Does wearing Invisalign® hurt? -

Remedies and solutions for managing the discomfort of Invisalign® treatment. | Understanding aligner fit and tooth movement pain. | Considerations in choosing which OTC pain reliever to use. | Soft-tissue (gums, cheeks, tongue, floor of mouth) irritation.

You don't necessarily have to expect that having Invisalign® treatment will be painful. But at the same time, it's not realistic to presume that your aligners, or the tooth movements they create, won't cause some minor aches or pains from time to time.

What types of discomfort are common?

So to give you an idea of what to expect, we've broken this topic down into categories, with each one providing some simple remedies and solutions.

  1. Aligner fit and tooth movement pain.
  2. Soft tissue irritation (gums, cheeks, tongue, floor of mouth).
  3. Discomfort when eating.

 


1) Aligner fit / tooth movement pain.

About half of all Invisalign® patients report that they experience at least some minor pain or discomfort during the course of their treatment. It's often described as a sense of pressure or tenderness.

  • The type or level of pain you experience while wearing one set of aligners may be different than with the next.
  • Any one aligner may irritate all of the teeth it covers, groups of adjacent teeth, or just individual ones in isolated locations.
  • The discomfort may be something that you notice while you wear your aligners...

    ... or it may just be triggered when you take them in and out.

 

Feeling pressure is a sign that your aligners are working.
For the most part, the discomfort that you notice is simply evidence that the pressure needed to realign your teeth is in fact being generated.
Experiencing it may not be fun, but it's a needed part of the process.

[Use this link for more details: How do Invisalign® aligners create tooth movement?]

a) What are the chances that you'll have pain?

To give you an idea of what to expect, a study by Nedwed polled a group of Invisalign® patients during their initial three to six months of treatment.

  • 35% of the patients reported that they had no discomfort related to wearing their aligners.
  • However, 54% did experience what they considered to be mild pain.

A study by Fujiyama compared the experience of Invisalign® patients and those being treated with traditional braces during the initial weeks of their treatment. (Periods at which archwires and aligner sets were changed were compared.)

  • Generally, the pain experienced by the Invisalign® patients was about 1/2 that of the traditional braces group. (Intensity of pain, overall discomfort level, number of days of pain.)
  • When advancing to a new set of aligners, on average the Invisalign® patients tended to experience pain rated at 3 (1 to 10 basis), for a period of 2 days.
  • However, the study did note that 11% of Invisalign® subjects did complain of significant pain or discomfort.

Section references - Nedwed, Fujiyama

 


Pictures of Invisalign aligner accessories.

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


b) You'll probably have the most discomfort when you switch to a new set of aligners.

The discrepancy between the shape of an aligner and the current alignment of your teeth will be greatest when you first start wearing the appliance.

Then, over time as your teeth begin to shift and conform, the fit of the aligner will become more relaxed and comfortable and your pain should subside. (See the link above for details about how aligners work.)

That's exactly what the study above reported.

Nedwed found that the pain that a patient experienced was typically associated with the initial use of a new set of aligners.

  • In most cases, this discomfort subsided within 2 to 3 days.
  • Overall, 83% of the study's participants reported that they got used to wearing aligners within a week's time.

Section references - Nedwed

c) This remedy should help.

Make your switch to a new set of aligners at bedtime.

One thing you can do to help to minimize the amount of discomfort you notice is to switch to your new set of aligners right before you go to bed. That way you'll be asleep during those first several painful hours while your teeth begin to adjust.

This approach can be especially effective in combination with the use of a bedtime over-the-counter analgesic (see below).

Also, it may be the act of taking your new set of aligners out that's the most uncomfortable part. If so, if you'll make your switch from one set to another at night, your teeth will have some hours of adjustment before your aligners have to be removed.

d) Try using an OTC pain reliever to manage your pain.

From time to time you may find that you need some relief from the discomfort that your aligners cause.

Picture of acetaminophen (Tylenol) pills.

Tylenol usually makes a better choice for orthodontic pain.

Avoid NSAID drugs.
Studies have shown that taking NSAID analgesics (non-steroidal anti-inflammatory drugs) tends to interfere with some of the biological processes required for orthodontic tooth movement. The proposed mechanism is one where:
  • An effect of taking NSAID compounds is that they block the production of prostaglandins.
  • Prostaglandins are a class of compounds produced by your body that perform a number of functions. One of these is aiding the process of bone resorption (the loss of bone tissue next to a tooth, thus allowing orthodontic movement to occur).
  • Since the formation of prostaglandins is inhibited by NSAIDs, taking them tends to inhibit the speed of tooth movement, and therefore the time needed for case completion.

NSAID analgesics include: ibuprofen (Advil, Motrin, Nuprin), aspirin, and naproxen (Aleve).

Tylenol usually makes the better choice.

A commonly used alternative for NSAID pain relievers is acetaminophen (Tylenol). And its use has not been shown to affect the rate of orthodontic movement.

Of course, in all cases you'll need to read the labeling of the product you plan to use (so to make sure that it is an appropriate one for you, and that you use it within its guidelines).

Section references - Karthi

2) Invisalign® aligners may cause gum or tongue irritation.

You may find that the edge of some of your aligners has a length, positioning, roughness or sharpness that irritates your gums, cheek, tongue and/or the floor of your mouth.

The amount of irritation that can be caused can be significant, especially if the situation is not brought under control early on. Persistent irritation can even result in the formation of an ulcer.

Statistics.

The Nedwed study cited above determined that 6% of its subjects experienced some degree of soft tissue irritation.

Despite this finding however, wearing Invisalign® aligners is generally considered to be less irritating than wearing traditional wire-and-brackets braces which have a reputation for being especially irritating to the interior surface of the person's lips and cheeks.

Check with your dentist before adjusting an aligner yourself.

Obviously, the needed remedy for this type of situation is to smooth off or trim down the offending aligner edge. But who should perform the adjustment, you or your dentist?

Before attempting to make an adjustment on your own (at least for the first time) you should contact your dentist's office for advice. Let them explain (or show you) what types of changes are acceptable.

How to adjust an aligner.
  • Your overall goal must be one where you do reduce the offending edge so the appliance is more comfortable to wear. But not to the extent that it compromises the aligner's fit over your teeth, or its ability to create the tooth movements it was designed to produce.

    (If you do damage an aligner, it will have to be remade. This will be an added cost for you and cause a delay in your treatment progress.)

  • You'll probably be surprised at how little reduction is needed to make a giant improvement.

A good tool for trimming the length or thickness of an aligner's edge can be a single-edged razor blade.

  • Pick out a new one, so you have a good sharp edge to use.
  • Think of using the blade like a plane (dragging it along the aligner's edge), as opposed to whittling with it, like when carving with a knife.

    [Instead of pushing the blade straight into the plastic (which might easily bite in and cut off too much), hold the blade perpendicular to the aligner's surface while firmly scraping it along the offending edge.]

Remember these two things: Trimming off just a little bit is usually all that's needed. And you can always come back and trim more but you can't put the plastic you've trimmed off back on.


3) Eating discomfort.

We now discuss this topic here: Invisalign® and Eating - Problems / Remedies.

 
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