Invisalign Attachments Keep Coming Off

I had my invisalign treatment started about three months ago. At first everything was going well, then about four weeks ago my attachments started coming off. First it was the one on my upper right and I had it put back on, then it was one on my lower right the following week. Now another one has come off, and I’m wondering what is going on. Is it something I’m doing or not doing?

Help me.

Candy

Dear Candy,

For those who aren’t sure what these Invisalign attachments are, in some cases,  tooth-colored attachments are bonded directly onto some of your teeth and your clear aligners snap on over these. It’s sometimes necessary to help with the tooth movement.

These attachments aren’t designed to be permanent and will be removed at the completion of your treatment. As such, they do occasionally come off, and this is not a cause for concern. Simply call your orthodontist when one comes off. They may say it’s fine to wait until your next appointment, or they may ask you to come in for an urgent orthodontic appointment.

During the normal course of treatment, there are times that your teeth will be shifting, and this movement can cause pressures that cause the attachments to pop off. This is common, and temporary.

My one concern is the number of them you’ve had come off in this short time period. There are some possibilities of what could be causing this.

1: Your attachments are too “tight”. The clear aligners should fit semi-loosely over the attachments, snug enough to cause retention, but loose enough that the patient can easily snap the trays in and out quickly. If you’re struggling to take them out, that may be putting undue pressure on the attachments. The doctor may simply need to lightly polish the attachment to ever-so-slightly “loosen” the fit.

2: The bonding material may be the cause. If the etching and bonding materials are either expired, compromised, or otherwise weakened in any way, they will not perform to expectations and will easily pop off. I’m sure your doctor or their staff wouldn’t mind double-checking the condition of the materials, just to be on the safe side.

3: Lots of acidic foods or alcohol. If you are someone who takes in a lot of acidic foods and drinks, including alcohol, the acids from these foods may weaken the bond between the attachment and your enamel. Switch to gentler foods/drinks, or rinse immediately after consuming them.

4: Your technique in placing/removing aligners may be in need of adjustment. Some patients lift and “twist” the clear aligners in an improper manner, causing pressures that pull the attachments off. There’s a trick to it, to remove them without causing damage, and you’ll get quick with it very soon–you haven’t had these that long. Ask your doctor or a staff member to go over proper technique with you at your next appointment.

I would talk to your orthodontist about this and he or she can help you determine if there is something unusual going on in your particular case.

This blog is brought to you by Bee Cave Orthodontist Dr. Alberto Tostado.