Cavities. Most people get at least one in their lifetime. But as common as they may be, they shouldn’t be ignored — especially if you’re looking to straighten your teeth with a clear aligner service like SmileDirectClub. That’s because pre-existing cavities can have a significant effect on your eligibility for treatment.
In this guide, we’ll give you the run-down on cavities and at-home clear aligners, including how to prevent cavities, what you should do if you have them, and more.
Why Can’t I Use Aligners with an Existing Cavity?
Technically, you can use at-home aligners with an existing cavity. But it’s a bad idea. In fact, some aligner companies will say you’re not a good candidate for aligner treatment when you have an untreated cavity. For example, Byte and Candid (our two favorite aligner companies) say that untreated cavities are the most common reason potential customers aren’t good candidates for treatment. However, they’ll typically reconsider a case after the cavities have been taken care of.
But even if an aligner company consents to treat you with your cavity as-is, we don’t recommend it. That’s because existing cavities can easily worsen during treatment, especially if you’re not vigilant about keeping your teeth and aligners clean.
You might be thinking, “I’ll just start wearing aligners and have my dentist fill my cavity at the same time!” Unfortunately, that won’t work, either. Whenever you get a cavity filled, the procedure actually changes the shape of your tooth. It’s a nearly imperceptible change. But to your aligners, the size of your teeth makes a big difference.
At-home clear aligners use very exact measurements to fit onto your teeth. That exact fit allows your aligners to exert force on your teeth, moving them into new positions. But when a filling is added, the whole fit is thrown off. And when your aligners don’t fit well, they’ll feel odd in your mouth. Worse, they won’t be as effective, making your treatment take longer. In some cases, you may need to be refitted for entirely new aligners (which is pricey, to put it mildly).
Preparing for Aligner Treatment
Even if you don’t think you have a cavity, you should make an appointment with your dentist before beginning an aligner treatment. For one thing, you can get a routine teeth cleaning, which is always a good idea. And your dentist will check for cavities and other oral health issues. If your dentist discovers a cavity, you should get it taken care of before you buy aligners. Most minor cavities can be treated the same day, and it doesn’t take too long.
Correcting any pre-existing dental issues is essential, and you should take the time to do so before buying an impression kit or getting your teeth scanned. Impression kits are the go-to method for determining whether or not you’re a good candidate for aligner treatment. As part of the process, you’ll take a bunch of photos of your teeth as well as create 3D molds of your teeth. Aligner companies may spot cavities (especially large ones) in the photos or molds, but that’s unusual. Typically, it’s up to you to ensure that you’re cavity-free before treatment.
One of our favorite clear aligner providers, Candid, offers free panoramic X-rays at many of their Candid Studios. Though these X-rays can identify an existing cavity, Candid only treats patients who have seen a dentist in the last twelve months anyway. So no matter which way you look at it, the best course of action is to see a dentist before beginning your clear aligner journey.
As an added plus, treating cavities before aligner treatment will help cut down on discomfort throughout your treatment. Aligners cause minor soreness and tenderness, so you don’t want to add a cavity-related toothache on top of that.
Can Aligners Cause Cavities?
Perhaps you’ve heard people say, “My Invisalign gave me a cavity.” That’s not true. Nothing about clear aligners (from Invisalign or anywhere else) inherently causes cavities. However, poor hygiene during aligner treatment can cause cavities.
Think about it this way: cavities occur because bacteria builds up on the teeth and erodes your enamel. Not to be gross, but dark, wet spaces—like your mouth—are breeding grounds for bacteria. Every time you brush your teeth, you clean away bacteria. Aligners, however, tend to trap bacteria against your teeth, contributing to bad breath, cavities, and infected gums. Avoiding those issues requires you to clean both your teeth and aligners carefully.
So technically speaking, aligners don’t cause cavities. But they can contribute to them.
Preventing Cavities During Treatment
Wearing aligners doesn’t mean you’re doomed to get a cavity…provided you care for your teeth correctly. Thankfully, good dental and aligner hygiene is as simple as completing a little to-do list. Here are the steps you should take to prevent cavities during treatment:
- Brush and floss after eating or drinking: First of all, you need to remove your aligners every time you eat or drink anything but water. That’s because your aligners aren’t stain-proof, and certain foods could damage them. Once you’re done enjoying your snack or drink, you should be sure to brush and floss your teeth before putting your aligners back in.
- Clean your aligners before reinserting: Ideally, you should clean your aligners every time you remove them. Sanitizing them every time is even better. At the very least, you should rinse them off with water. But it’s even better to use your aligner cleanser (usually included in your aligner package).
- Limit sugary and acidic foods and drinks: Love soda? Candy? Coffee? Very sugary or acidic foods are the most common contributors to tooth decay even without aligners. Add aligners into that, and decay is much more likely. By keeping those foods to a minimum, you can protect your teeth.
- Visit the dentist for regular check-ups: You should be visiting your dentist regularly for teeth cleanings (every six months is the gold standard). That’s even more important during aligner treatment, since your dentist can give you a deep-clean that’s even better than brushing and flossing.
- Wear your aligners as prescribed: It might sound odd, but wearing your aligners 22 hours a day actually helps your overall dental health. Here’s why: regular wear allows your gums to adjust to your aligners.
Until you adjust, your gums can be inflamed and tender, which leaves them more prone to damage. If you don’t wear the aligners as prescribed you’ll be stuck in the “adjustment period” longer than necessary, leaving your teeth vulnerable.
At-home aligners are well-known for being incredibly convenient, but don’t get ahead of yourself. You need to get a dental check-up before treatment. And if your check-up uncovers any dental work, you should get it taken care of first. In general, your overall dental health will be much better if you don’t have cavities during aligner treatment.
However, we can’t definitively speak to your unique needs. If you have specific questions about your smile, you should consult with your dentist or the aligner company you’re considering.
Your dentist knows your dental history, so he or she can give some insight into how cavity-prone you might be during aligner treatment (some people are more susceptible than others). And the aligner company you’ve chosen can give you better insight on tips for cleaning their unique aligners.