Issues with Invisalign® staining (aligners, attachments and teeth).

- The usual causes. | Prevention - General rules and precautions. | Remedies and solutions - What can be done to whiten up yellow or brown aligners, teeth and/or attachments?

How big of an issue is stain formation during Invisalign® treatment?

a) Aligner discoloration.

For most people (especially those who follow Invisalign's guidelines), the formation of aligner discoloration during the short two-week period that they're usually worn should be at most only a minor problem, and more likely a non-issue.

Problematic cases.

But for those patients who insist on consuming dark beverages like coffee, black tea, soda (colas) and/or red wine, without regard to standard precautions or guidelines, the crystal clear nature of their aligners may soon be lost.

If so, the clouded, yellow or even brown aligner appearance that results can be a tip-off to others that you're wearing your appliances. Fortunately, there are some remedies that usually provide a solution.

b) Teeth and attachment staining.

Different than with your aligners that are swapped out regularly with a sparkling new set, any stain that forms on your teeth or the Invisalign® attachments that have been bonded to them ultimately becomes a chronic problem that continues to be visible with each successive set of appliances you wear.

A common problem is tooth and/or attachment yellowing. In some cases, the staining may be heavy enough to be noticeably brown. Fortunately, solutions do exist but for actual removal, you'll need the assistance of your dentist.


What's the official word from Invisalign® about staining and stain prevention?

While Align Technology, Inc., the company that makes the Invisalign® system, apparently shares more information about staining concerns with their dentist providers as opposed to consumers (discussed here), they are clear in stating that patients should remove their aligners before drinking beverages other than just plain water.

Section references - Invisalign

In regard to the potential for stain formation, darker beverages are generally the ones of most concern. This includes: coffee, soda (colas), black tea, and red wine.

Is that level of abstinence really needed to prevent staining?

While their recommendation may seem astoundingly limited, we will say that following it clearly makes the best practice.
[Our comment here isn't just based on the issue of aligner, attachment and/or tooth staining alone. There are other important considerations involved too.

Use this link for a discussion about the host of issues that can be associated with drinking different kinds of beverages while your aligners are in. This especially applies to hot or sugary drinks, and is information that's vital for you to be familiar with.]

But in regard to just stain formation alone, it would be our opinion that there may be some possible wiggle room in exactly what you do. This page explains below.

Staining issues associated with wearing Invisalign®.

1) Aligner staining.

Consuming beverages that have a strong or bold coloration can cause aligner discoloration. This effect can be expected to be a gradual one that worsens as repeated exposures to the chromogenic agent take place. (An issue of slight or moderate exposure vs. a prolonged or excessive one.)

What type of beverage is most likely to cause staining?

As you'd expect, dark beverages tend to cause more of an effect than lighter color ones. This includes soda (cola), black tea, coffee and red wine. But really, any type of beverage that has a strong tint, and especially if consumed frequently or sipped from for extended periods, will have the potential to cause aligner discoloration.

Aligner staining usually starts off as a yellow hue. (A paper by Liu states that coffee and tea solutions frequently contain yellow dye compounds.) As more exposure occurs, the appliance's color may take on more of a brown tint.

Research findings.
A study by Liu evaluated the staining effect of coffee, black tea and red wine (Cabernet Sauvignon) on several removable aligner systems and commented that of these three, coffee was the one that tended to be the worst offender.

Section references - Liu


Pictures of aids used with dental retainer cleaning.

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The new Invisalign® plastic.

In 2013, Align Technology began using a new plastic ("SmartTrack® aligner material") to fabricate their Invisalign® aligners.

As compared to the previously used plastic (EX30®), the company stated that the SmartTrack® material was found to deliver a more constant force to the patient's teeth. They also stated that patients found aligner's made out of the new plastic more comfortable to wear.

Issues with staining.

While reading through Align Technology, Inc. communications to dentist providers, we noticed that information sent in March of 2015 included a statement reporting that some dentists felt that staining was more noticeable with the new SmartTrack® material (vs. the EX30®).

In fact, the study mentioned above seems to have confirmed this issue, at least in part. Its findings were that the Invisalign® SmartTrack® material was more prone to pigmentation (picking up stain) than the plastic used to make aligners for two competing brands. However, they only identified this issue in regard to coffee, and not exposure to black tea or red wine.

Section references - Liu

What can you expect?

Each person's experience with aligner staining will vary according to their specific consumption habits (beverage involved, duration of exposure, number of exposures).

And remember, if you simply follow Invisalign's® recommendation and remove your aligners when consuming all beverages other than cool water, aligner staining will be a non-issue for you.

But if you can't abstain totally, for many patients the degree to which their aligners discolor over the short two-week time span that they're worn may not be readily apparent, and therefore not a significant problem.

For most people, this will probably be the case. But beyond just hoping so, there are some things you can do proactively.

Picture of an Invisalign® tooth aligner.

It doesn't take a lot for the crystal clear nature of your aligners to be degraded by staining.

Prevention / Minimizing aligner staining.

a) Creative scheduling.

The staining caused by drinking dark beverages only deepens when these items come into contact with your aligners. So, what you need to do is figure out ways of minimizing this type of event.
The compromise.

Your dentist probably expects you to wear your aligners on the order of 22 hours per day. So, after assessing your daily routine, you may be able to come up with a schedule that allows for both wearing your appliances as directed, and removing them while you enjoy your favorite beverage.

  • We'll admit that the scheduling you're forced to adhere to may not offer as much time for enjoyment as you might like. But that seems to be the price that's required to have your treatment go smoothly and predictably, while also guaranteeing that your aligners stay clear and invisible.
  • Keep in mind when you make up your routine that before putting your aligners back in you'll need to rinse your mouth with water, so to remove any residual amounts of the beverage. You'll need the facilities for that, or at least a bottle of water or nearby drinking fountain.

 

b) Using a straw may help to prevent staining.

If you plan to drink beverages with your aligners in, you might try using a straw. Doing so doesn't necessarily provide a perfect solution but it may help to minimize the amount of staining that forms on the front aspect of your appliances, which is the side that poses the greatest concerns in terms of appearance.

Positioning.

When using a straw, your goal should be to position it so it shunts as much of the liquid as possible directly to the rear-most portion of your mouth, and then on down your throat.

The problem.

The general difficulty with this technique is that no matter how far back you're able to position the straw, the oral cavity is a wet environment. That means that maintaining total separation of the beverage from your aligners won't be possible because it will co-mingle with the saliva in your mouth, and subsequently disperse throughout it and linger.

Possible benefits.

In terms of stain prevention, using a straw may have the potential to provide some positive effects:

  • Whatever amount of the beverage your mouth is exposed to will at least be in a diluted form, thus reducing its ability to cause staining.

 

Another possible benefit of using a straw is related to the portion of your aligners' plastic that's most likely to become stained.

  • The front side of your front teeth is a comparatively drier, less connected portion of your mouth. So when a straw is used, not only does the beverage in its full-strength totally bypass this region, but any diluted amount of the dark liquid that remains in your mouth will have some difficulty in migrating up to this front location.
  • Since this is the portion of your appliances that shows the most, the assistance that a straw provides in preventing staining in this region may be all that you really need to help to keep the appearance of your aligners reasonable for the few weeks each set is worn.

 

c) Better aligner home care should help.

In some cases, it may be a film of debris that has accumulated on the surface of your appliances (like tartar) that has picked up the stain from the dark beverage.

  • In terms of prevention, the remedy for this problem lies in being more diligent when cleaning your aligners, so there is no debris buildup to stain. (For details how, start with our page: Best practices for brushing Invisalign® aligners.)
  • Keep in mind, it's not always just a matter of doing a good job that's important. You must also perform your cleaning routine frequently enough so that the formation of the debris (especially tartar) is kept at bay.

 

d) Possible remedies for stained aligners.

If your aligners have already discolored, or debris that's accumulated on them has, there are some types of soaking solutions that may help to lighten or whiten them up. For details, here's a link to our page that addresses soaking solutions for aligner cleaning.

While reading that page, take note of the fact that essentially all cleaning solutions have been found to affect aligner plastics in some way. So limiting your appliances' exposure to the agent to just what's needed always makes the wisest choice.

Bleach (Clorox) solution has a reputation for being able to whiten yellow and brown staining. Vinegar solution excels in softening up and removing discolored calcified deposits that have adhered to appliances. As our page explains, research suggests that there may be greater concerns with the use of a peroxide-based soak rather than other solutions.


2) Discoloration associated with teeth and attachments.

a) Stain formation on Invisalign® attachments.

There is some potential that a person may experience some degree of staining with their Invisalign® attachments. Although for most people, this should be a non-issue.

Attachments are generally fairly resistant to staining.

While the specific material used to make a patient's attachments is selected by their dentist, they'll generally choose a type of restorative referred to as "dental composite." This is the same kind of material used to make "permanent" white fillings.

As it happens, it's the nature of dental composite to discolor and yellow over time, specifically due to repeated exposure to agents like colas, tea, coffee or red wine (multiple years are usually involved). But due to the fact that attachments are only on your teeth for a short duration (measured in months to a year), material discoloration doesn't have to be expected to become a problem.

 

Attachment stain prevention.

Just in case you want to take every precaution possible, do whatever you can to minimize your attachments' exposure to the dark beverages you drink.

Things to do.

When your aligners are out, using a straw can be beneficial. Doing so will help to shunt the liquid past your front teeth (where your attachments that show the most are), thus minimizing its contact with them.

If you choose to drink beverages while your aligners are in:

  • The fact that they create a plastic barrier covering over your attachments will generally help to protect them from staining influences.
  • It's logical to assume that any time you drink a beverage that at least some fraction of it will seep into the internal aspect of your aligners. So rather than just letting it pool there and potentially stain your attachments, rinse your mouth and appliances out with water.

 

Remedies for stained attachments.

  • If the discoloration on your attachment is surface staining (due to accumulated surface debris), your dentist may be able to whiten up its surface by polishing it.
  • For staining that's become incorporated into the thickness of the dental composite itself, there may not be an easy whitening solution.

    That's because each attachment has a specific shape specially designed to key into your aligners, and therefore your dentist will be hesitant to want to do anything (extensive polishing or buffing) that will alter it.

  • For deeper staining, at-home whitening products are unlikely to provide a solution. Peroxide application usually will not create a significant whitening effect for dental materials, and therefore cannot be expected to be effective.
  • You'll probably also find that your dentist is hesitant to offer to replace stained attachments.

    It represents added time and expense for them. The stent used to create and precisely position each attachment may no longer fit (due to case progress), making replacement difficult or impossible. And generally, they're going to be hesitant to make any changes with something that is otherwise working well.

 


b) Teeth staining associated with wearing Invisalign®.

It's possible that tooth staining issues might be amplified by a person wearing their Invisalign® aligners, in a couple of ways.

Illustration warning that sugary beverages can seep inside Invisalign® aligners.

Beverages can seep into your aligners.

a) Your teeth aren't as protected as you might think.
While the way a person's removable orthodontic aligners fit snugly over their teeth does create somewhat of a barrier that isolates them from the rest of the mouth, it's not a waterproof seal.

And that means that any dark-colored beverages you drink may seep into them (see illustration).

b) How an aligner's presence might promote tooth staining.

Once a chromogenic agent has seeped inside an aligner, the tables are reversed. The appliance now acts as protection for the liquid from the washing and diluting effect of saliva. And due to this protection, the beverage may have an exposure to tooth surfaces that's more pronounced than would otherwise exist.

Preventive steps you can take.

Rinse out with water afterward.

If you must drink a beverage while wearing your aligners, afterward take them out and rinse both them and your mouth with water so to dilute and wash away any remaining portions of the drink. And the sooner you do so the better.

Using a straw may help.

Just as discussed above, the use of a straw may help to minimize tooth staining by way of directing the most concentrated form of the beverage on down your throat as opposed to into your mouth.

Performing effective oral home care will help.

Much of the tooth staining that occurs in a person's mouth is of the surface-stain variety. With this phenomenon, it's not really the tooth that has discolored but instead a thin film of tartar accumulation on its surface that has. (This is the type of stain that polishes off when your dentist cleans your teeth.)

The protected environment created by wearing aligners can lead to the increased formation of surface debris on teeth when proper home care is not practiced, and therefore can have the effect of contributing to the person's tooth staining problem.

Remedies for teeth staining.

Having a routine dental cleaning is the way to whiten teeth that have stained due to surface accumulation. The thin layer of debris (usually yellow to brown in color) can be expected to polish off. Larger clumps (dental tartar) will need to be scraped away.

 

 Page references sources: 

Invisalign.com Invisalign FAQ.

Invisalign.com Frequently Asked Questions.

Liu CL, et al. Colour stabilities of three types of orthodontic clear aligners exposed to staining agents.

All reference sources for topic Straightening Teeth.

Comments

Clear attachments.

I'm worried about my attachments staining. I whiten my teeth regularly. I don't want my attachments to look a different color. Are there clear ones available?

* Comment notes.

Ooot

Your short comment has a number of issues that need to be addressed.

Like this page explains, attachment staining is possible. But keep in mind that your attachments are made out of the same type of material (dental composite) as white fillings. And while it is the nature of composite to pick up stain over time, usually that doesn't become a problem for some years (an interval longer than most people's Invisalign treatment).

As far as placing clear attachments goes ... yes, that might be possible. Clear dental composite is sold, although it's not all that common for a dentist to have that on hand. And as far as the way clear attachments might look, we're not so sure they would be as invisible as you imagine.

Probably the most important thing to pass on to you is that performing bleaching treatments while you have attachments on your teeth makes a poor choice.

That's because an attachment is bonded onto the surface of its tooth, which means that none of the bleaching agent will be able to contact and treat that portion of your tooth's dental enamel that lies underneath. As a result, when your attachments are taken off, a little dot will show (the darker, untreated area of enamel).

In theory, continued whitening treatments can probably even this color imbalance out. But the exact outcome you get can't be predicted. You'd do much better to stop your bleaching activities altogether until your attachments are removed.

* Comments marked with an asterisk, along with their associated replies, have either been edited for brevity/clarity, or have been moved to a page that's better aligned with their subject matter, or both. If relocated, the comment and its replies retain their original datestamps, which may affect the chronology of the page's comments section.

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