Why are my clear aligners not working? Why are they not straightening my teeth?

- November 1, 2023

There could be several reasons why your clear aligners may not be effectively moving your teeth. There are two scenarios we will consider (Orthodontic provided aligners and Do-it Yourself aligners).

If your aligners were provided by a Board Certified Orthodontist like Dr. Nizam, here are a few possible explanations:

  1. Incorrect or inconsistent usage: Clear aligners need to be worn consistently as instructed by Dr. Nizam, which is usually 20 hrs/day. If you are not wearing them for the recommended amount of time each day or if you are not following the prescribed schedule, it can hinder the progress of tooth movement.
  2. Poor fit or improper adjustments: Clear aligners are custom-made to fit your teeth. If they are not fitting properly or if adjustments are not made correctly during the treatment process, it can affect the aligners' ability to move your teeth effectively. We place attachments on your teeth to allow for the clear aligners to grab the tooth they are moving, if you lose these attachments, it can hinder their movement.
  3. Complex tooth movements: In some cases, certain tooth movements may be more challenging to achieve with clear aligners alone. Dr. Nizam will assess the complexity of your case and determine if additional orthodontic interventions, such as braces or attachments, are necessary to achieve the desired results. This is usually discussed during your initial consultation.
  4. Compliance with treatment plan: It is important to follow Dr. Nizam’s treatment plan and attend regular check-up appointments. If you are not adhering to the recommended treatment plan or missing appointments, it can impact the progress of your tooth movement.
  5. Individual response: Every individual's response to orthodontic treatment can vary. Some people may experience slower or less noticeable progress compared to others. It is important to communicate any concerns or issues with Dr. Nizam so they can evaluate your progress and make any necessary adjustments.

If you are experiencing issues with your clear aligners, it is recommended to contact us at 403-457-7700 or text us at 587-875-0830. We will be able to assess your specific situation, address any concerns, and provide appropriate guidance to ensure the success of your orthodontic treatment.

Now if your aligners are provided by a Direct-to-consumer orthodontic aligners (DTC)(also known as mail-order or do-it-yourself aligners) there are several other factors to consider. Companies selling these aligners imply you can get the same results as if you were treated by a local orthodontist, only faster, cheaper, and more convenient. If you are currently attempting to fix your smile yourself using these aligners but are not seeing the results you were hoping for, here are five possible reasons why:

  1. The tooth movement was too difficult in the first place to be done as an at-home do-it-yourself project. Every patient we treat, Dr. Nizam spends at least 4-5 hours treatment planning their case. This past is missing in the Direct-to -consumer products. The machine plans an outcome and prints your aligners. Without any regards for your age, gum health or any other concerns. Tooth movement such as moderate to severe crowding and alignment issues, tipped or rotated teeth (especially those with round shapes like canines), overbites (top teeth stick out), crossbites (top teeth are inside of the bottom teeth), open bites (front teeth don't overlap), and deep bites (front teeth overlap too much). Although orthodontists can fix these problems with plastic aligners, these tooth movements are usually too difficult for direct-to-consumer products.
  2. No Attachments were added: Most tooth movements require "handles" on the teeth. With braces, silver or tooth-colored brackets perform this function. Plastic aligners need tooth-colored handles called “attachments” bonded to the teeth for movements such as the rotation of round or small teeth, extrusion (making teeth longer), intrusion (making teeth shorter), and tipping (changing the angle of a tooth).
  3. When an orthodontist diagnosis and designs your case, we establish speed of tooth movement based on your age and gum health. This part is missing in a machine designed system. The speed of tooth movement is limited by your body’s ability to remodel bone. If the prescription in your aligners attempts to move the teeth too fast or too far in a single step, your teeth will not move as prescribed. Furthermore, orthodontic alignment requires space. A tooth must have somewhere to go before it can move. If your DTC aligners aren't working, it may be because the prescription tried to move your teeth too fast or did not create enough space before trying to correct the alignment.
  4. Bite was not taken into account only the crooked teeth were looked at. DTC’s only corrects what we call the social six (straightening the front 6 teeth top and bottom) without considering the back teeth that establish your bite. Proper bite in the back is critical for the functional of your jaw and bite. Although aligners alone (with or without attachments and tooth reshaping) may be able to align upper and lower arches separately, improving the relationship of the upper teeth to the lower ones may require the use of rubber bands (elastics). Aligners provided by Dr. Nizam will incorporate elastics that improve overbites, underbites, and mismatched midlines. Currently, most direct-to-consumer aligners systems do not include rubber bands.
  5. Dis-regard for In-Person Care: Tooth movement is a dynamic (constantly changing) process. As with most things involving the human body, progress rarely goes exactly as planned. When you work with Dr. Nizam, you will have the advantage of an in-person doctor who can evaluate your x-rays, examine your teeth AND bite, discuss your goals and concerns, present all treatment options, provide the attachments, tooth reshaping and rubber bands needed for complex movements, make sure your aligners fit, monitor your progress, and change your treatment plan along the way if needed. There really is no substitute for a local orthodontist when it comes to getting your best smile.