Clear Aligner Attachments

What Are They and Why Are They Used?

If you've looked closely at someone's clear aligners, you may have noticed small bumps on their teeth.

These are called attachments.

Attachments are small, tooth-coloured pieces of dental composite that are temporarily bonded to selected teeth. When you put your aligners in, the aligner fits around these attachments and uses them to help apply controlled forces to the teeth.

They may be tiny, but attachments can play an important role in making certain tooth movements more predictable.

What are clear aligner attachments?

An attachment is a small amount of dental composite material bonded to the surface of a tooth.

Your dentist places each attachment in a specific location according to your treatment plan.

The aligner is then designed to fit over the attachment.

This gives the aligner an additional point of contact and allows it to apply forces in a more controlled way.

A simple way to think about it is that the attachment gives the aligner something to "grip".

Why do clear aligners need attachments?

Clear aligners work by applying carefully planned forces to your teeth.

Some movements are relatively straightforward. Others are more difficult to control using the smooth surface of an aligner alone.

Attachments can provide additional leverage for movements such as:

• Rotating teeth

• Moving teeth vertically

• Controlling individual tooth positions

• Closing spaces

• Managing certain types of crowding

• Improving the control of more complex movements

The exact purpose of an attachment depends on where it is placed and what your treatment plan is designed to achieve.

Does everyone need attachments?

No.

Some patients may have a treatment plan that requires only a small number of attachments, while others may have several.

It depends on the movements required.

The presence of attachments doesn't necessarily mean your treatment is unusually complicated. They are a common part of modern clear aligner treatment and are simply one of the tools a dentist may use to control tooth movement.

What do attachments look like?

Attachments are generally made from tooth-coloured composite material.

Their visibility depends on their size, shape, location and the natural colour of your teeth.

When you're wearing your aligners, the attachments sit inside the aligner and are often difficult for other people to notice.

You may notice them much more than anyone else does, particularly when you first have them placed.

How are attachments placed?

Your dentist will first prepare the tooth surface and use a bonding process to attach the composite material.

The composite is shaped according to the treatment plan and hardened using a dental curing light.

The entire process is generally straightforward and doesn't usually require local anaesthetic.

Your dentist will then check that your aligner fits correctly over the attachments.

Do attachments hurt?

Having attachments placed is generally not painful.

You may notice some pressure during the procedure and the attachments can initially feel unusual when your tongue moves across your teeth.

Most people become accustomed to them relatively quickly.

The aligners themselves may feel tighter or different when you first begin wearing them with attachments, particularly during the first few days.

How long do attachments stay on?

Attachments are normally kept on your teeth for as long as they're required by your treatment plan.

Some may remain throughout most of treatment, while others may be removed earlier if they are no longer necessary.

Your dentist will remove them at the appropriate stage.

You shouldn't attempt to remove or modify an attachment yourself.

What happens if an attachment falls off?

Attachments can occasionally become loose or fall off.

If you notice that an attachment has come away, contact your treating dental practice.

Your dentist can determine whether it needs to be replaced and whether it affects your current aligner stage.

It's important not to try to repair or replace an attachment yourself.

Do attachments damage your teeth?

Attachments are bonded to your teeth using dental composite.

When they're removed correctly by your dentist, the composite is carefully taken away and the tooth surface is finished appropriately.

Maintaining good oral hygiene while wearing aligners is still important because plaque and food debris can accumulate around teeth and attachments.

Brush your teeth regularly and clean between them as recommended by your dental professional.

Can you eat with attachments?

Attachments remain bonded to your teeth, so they don't need to be removed when you eat.

Your aligners, however, are generally removed for meals unless your treating dentist has given you different instructions.

After eating, clean your teeth as appropriate before putting your aligners back in.

Why are attachments planned digitally?

Clear aligner treatment isn't simply a matter of making a tray that fits over your teeth.

Your treatment plan specifies how individual teeth are expected to move and how the aligner needs to interact with those teeth.

Attachments are incorporated into that planning process.

Their location, shape and orientation can all be relevant to the movement they're intended to support.

This is why treatment planning is such an important part of clear aligner treatment.

Attachments and treatment predictability

No orthodontic technique can guarantee that every tooth will move exactly as predicted.

Biological response varies between individuals.

However, attachments can give your aligners greater control over certain movements and may improve the ability of the aligner to apply forces in the intended direction.

If your treatment plan includes attachments, wearing your aligners for the recommended amount of time is particularly important.

Will attachments be removed before my final aligner?

Not necessarily.

Some attachments may be needed until the end of active treatment, while others may no longer be necessary at later stages.

Your treating dentist will determine when they should be removed.

Frequently Asked Questions

Are clear aligner attachments permanent?

No. Attachments used for orthodontic treatment are generally temporary and are removed by your dentist when they are no longer required.

Can you see clear aligner attachments?

They can be visible, particularly without the aligners in. However, they are generally tooth-coloured and designed to be as discreet as practical.

Do attachments make aligners less comfortable?

You may notice some additional pressure or a different sensation when you first receive attachments. Most patients adjust to the feeling.

Can an attachment fall off?

Yes. Attachments can occasionally become loose or fall off. If this happens, contact your treating dental practice.

How many attachments will I need?

There is no standard number. The number and location depend on your individual treatment plan and the movements required.

Do all clear aligner patients need attachments?

No. Some treatment plans can be completed without attachments.

Can I brush normally with attachments?

Yes. Continue your normal brushing and interdental cleaning routine, paying attention to the areas around the attachments.

The bottom line

Attachments are small, but they can have an important job.

By giving clear aligners additional points of contact, they can help your dentist control specific tooth movements that may otherwise be more difficult to achieve.

If your Aalto treatment includes attachments, your treating dentist will explain what they are for and how they fit into your treatment plan.

They're not an extra complication — they're simply another tool used to help your teeth move as planned.