Clear aligners can give you a smile you love and even make your mouth easier to clean, but you might be wondering about potential risks, including tooth loss. While clear aligners don’t directly cause tooth loss, it can make your oral health more complicated.
In this guide, we will examine the causes of tooth loss and see how clear aligners can affect this process.
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What Causes Tooth Loss?
Before we can understand how clear aligners may play a role, let’s explore what causes tooth loss in the first place. Most cases of tooth loss are the result of letting oral health problems go untreated, and the main culprit behind these problems is plaque.
Plaque is a sticky film composed of bacteria and food particles that can build up on your teeth.[ 1 ] Given the right conditions to thrive, plaque can cause a variety of oral health issues — primarily periodontal (gum) disease and tooth decay, which can both lead to tooth loss if left untreated.
Periodontal disease begins with plaque buildup at the gum line.[ 1 ] When plaque isn’t removed from your teeth, it can harden into a substance called tartar, which works as a shield for the bacteria on your teeth and is difficult, if not impossible, to remove with a toothbrush.
Gingivitis (gum inflammation) can also lead to periodontal disease.[ 2 ] It’s a very common condition and can be easily reversed, but once it progresses into periodontal disease, it can’t be cured, only treated. That’s why it’s important to address gingivitis right away before it can escalate. Periodontal disease leads to gum recession, which can eventually cause tooth loss.
Tooth decay can also cause tooth loss. When the acids in plaque eat through your enamel, it creates cavities.1 If cavities go untreated, they can move deeper into the dentin and pulp — the deepest part of your tooth. When bacteria gets to your pulp, it can form an abscess (a pus-filled sack) that is extremely painful. At that point, you will need a root canal[ 3 ] to remove the infected pulp. If you let the infection go too far, you may need to have the tooth extracted.
Neither of these scenarios is due to a single mistake in oral hygiene. Rather, they’re the cumulative effect of poor oral hygiene over a long period of time.
Can Clear Aligners Cause Me to Lose a Tooth?
In theory, clear aligners can lead to tooth loss. With that said, it is incredibly unlikely for this to happen. In fact, there are no documented cases where someone started clear aligner treatment, then lost a tooth strictly due to clear aligners — no other complicating factors present.
So what is it that, in theory, could allow clear aligners to cause tooth loss? Root resorption.
Root resorption during orthodontic treatment is an inflammatory response to the force placed on teeth during treatment.[ 3 ] Sometimes, the pressure is too great and it causes a tooth’s root to begin to dissolve.
In most cases, they just make the roots a bit shorter. But they could dissolve the entire root if given the chance. This would leave the tooth without its anchor, allowing it to migrate up and out.
This is very rare, and it is unlikely that pressure would be placed on a single tooth long enough with clear aligner treatment to dissolve an entire tooth root.[ 3 ] The bigger concern is poor oral hygiene while wearing your aligners. Clear aligner treatment requires a higher level of attention to your oral hygiene. If you fail to stay on top of things during treatment, you might develop oral health issues that could result in tooth loss if left untreated.
Aligners are designed to fit snugly around your teeth. This prevents saliva from reaching them. While we don’t think much about saliva, it is an amazing thing and plays a key role in your oral health.[ 4 ] Saliva helps wash away plaque between your brushing and flossing sessions. So, if you fail to brush and floss before putting in your aligners, bacteria and food particles will have free reign to wear through your enamel.
Clear aligner treatment presents an oral hygiene challenge, and how you meet this challenge will partially determine your oral health moving forward.
How Can I Prevent Tooth Loss During Clear Aligner Treatment?
Most oral health problems that cause tooth loss are a result of our own behavior. The good news is if you take control of your oral health, you can prevent tooth loss. Here are some preventative measures you can take to avoid tooth loss during and after clear aligner treatment.
Maintain Great Oral Hygiene
Unlike braces, clear aligners are removable, which makes maintaining great oral hygiene much simpler. However, you’ll need to brush and floss after each meal and keep your aligners clean.
Use a fluoride toothpaste and rinse to help protect your teeth from tooth decay. Fluoride is backed by the American Dental Association (ADA) because many years of research have shown its ability to remineralize teeth.
Maintaining good oral hygiene with clear aligners often comes down to preparedness. Always pack your oral hygiene necessities with you so you can brush and floss on the go. As we mentioned, never put in your aligners without brushing and flossing first, as this will trap food and bacteria inside the aligners.
Make Regular Trips to the Dentist
Twice-annual trips to the dentist are imperative to maintain good oral hygiene. Dentists can access hard-to-reach nooks and crannies that you might be missing with your toothbrush and remove tartar from your teeth and even under your gums. Plaque under the gums can lead to gingivitis, receding gums, periodontal disease, and eventually tooth loss — so this is an especially important part of cleanings.
If you’re experiencing the beginning stages of tooth decay or periodontal disease, you may not notice it on your own. Your dentist can catch these problems early on, so regular oversight can save you from bigger problems down the line. Depending on your ability to maintain your oral health between visits, your dentist may recommend three cleanings a year instead of two.
If you put off dental appointments because of the cost, try searching for dental schools in your area. They offer free or low-cost treatments from their students, all supervised by licensed dentists.
Dietary Changes
Your diet has a major impact on your oral health. Sugar is a dentist’s greatest adversary[ 5 ] because sugars turn into the acid within plaque that wears down enamel. Eating foods with added sugars makes our saliva’s job harder, and plaque buildup much more likely.
On the flip side, certain foods actually stimulate the flow of your saliva — a huge help in your fight against plaque. Whole, plant-based foods are high in fiber and require a lot of chewing, which stimulates the production of saliva. Processed foods have the opposite effect.
If you can, trade out your soda for green tea, your potato chips for nuts, and your candy for fruit. Your fight against plaque during clear aligner treatment will get a whole lot simpler.
Quit Smoking
We know this isn’t the first time you’ve heard this, but smoking can cause a tremendous number of health problems.[ 7 ] Smokers are more prone to periodontal disease and tartar buildup. As we’ve established, these conditions can result in tooth loss if left untreated.
Do All Teeth Straightening Options Present This Risk?
All teeth straightening treatments require you to pay more attention to your oral hygiene. However, some options make this process easier than others.
Braces are typically a more high-maintenance treatment in terms of oral hygiene. Since the brackets and wires aren’t removable like clear aligners, braces can trap food particles, making it easier to miss plaque when cleaning your teeth. Braces hardware makes oral hygiene a more time-consuming task, which can cause some to skip their brushing and flossing.
Lingual braces are attached to the back of your teeth instead of the front. They provide total discretion, but also demand a great deal of responsibility on the patient’s part since it’s challenging to brush and floss an area that’s totally out of sight. Lingual braces tend to be more difficult to keep clean than traditional braces.
Final Thoughts
Clear aligner treatment requires you to step up your oral hygiene routine. If you fail to do so, serious problems can arise that, if left untreated, can eventually lead to tooth loss. However, that doesn’t mean that clear aligners are causing those problems. Taking the time to prioritize your oral hygiene during treatment can be the difference between healthy or unhealthy teeth and gums after you finish.
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Frequently Asked Questions
Will gingivitis go away if I change my oral hygiene habits?
In some cases, yes. If gingivitis occurs because of poor oral hygiene, changing your oral care routine can treat your gingivitis without further intervention. Talk to your dentist about the best course of treatment.
Can tooth loss occur suddenly?
Tooth loss is usually only sudden when it’s due to an injury. Typically, tooth loss is the result of another untreated oral health problem like periodontal disease or tooth decay. It’s important to stay on top of your oral hygiene and your trips to the dentist so they can detect issues in their early stages.
Is gum disease reversible?
Gingivitis is the only reversible stage of gum disease. Gingivitis is common, but don’t let that stop you from treating it right away. Once gingivitis has progressed, there is no cure, only management.
Can a cavity lead to tooth loss?
It depends on how deep the cavity is. If a cavity reaches the pulp (your tooth’s innermost layer), it can create an abscess (a pus-filled sack), which will require a root canal.
Which is worse for my teeth: soda or black coffee?
Just because a food or drink stains your teeth does not mean it is bad for them. Black coffee stains your teeth, but it’s not necessarily causing you harm. Soda has tons of added sugars, which turn into acid in your mouth and wear away your enamel.
Are there low-cost options for dentist visits?
Dental schools often provide free or low-cost dental cleanings, all supervised by licensed dentists. If you want to stay on top of your oral hygiene but you’re on a budget, try searching for dental schools near you.
Why do my teeth feel loose during clear aligner treatment?
Your aligners need to loosen your teeth to move them into their new positions. It can feel a little jarring at first, but this is a very normal and necessary part of the process.
Is tooth loss more likely with braces or clear aligners?
Tooth loss isn’t likely with either treatment as long as you maintain great oral hygiene. Usually, people find their oral care routine more manageable with clear aligners than they do with braces since clear aligners are removable.
Do genetics have anything to do with gum disease?
If gum disease runs in your family, you are more likely to get gum disease yourself. However, it’s important to take preventative measures and maintain good oral hygiene either way.
Do genetics have anything to do with tooth decay?
People are genetically predisposed to have softer or harder enamel on their teeth. The softer the enamel, the more easily plaque’s acids can wear through and cause cavities. You can still prevent cavities by taking preventative measures, regardless of your enamel’s genetic predisposition.
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