The last two decades have marked a tremendous transformation in the world of orthodontics. Gone are the days when a patient had to wear metal braces for a couple of years and avoid their favourite food as well. But this is not the case with clear aligners. As they are a discreet solution with more outstanding results, they have become a cornerstone of modern orthodontic practice. No wonder that the Indian clear aligners market is projected to become a USD 967.19 million industry by 2030 from USD 96.02 million in 2022.Â
Let’s walk through the role of clear aligners in treating specific dental problems.
Understanding the Evolution of Clear Aligner Therapy
If you think that clear aligner therapy is a modern treatment, think again. Using a removable tray to move teeth dates back to the 1940s, while the boom in digital technology paved the way for the mass production of custom-fitted aligners.Â
In the early days, the list of clear aligner indications was short. They were mostly used for very minor tooth movements or as a way to “finish” treatment after traditional braces were removed. However, thanks to 3D imaging, artificial intelligence, and advanced polymer materials, modern orthodontic practice now uses aligners to treat a vast array of complex cases.
According to a systematic review published in MDPI, the increasing interest in CAT (clear aligner treatment) is driven by the desire for a more aesthetic appearance and better oral-health-related quality of life compared to conventional fixed appliances.
5 Key Clear Aligners Indications
Deciding if a patient is a candidate for clear aligners involves a detailed assessment by an orthodontist. Here are the most common scenarios where clear aligners are usually recommended.
Dental Crowding
Crowding occurs when there simply isn’t enough room in the jaw for all the teeth to fit normally. This can cause teeth to overlap or twist. In modern orthodontic practice, aligners are excellent for expanding the arch slightly or using “Interproximal Reduction” (IPR) to create the space needed to guide teeth into a perfect line.
Spacing and Gaps
If you have extra space between your teeth, clear aligners can gently “pull” the teeth together. This is one of the most classic indications of clear aligner indications. Closing gaps not only improves the look of your smile but also prevents food from getting trapped, which protects your gum health.
Overbites and Underbites
Many people believe that “bite” issues require heavy metal wires. While severe skeletal issues might still need traditional braces, many moderate overbites (where top teeth overlap bottom teeth) and underbites (where bottom teeth sit in front of top teeth) are now standard clear aligner indications.
Crossbites
A crossbite happens when some upper teeth sit inside the lower teeth rather than outside. This can cause wear and tear on the teeth and even jaw pain. Specialised attachments (small, tooth-colored bumps) allow aligners to grip the teeth and move them into the correct position.
Open Bites
An open bite is when the upper and lower teeth don’t touch, even when the mouth is closed. Recent clinical consensus studies have shown that clear aligner indications effectively include managing open bite cases, often by intruding the back teeth to allow the front teeth to meet.
Why Modern Orthodontic Practice Prefers Aligners
There is a reason why more dentists and orthodontists are recommending aligners over traditional braces for eligible patients. It isn’t just about the looks; it’s about the overall health of the mouth.
Better Oral Hygiene
Cleaning around the brackets and wires is one of the most difficult aspects of metal braces. The accumulation of plaque leads to the development of white spot lesions (early cavities). Due to the removable nature of clear aligners, patients can brush and floss as usual. Studies have indicated that patients who wear aligners record improved periodontal (gum) health since they are able to continue their normal routine of hygiene.
Comfort and Lifestyle
Conventional braces may lead to emergency visits because of broken wires or pierced brackets. Aligners are produced using smooth medical-grade plastic, so they do not irritate cheeks and gums. Moreover, as you take them away to eat, there are generally no restrictions on eating certain foods- patients can still eat apples, popcorn and nuts.
Predictability through Technology
In modern orthodontic practice, intraoral scanners are used to provide precise impressions. An orthodontist creates a 3D digital roadmap of the treatment. They can let the patients see the virtual representation of how their teeth will move and what their final smile may look like before the treatment even starts.
The Role of Patient Compliance
- The 22-Hour Rule: Aligners need to be used 20 to 22 hours a day to get the desired tooth movements.
- The Switching Cycle: The patients normally switch to new trays after 1 to 2 weeks. The teeth are moved by a fraction of a millimetre by each tray.
- Discipline: When the trays are not taken out in time, the teeth would either relapse or shift back and then the next tray in the series would not fit.
Are There Limitations?
Despite the many clear aligner indications, they aren’t a “magic wand” for every single dental problem. There are still cases where traditional fixed braces are the better tool.
Severe Rotations: Teeth that are severely rotated (more than 20 degrees) can be difficult for a plastic tray to “grab” and turn effectively.
Large Vertical Movements: Moving a tooth significantly up into the bone or down out of the bone (intrusion and extrusion) is more predictable with wires and brackets.
Skeletal Corrections:
In case the problem lies in the form of the jawbone itself, and not the location of the teeth, a patient needs to undergo surgery or wear special orthopaedic appliances.
In such tricky cases, a modern orthodontic clinic may recommend a hybrid solution, which is to put on braces to do the heavy lifting for a few months and then switch to clear aligners to complete the alignment.
What to Expect During the Treatment
If a patient is eligible for common clear aligner indications, the process usually looks like this.
| Phase | Description |
|---|---|
| Consultation | X-rays and 3D scans are taken to evaluate your bite and tooth positions. |
| Digital Planning | Your doctor uses software to plan the exact movement of every tooth. |
| Custom Fabrication | A series of custom trays is printed using high-resolution 3D printers. |
| The Wear Cycle | You wear each set for 1–2 weeks, removing them only for meals and cleaning. |
| Monitoring | You’ll visit the office every 6–10 weeks for a progress check. |
| Retention | Once finished, you wear a clear retainer at night to keep your new smile in place. |
Conclusion
Clear aligner therapy has moved far beyond being just a “cosmetic” fix for minor gaps. In modern orthodontic practice, they are a sophisticated medical tool capable of correcting everything from deep bites to severe crowding.
In future, we can expect more path-breaking innovations in the field of CTA, giving more desirable outcomes.
