Does Invisalign still work without attachments? The short answer is yes. If you’ve done your homework on Invisalign, then you know Invisalign is a brand name for a clear aligner product that uses clear aligners plus attachments to apply force and in turn move teeth. So how can it work without attachments?

Let’s go back to basics. Orthodontically, teeth move from the forces applied to the periodontal ligament, or PDL for short, that surrounds each natural tooth’s root. That force on the PDL signals the bone, which holds those teeth in the mouth, to start to remodel and thus allows the teeth to move.

When you apply a force to the teeth, biological bone-remodeling cells called osteoclasts and osteoblasts, work together to start to soften the bone and allow the roots of the teeth to move into the position the Invisalign aligners are pushing them in. Invisalign more or less works by the clear aligners “pushing” a force onto the teeth. (In the contrary, traditional brackets and wires work by “pulling” the force onto the teeth.)

Because the clear aligners themselves are applying force directly on the teeth by pushing on the surface area of the teeth, you will still get bone remodeling and tooth movement. So why have attachments at all?

Well, attachments allow the force to be more specific in force level and direction of movement. The more specific the movement, the more efficiently you get to the desired treatment results. Without an attachment, it’s like gripping a wet watermelon seed.

While technically, yes, Invisalign can still work without attachments. However, as a board certified orthodontist practicing in New York City at my office Smile Pop, I recommend using attachments with your Invisalign treatment for at least half of the total treatment. It gives the doctor more control in the tooth movement, and the more control the doctor has, the shorter your treatment time will be because that means the doctor can better control the undesirable side effects.

During a time like the COVID-19 pandemic, where everyone is forced to self-quarantine, consider asking your orthodontist if you can at least start your treatment without any Invisalign attachments to get the ball rolling.

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