Invisalign® - Issues and concerns with drinks & beverages. -

General rules and precautions. - Is drinking coffee, tea, red wine or soda permitted? What drinks are acceptable? | Issues - Aligner warping (from hot beverages), staining, increased risk for tooth decay.

What beverages can you drink while wearing Invisalign®?

Drinking anything other than just water is not recommended.

You might be surprised to learn that Align Technology, Inc., the maker of the Invisalign® system, states that you should remove your aligners before drinking any kind of beverage other than just plain water (cool or room temperature, not hot).

Section references - Invisalign.com

So yes, that generally means that soda, tea, coffee, fruit drinks, and the like should be avoided (of course only while wearing your aligners). And while that recommendation may seem disappointingly limited, this page outlines much of the reasoning that lies behind it.

There may be some wiggle room.

While blindly following Invisalign's® advice is a best practice, once you understand the issues and concerns their recommendation is based on, you'll likely find that there can be a little leeway in exactly what you do. We explain below.


Reasons why you shouldn't consume beverages while wearing Invisalign®.

In general, the kinds of problems associated with drinking beverages other than just cool water tend to fall into the following two categories. They are:

  1. Adverse effects that the drink might have on aspects of the Invisalign® system, such as aligner warping or staining, or affecting the properties of its plastic.
  2. Or else effects that the drink may have on your teeth, such as staining or increasing your risk for tooth decay.

Possible adverse effects caused by consuming beverages -

1) Issues associated with your aligners.

a) Effects due to exposure to hot beverages.

At least in theory, it's possible that drinking hot liquids while wearing your orthodontic aligners may damage them. This concern doesn't only apply to beverages like coffee or hot tea or coco but also to food items like hot soup too.

The basis of the concern.

The primary issues at hand seem to center around these points:

  • The potential an exposure to a hot beverage may have in causing physical distortion or warping of your appliances.
  • A possible change in physical characteristics of your aligner's plastic due to experiencing thermal cycling (repeated exposure high temperature events).

1) Aligner warping / distortion caused by hot beverages.

Background.

While normal body temperature is 37 degrees Celsius (98.6 degrees Fahrenheit), studies have shown that the oral environment may experience periods of up to 57 degrees C (135 degrees Fahrenheit) when a hot beverage, like hot coffee, is consumed. This elevated temperature may exist for several minutes before returning to normal.

Section references - Iijima

As a local event (like the initial contact of a beverage with an Invisalign® aligner), hot coffee is frequently served at a temperature of 71 degrees C (160 degrees F) to 85 degrees C (185 degrees F).

The concern.
  • Invisalign® appliances are made out of thin plastic. (This goes for other brands too, like ClearCorrect®, ClearPath®, eCligner®, Simpli 5®, as well as clear plastic orthodontic retainers like Vivera® and Essix.)
  • When they're made, a sheet of the plastic is first heat-softened, and then vacuum-formed (sucked down) over a model of the patient's teeth, thus giving the aligner its precise shape.

So just like when your appliances were made, when you drink something hot and create a high-temperature environment in your mouth, a concern is if this type of exposure can create some level of aligner distortion.

Is this really a problem?

We couldn't find a research study that specifically mentioned that an exposure to hot beverages, like coffee, could cause aligner distortion or warping.

  • In researching this subject, we came to the conclusion that even a direct exposure to coffee served in the range of 160 to 185 degrees F would fall below that temperature at which the plastic was originally heated to form the aligner.
  • There's also the point that the type of plastics most frequently used to fabricate aligners nowadays are thermoset materials as opposed to thermoplastic. The latter will continually soften up when heated, all of the way to a liquid state. Thermoset plastics in comparison remain in a permanent solid form and have a reputation for increased dimensional stability and heat resistance.

    (It does seem clear that elevated temperatures associated with direct sunlight, curling irons, etc... have fairly frequently been reported as the cause of aligner warping).

Even minor distortion can be a big issue.

Of course, the problem at hand is that any distortion that does occur may be essentially impossible to identify. And since it's the snug fit of your aligners over your teeth that create the orthodontic forces needed to move them, even a minor amount of warping could render one unable to accomplish its full task.

(Each individual aligner is typically designed to create just .25 to .33 mm of tooth movement, which is on the order of about 100th of an inch.)

Best practices associated with the issue of hot drinks and aligner warping.
  • It's easy enough to say that avoiding hot beverages while wearing your appliances makes the least worrisome and most predictable practice.
  • It would be our conjecture that especially when thermoset plastics are involved (like Invisalign®), experiencing a few isolated events can be tolerated.

2) Changes in aligner physical characteristics due to thermal cycling.

Background.

The molecules that make up the kinds of plastics that are used to fabricate orthodontic aligners have some degree of crystalline structure. With the level of crystallinity influencing the physical characteristics of the plastic, like its hardness and elasticity, which in turn correlates with the effectiveness of the appliance in moving the patient's teeth.

Research findings.
  • A study by Kwon evaluated the effects of thermocycling (5 to 55 degrees C) for a period simulating over a month of appliance wear. At the completion of the period, the study found no evidence that the force delivery properties of the plastic had deteriorated.

    (As reference points, oral temperatures have been documented to rise to 57 degrees C when hot beverages are consumed. Hot coffee is frequently served at a temperature above 71 degrees C. Note, both of these levels lie above the range studied.)

  • In comparison, a study by Iijima also evaluated the effects of thermocycling between the extremes of 5 to 55 degrees C during simulated long-term wear. This study however found that the forces generated by the appliances did decreased with thermocycling, especially when higher temperatures were involved.

Section references - Kwon, Iijiam

Neither these studies or our reporting here should be considered a definitive statement on this issue.

  • When it comes to removable orthodontic aligner systems, proprietary plastics are frequently involved (so the information from these studies may not extrapolate to many systems).
  • Both of the studies evaluated thermoplastic materials, whereas the more current trend is to use thermoset ones and the nature of their crystallinity (molecular crosslinking) is different.
Best practices associated with the issue of hot drinks and thermal cycling effects.
  • Similar to above, it's easy enough to suggest that avoiding hot beverages while wearing your appliances makes the least worrisome and most predictable practice.
  • It would be our conjecture that especially when thermoset plastics are involved (like Invisalign®), experiencing a few isolated events can be tolerated.
Picture of an Invisalign® tooth aligner.

Removable tooth aligners may warp when exposed to hot beverages.

Prevention / Minimizing your potential for aligner warpage.

Hot drinks abstinence

Obviously, the surest way to prevent damage to your aligners from exposure to hot drinks is simply to avoid them all together.

  • When you do plan to enjoy a hot beverage, cool it down (iced coffee is a thing, and clearly iced tea is too).

    As a very safe rule of thumb, when wearing your aligners be hesitant to place anything in your mouth that's warmer than your body's temperature.

    (Note: This plan overlooks many of the additional beverage-related issues discussed below.)

  • Or just take your Invisalign® aligners out (as you really should anyway).
Using a straw probably isn't a complete alternative.

Some people might be tempted to use a straw when they drink hot beverages, thinking that that offers a solution.

The problem we envision with this plan is simply that it still seems possible that the tongue-side portion of a person's aligners covering their rear-most teeth (molars) could still be exposed to the beverage's elevated temperature.

Solutions for aligner warpage.

Unfortunately there really aren't any. Once the problem has been discovered (possibly the fit of your aligner has noticeably changed, or your next set of aligners doesn't fit as expected), new aligners will need to be made. That will be an added expense for you.

b) Aligner staining.

Beverages that have a strong color will tend to stain your Invisalign® aligners. The effect isn't usually immediate but instead forms gradually as repeated exposures to the drink occur.

Dark beverages tend to cause more of an effect. This includes colas, black tea, coffee and red wine. But really, any type of beverage that has a strong tint, especially if consumed frequently or sipped for extended periods, will have the potential to cause aligner discoloration.

A study by Liu evaluated the staining effect of coffee, black tea and red wine (Cabernet Sauvignon) on removable aligner systems and commented that coffee caused the most marked color changes.

Section references - Liu

Prevention / Minimizing your potential for aligner staining.

Abstinence

Of course the easiest way to prevent stain from forming is to simply follow Invisalign's® guidelines and restrain from drinking anything other than just cool water while your aligners are in.

You don't have to give up enjoying your favorite drinks. Just don't consume them while wearing your aligners, which seems a simple enough rule to follow.

Other remedies and solutions.

It seems many patient's aren't so inclined to strictly adhere to Invisalign's® recommendation. And even we would agree that there's probably some wiggle room in exactly what you do.

As coverage for this subject, we've created a dedicated page: Stain issues associated with the Invisalign® system: Causes and solutions.


2) Potential effects of beverages on your teeth as your aligners are worn.

When you wear your Invisalign® appliances, they tend to create a barrier between your teeth and the rest of your mouth. And due to this isolation, the harmful effects of some types of drinks to your teeth may be amplified.

 

a) Problems with sugary beverages.

Background.

Saliva provides some beneficial functions for your teeth:

  • It creates a washing and cleansing effect for them.
  • It dilutes and buffers bacterial byproducts that can cause cavities (tooth demineralization).
  • The minerals it contains play an important role in tooth remineralization, a reparative mechanism that helps to reverse damage caused by demineralization.

Unfortunately, when you wear your orthodontic aligners, the barrier they create inhibits these actions.

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

Sugary drinks that seep inside your aligner can promote tooth decay.

An example.

Take the situation where a sugary drink (soda, fruit juice, alcoholic beverage, sweet tea, sweetened coffee, etc...) is consumed while a person is wearing their appliances.

  • At least some of the beverage will seep into the internal aspect of their aligners ...
  • And once it has, it becomes a food source for the cavity-causing bacteria living in the dental plaque on and around the encased teeth.

Since the presence of the aligner acts as a barrier and therefore inhibits the movement of saliva, the tooth-damaging acids created by the bacteria won't be diluted and neutralized as effectively, and any potential for remineralization will be inhibited. As a result, the net effect can be one where the environment within the aligners is tipped towards active tooth decay formation.

The time and cost involved with repairing this type of damage can be substantial.

Section references - Birdsall


Pictures of Invisalign aligner accessories.

Our affiliate links can be used to shop  Invisalign accessories  on  Amazon.com  or  Walmart.com

Innovative devices and solutions for the issues Invisalign® wearers encounter.


Preventive steps you can take.

Rinse out with water afterward.

If you must drink a sugary 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 amounts of the drink.

The plot of the Stephan Curve illustrates that it just takes a few minutes after an exposure to sugar for oral conditions to swing to one that favors cavity formation, so be prompt.

Issues concerning the use of a straw.

Some people may be under the impression that the use of a straw can help to avoid the risks associated with drinking sweetened beverages when their orthodontic aligners are in.

In agreement with this thought, we can see how if the straw is positioned far enough back that a large percentage of the beverage might be funneled directly past their oral cavity. And we don't see how that could be a bad thing.

But it must be kept in mind that the oral environment is a wet one. And despite the use of a straw, in all cases there will be some co-mingling of saliva and the sugary beverage. And ultimately it will be distributed throughout the person's mouth, including within their aligners.

b) Problems with acidic beverages.

Acidic drinks, like soda and some kinds of fruit juices, can leach mineral content from teeth. A person's potential for experiencing this type of damage is simply a function of how acidic the drink is and how long the tooth is exposed to it.

In those cases where an acidic beverage is consumed while a person is wearing their orthodontic aligners, at least some amount of it will pool inside them. In regard to whatever amount does:

  • Because the aligners act as a barrier to the flow of saliva around the teeth they cover over, the drink's concentration will not be as effectively buffered and diluted by it.
  • Once inside the aligners, the acidic drink will be held in close contact with the teeth, possibly for a prolonged period of time.

Both of these issues mean, at least in theory, that drinking an acidic beverage while wearing aligners will tend to amplify the tooth-eroding potential of that beverage.

Preventive steps you can take.

Rinse out with water afterward.

If you must drink an acidic beverage while wearing your aligners (soda would be a common concern), when you're finished take them out and rinse them and your mouth with water so to dilute and wash away any remaining portions of the drink.

Remember, the level of damage that occurs is simply cause and effect (higher acid levels + longer exposure = more tooth erosion). So the sooner you dilute and/or rinse away the drink's remnants, the better.

Using a straw may help.

When you consume an acidic beverage, your goal should be one of minimizing your mouth's exposure to it, both in terms of duration and concentration. And towards this goal, we can see how using a straw might help.

Especially if positioned toward the rear of your mouth far enough, the straw will help to shunt a great amount of the acidic solution on past your oral cavity. The thought being, the less total volume of acidic drink in your mouth, the less acidic it will become.

Even with the use of a straw there will still be co-mingling of the acid with your saliva (just like with our sugar example above). So you'll still need to take your aligners out and rinse both them and your mouth afterward so to remove and dilute all traces of the drink. But overall, it seems that the use of a straw could lessen the full damaging potential of the beverage.


Drinking water when wearing Invisalign® is encouraged.

Sipping cool water while wearing your Invisalign® aligners is OK and in fact makes a great idea.

There's no potential for it to stain or warp your aligners. And any water that does seep inside of them will only help to dilute and flush away bacteria and their byproducts that might cause harm to your teeth or gums.

You don't have to give up your favorite beverages.

Of course, you can still continue to enjoy a cup of coffee or tea, a soda or even some red wine whenever you want. Just take your aligners out first.

Then, once you're finished, clean your teeth as is appropriate (brush and floss if you've eaten something, and rinse out with water) and then reinsert your appliances so your treatment progress continues.

 
 
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