What Dental Problems Can Teeth Aligners Not Fix?

Although invisible aligners for teeth are a great option for straightening, they may not be the right choice for correcting every kind of dental misalignment. Certain teeth alignment problems—like protrusion, teeth that are too spaced out, or narrow jaws—may require traditional braces to correct. Here’s a look at a few dental health issues that aligners cannot typically fix.

Protrusion

Protrusion occurs when your front teeth stick out too much. You may have heard this condition referred to as “buck teeth.” This happens when your upper jaw sits in a position that is too far foward, your lower jaw sits in a position that is too far back, your teeth grew in angled, or a combination of these conditions—according to the American Academy of Orthodontics.

“Protrusion is sometimes difficult to treat with aligners alone,” Oleg Drut, DDS, an orthodontist and founder of Diamond Braces Clinics, tells ishonest Connect to Care. “This condition isn’t just cosmetically inconvenient; it can cause speech impediments, breathing problems, and chewing issues if left untreated. [Braces that are fixed to your teeth] may be required to correct these [issues] and bring the teeth and jaws into proper alignment.”

Jaw Expansion

If your teeth are crowded or overlapping because of narrow jaws, you may need jaw expansion.

“A patient may require [jaw] expansion to widen the jaw and align their top and bottom teeth fully,” Drut says.

Invisible aligners may not “offer sufficient force to expand the upper arch or sufficient stabilization after [jaw] expansion,” Drut says. This is why traditional braces may be recommended instead.

Large Gaps and Over-Rotated Teeth

You may have too much of a gap between your teeth due to small teeth, missing teeth, or large jaws, according to the American Academy of Orthodontics. Often, aligners are not the ideal solution for this problem.

“The aligners are only able to move the teeth about 6 millimeters on the top and the bottom,” Mahnaz Rashti, DDS, a periodontist in Beverly Hills, tells ishonest Connect to Care. “Additionally, they are not able to rotate teeth beyond 20 degrees. This is because the aligners lack the proper strength and push that ordinary metal braces have.”

Impacted Teeth

According to the American Academy of Orthodontics, a tooth that has not grown in as expectedis impacted. A tooth can also be considered impacted if it cannot grow in due to insufficient room, or it grows in at the wrong angle or in the wrong position.

Drut says that sometimes an impacted tooth will need to be removed if it fails to push through your gums to become visible, which may require dental surgery. Other times, the tooth may need to be moved into proper alignment. Clear aligners are not capable of addressing this issue. You'll need a fixed appliance, like braces, to bring the tooth into place.

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