate better control and a higher range of tooth movement […] with attachments than without attachments.”

This higher degree of control means that teeth are more likely to move into their proper positions following your treating doctor’s projections. In the end, you get more predictable results and timely progress. Translation: fewer surprises!

3. They enable aligners to grip and move irregular teeth.   

Clear aligners consist of a flexible plastic material, which makes them comfortable. However, that flexibility can limit how much force aligners can apply, especially when a tooth has an irregular shape, size, or position. Attachments create a uniform contact point for aligners to grip, allowing for more consistent force application.

What to Expect When Getting Aligner Attachments

A woman smiling while getting her teeth assessed by the dentist.
Not everyone needs attachments – talk to your doctor about your case.

The only way to know if you’ll need attachments is to discuss them with your treating doctor. They’ll perform comprehensive exams to determine how best to approach your case.

Your doctor might propose attachments during the planning phase 

This is also the best time to express your goals and preferences. If you strongly oppose attachments, your doctor may offer alternatives like cutouts with elastics and other auxiliaries.

They’re generally nondisruptive, but they still have a few downsides. 

Since they sit on a tooth’s surface, they attract plaque – you’d need to pay extra attention to the affected areas to prevent tooth decay. They’re not removable, so you can’t pop them off during meals. This can lead to visible staining and discolouration, especially if you consume dark-coloured foods or drinks. If these are dealbreakers for you, you should discuss other options and your concerns with your doctor. 

They come in different shapes, sizes, and designs, depending on the brand. 

ClearCorrect offers two main types in their setups: vertical and horizontal. They also vary in size from two to four millimetres. Your doctor will decide what’s right for you based on your condition.

They’re much more discreet than clear brackets on braces. 

Attachments are typically small and tooth-coloured or transparent. As such, they won’t interfere with the subtle appearance of clear aligners. They’re barely visible even without the appliance on top.

They’re a semipermanent feature, but not foolproof. 

Since they bond to teeth, you won’t be able to remove them without the help of your doctor. Otherwise, you risk damaging your enamel. But sometimes, attachments can fall off or become loose. It can happen when chewing on hard foods or brushing your teeth too vigorously. It helps to be mindful of your oral care habits. Ask your doctor about adjustments if your aligners frequently dislodge.

They only work in conjunction with aligners. 

They can’t address misalignment on their own. You’ll still need to wear your appliance for at least 22 hours daily for optimal effectiveness. Remember: neglecting your wear schedule can prolong your treatment and compromise your results.

Aligner attachments can enable more controlled and consistent orthodontic treatment, especially for complex malocclusions. Talk to your treating doctor to determine if they should be part of your plan.

 

References:

Australian Society of Orthodontics. (2023). The role of attachments in clear aligner treatment. Orthodontics Australia.

Jedliński, M., Mazur, M., Greco, M., Belfus, J., Grocholewicz, K., & Janiszewska-Olszowska, J. (2023). Attachments for the Orthodontic Aligner Treatment—State of the Art—A Comprehensive Systematic Review. International Journal of Environmental Research and Public Health, 20(5), 4481.

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