Can You Get Invisalign With a Missing Tooth?

Clear aligners, such as Invisalign, are a popular way to straighten teeth without the use of metal brackets or wires. If you're missing a tooth (or already have a dental implant), you may wonder whether these trays will still be effective for you.

The good news is they often do. As long as your gums and bone are healthy, aligners can be used to reposition teeth before, around, or even after a tooth is replaced.

Let’s walk through when this option makes sense and how your care team decides the best path forward.

Can You Use Invisalign With a Missing Tooth?

Yes, Invisalign can usually be used when you have one or more missing teeth. But there are a few things your dentist will check before giving the green light.

These include:

• Healthy gums and bone — No active gum disease or recent bone loss.
  
• Enough space or room to create it — Based on your treatment goals.
  
• Stable neighboring teeth — Teeth next to the gap aren’t loose or infected.
  
• No urgent dental issues — Cavities or other conditions are treated first.

If your tooth loss was caused by gum disease, the area must be fully treated and stable before starting aligners. Moving teeth when inflammation is present can make bone loss worse and increase the risk of tooth loss.

If your dentist uses 3D scans, they can assess tooth positions and spacing to determine if aligners are the right fit.

How Does Invisalign Work with Missing Teeth?

Missing teeth often cause nearby teeth to tilt or shift, especially if the space has been there for a while. That can affect how your bite fits and may make future dental work more complex.

Clear aligners can help correct these issues, but only if the teeth and gums are healthy enough to support movement. Invisalign trays are custom-made from 3D scans of your teeth. If a tooth is already missing, that space can be maintained, closed, or prepared for a future implant.

Sometimes, your aligners will include a temporary “pontic” (a tooth-colored filler) so the gap doesn’t affect your smile during treatment.

What to Expect During Evaluation and Planning

To safely and effectively use clear aligners with a missing tooth or implant, your dental team will begin with a full evaluation. This isn’t just a quick look. It’s a thorough workup that includes:

• Dental records — Intraoral and facial photos to track progress.
  
• 3D scans — Digital models to design your custom aligners.
  
• X-rays or CBCT — Standard X-rays, or 3D cone beam imaging, to check root angles, bone levels, and space needs.

If you’ve had a missing tooth for some time, your dentist will check for tooth drifting, tilting, or super-eruption, which is when a tooth in the opposite arch has moved out of place due to the gap.

Depending on your age, goals, and oral health, your dentist may suggest one of two main strategies:

• Close the gap — Move nearby teeth to fill the space and avoid needing a replacement.
  
• Hold or create space — Prepare the gap for a future implant or bridge by guiding roots into the ideal position.

Sometimes, the clear aligner itself acts as a space maintainer. If the missing tooth is in the front, a temporary “pontic” may be built into the tray for appearance.

Your dentist will weigh these options based on several factors:

• Age and growth stage — Implants aren’t placed until growth is complete.
  
• Bone support — Thinner ridges may not support tooth movement.
  
• Overall bite — Complex cases may benefit from preserving space.
  
• Patient preference — Some prefer a natural solution; others want a prosthetic.

The best approach balances biology, function, and your goals. Your team will help you decide what’s right for your smile.

Should You Get an Implant Before Invisalign?

Most of the time, aligner treatment comes before an implant is placed. This sequence gives your dentist full control over spacing, bite correction, and root angles before placing a permanent fixture that can’t be moved.

In some cases, though, the implant might go in during or after aligner treatment. Let’s look at each path.

Before Implant

This is the standard route: aligners are used first to straighten teeth, create space, and guide root positions. Then the implant is placed in the optimized site.

Doing it this way helps:

• Align the bite — So the final tooth fits properly.
  
• Shape the space — Making sure there’s just enough room.
  
• Correct root angles — Avoiding crowding or impingement.

Starting with orthodontics reduces the risk of a poor implant position or fit. Your dentist will create a step-by-step timeline for when to begin implant planning once your teeth are in place.

Implant During Invisalign

In rare cases, an implant may be placed mid-treatment, usually when the teeth next to the space are already properly aligned.

This option can:

• Shorten the timeline — Healing occurs while trays work on other teeth.
  
• Avoid delays — If implant timing is urgent.

However, this option comes with a higher risk. Clear aligner plans can drift from the digital simulation. If your final tooth positions shift, the implant could be off target. That’s why this route is reserved for low-risk cases with experienced teams.

After Implant

If you already have a dental implant, Invisalign can still work. The key is understanding that the implant doesn’t move—it’s fixed in the bone.

Your aligner plan will:

• Avoid moving the implant — The crown stays in place.
  
• Use it for anchorage — The implant may help guide other teeth.

Your dentist will design your aligners to fit snugly around the crown without applying pressure. That way, your natural teeth move, but the implant stays fixed.

Does It Matter if Gum Disease Caused Tooth Loss?

If you lost a tooth due to gum disease (also called periodontitis), treatment takes a careful, staged approach.

You can still use clear aligners, but only after the disease is fully treated and stable. That means:

• No bleeding or swelling — In the gums near the missing tooth.
  
• Shallow pocket depths — Verified during a gum exam.
  
• Controlled bone levels — With no active inflammation or recent bone loss.

If needed, your dentist might recommend a grafting procedure before moving teeth. This adds bone support to allow safe movement or future implant placement.

You may also benefit from aligners instead of braces if you’ve had gum issues before. That’s because trays are removable, making it easier to brush and floss without brackets getting in the way.

What to Expect When Wearing Aligners With an Implant

Aligner life is generally simple, even with a missing or replaced tooth. You’ll typically:

• Wear aligners 20–22 hours a day
  
• Switch trays every 1–2 weeks
  
• Visit your dentist every 6–8 weeks

If you're waiting on an implant, your aligner can include a built-in pontic to hide the gap during treatment. This pontic does not apply pressure and serves only aesthetic purposes. If you already have an implant, the tray is shaped to fit over it without applying force.

Here are a few care tips to keep things on track:

• Brush before reinserting aligners — Food or bacteria can stain the tray.
  
• Check fit daily — Especially near the implant or missing tooth, as improper fit can affect treatment outcomes.
  
• Use a case — To avoid damage when they’re out.
  
• Report discomfort — Like swelling, pain, or mobility near teeth or implants.
  
• Replace damaged trays promptly — Even small cracks can affect movement.

Call your dental clinic if anything feels off, especially around the implant site.

Retainers and Long-Term Stability

When aligner treatment ends, retention begins. This phase is lifelong and it’s even more important when you have an implant because natural teeth continue to shift over time while implants don’t.

If your other teeth move even slightly, your bite may no longer fit correctly around the fixed crown. Most patients use a clear, full-coverage night retainer. This appliance keeps everything aligned, acting like a splint that locks in your final results.

You may also consider:

• Removable retainers — Easy to clean; fit over the implant and all teeth.
  
• Fixed retainers — Bonded behind front teeth; not suitable for a full arch.

Skipping retainers can undo months of work and leave the implant out of harmony with your bite. It’s always best to plan your retainer strategy with your dentist before your last tray.

Alternatives If Implant Is Delayed

If you're not ready for an implant yet, your dentist can still move forward with clear aligners. Several temporary solutions help preserve the space:

• Pontic in an aligner — Aesthetic filler built into the tray.
  
• Essix retainer with pontic — Used between treatment phases.
  
• Resin-bonded bridge — A short-term fix that doesn’t require surgery.
  
• Leave the space open — If you’ll replace the tooth later.

The key is preventing teeth from drifting into the gap. Letting the space collapse can make future implant surgery harder—or even unfeasible.