Teeth Sensitivity & Invisalign (Clear Aligners)

Can Clear Aligners (Invisalign) Cause Tooth Sensitivity? 

Some people have naturally sensitive teeth. If you would like to straighten your teeth using Invisalign aligners, this sensitivity may come into play. 

Invisalign aligner trays are a popular alternative to traditional braces that help straighten the teeth into a better position. 

Invisalign-induced sensitivity can lead to discomfort when straightening teeth. However, people experience different levels of pain during orthodontic treatment, ranging from mild to severe.

If you experience Invisalign pain during treatment or suffer from tooth sensitivity, there are ways to manage it.

In most cases, sensitivity from Invisalign treatment is unlikely to be directly caused by the aligners. 

Tooth pain from sensitivity is mainly caused by reduced tooth enamel. Enamel protects your teeth. The less there is of enamel, the less protection your teeth will have.

Tooth sensitivity can also occur from:

  • Brushing your teeth vigorously
  • Cavities 
  • Naturally receding gums
  • Cracked teeth
  • Tooth fillings
  • Teeth whitening

How Long Will Your Teeth Be Sensitive With Invisalign?

You may experience mild sensitivity during or right after completion of Invisalign treatment. However, any pain caused by Invisalign usually settles down within the first few weeks of treatment.

3 Tips for Preventing & Managing Invisalign Pain  

There are various ways to prevent and manage sore teeth during Invisalign treatment:

1. Practice Proper Oral Hygiene

Practicing proper oral hygiene is one of the best ways to avoid sensitive teeth. Be sure to floss daily and brush your teeth at least twice a day. 

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Many kinds of toothpastes available contain fluoride, which can help reduce sensitivity. Some toothpastes have more fluoride concentration than others.

Many patients find that switching to a soft-bristled toothbrush with a lighter touch also helps with sensitivity. When you brush your teeth vigorously, it can wear off the cementum, which protects the root of your teeth.1

If you notice any pain from sensitivity during the day, apply a small amount of toothpaste over the area of discomfort. However, do not get any toothpaste onto the Invisalign aligners and avoid rubbing them excessively.

Watch your Diet

You should also avoid brushing immediately after eating a snack or meal that includes acidic foods. These acids weaken tooth enamel, and brushing your teeth too soon can remove the enamel. 

If you know you will eat or drink something acidic, brush your teeth first, then rinse your mouth with water after eating or drinking.

A common list of acidic foods and beverages include:

  • Citrus fruits and juices
  • Sodas
  • Energy drinks
  • Sports drinks
  • Candy 
  • Chips
  • Ice cream
  • Sweeteners

Patients should limit how often they consume these foods and drinks, especially soda. Every sip of soda leads to increased demineralization. If you want to consume these foods, be sure to eat or drink them quickly instead of nursing them for a prolonged period.

Chewing ice cubes can also result in microfractures in the tooth structure. This may lead to sensitivity.

Likewise, avoid consuming hot and cold beverages, hard foods, and sugary substances as these can also irritate your teeth, leading to soreness.

Avoid Grinding Teeth

Clenching or grinding teeth may also lead to sensitivity. If you experience a sore jaw, teeth sensitivity, or pain that may suggest teeth grinding, be sure to speak with your doctor. 

If you grind your teeth, consider chewing sugarless gum. This creates saliva, which strengthens tooth enamel.

What to Do if Invisalign Pain Doesn’t Improve

It is essential to visit your dentist or orthodontist immediately if you suddenly experience an extreme level of sensitivity. Keep your trays out of your mouth in a safe, clean container. 

You should also visit your dentist or orthodontist if one particular tooth or area becomes sensitive. Do not wait for your next scheduled appointment.

The longer you wait to visit your dentist or orthodontist, the worse it can get. You should also get a dental evaluation if a tooth is highly sensitive for more than a few days and reacts particularly strongly to hot and cold temperatures.

It is important to get evaluated. The longer you leave your Invisalign trays out of your mouth, the higher the risk your aligners won’t fit properly.

When to Worry About Tooth Sensitivity  

People with sensitive teeth may experience discomfort or pain as a response to specific triggers. This pain may occur at the roots of the affected teeth.

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The most common triggers include:

  • Hot foods and beverages
  • Cold foods and beverages
  • Cold air
  • Sweet foods and beverages
  • Acidic foods and beverages
  • Cold water, especially during dental cleanings 
  • Brushing or flossing teeth
  • Alcohol-based mouth rinses

These symptoms may come and go over time for no apparent reason. They may range from mild to strong. 

If you experience any of these symptoms while wearing Invisalign, they may suggest the sensitivity is from something other than orthodontic treatment.

If you are experiencing pain from any of these symptoms, it may suggest one of the following conditions:

1. Tooth decay

If you are experiencing discomfort from one tooth, your dentist will examine the tooth and ask you to describe symptoms. 

The pain could result from tooth decay. In these cases, acids created by the bacteria built up against the tooth can eventually dissolve the enamel, exposing the dentin layer.

Dentin is filled with tiny nerve endings, so you may experience pain and temperature sensitivity when biting down if you have tooth decay. 

Once your dentist removes the tooth decay and fills the tooth with an amalgam or tooth-colored filling, you should be pain-free.

A full-coverage crown may be necessary for more stability and longevity.

2. Loose or broken filling

Fillings do not last forever. When they break or loosen, you may experience a painful feeling due to bacteria getting underneath the filling. This can cause the tooth to decay further.

A loose or broken filling can be treated with a new filling or crown.

3. Cracked tooth

A common sign of a cracked or broken tooth is sharp pain when biting down. However, the pain usually goes away after releasing the bite. 

A cracked tooth may not be noticeable to the naked eye. It may not even show on x-rays. This makes the diagnosis process more difficult. 

Cracks involving a break surrounding a filling can be fixed with a new filling or crown. However, when a crack extends into the tooth's pulp, you may require root canal treatment before a crown can be placed.

A crack that extends below the gum line and into the tooth’s root must be removed.

4. Abscess

An abscessed tooth develops when the pulp of the tooth becomes infected.

Symptoms of an abscess may include fever, persistent pain, and facial swelling. Often, there is a pus-filled swelling at the root tip. This swelling drains periodically and leaves a bad taste in the mouth.

Root canal treatment is necessary to save an abscessed tooth.

Should I Get Invisalign if I Have Sensitive Teeth?

The main objective of orthodontic treatment is to move the teeth into a better position. As a result, most patients may feel uncomfortable at some point during treatment. 

However, with modern technologies and treatments, any sensitivity caused can be kept to a minimum.

If you have sensitive teeth, it is unlikely that Invisalign treatment will worsen them to a significant effect. For most patients, any discomfort occurs at the beginning of treatment and the first few days following switching to new aligners and then resolves.

Resources

The perils of sensitive teeth, Healthcare, University of Utah, December 2017

What causes sensitive teeth, and how can I treat them?, Mayo Clinic, October 2019

Fujiyama, Koji et al. “Analysis of pain level in cases treated with Invisalign aligner: comparison with fixed edgewise appliance therapy.” Progress in orthodontics vol. 15,1 64. 22 Nov. 2014

Krieger, Elena et al. “Accuracy of Invisalign® treatments in the anterior tooth region. First results.” Journal of orofacial orthopedics = Fortschritte der Kieferorthopadie : Organ/official journal Deutsche Gesellschaft fur Kieferorthopadie vol. 72,2 (2011): 141-9

Davari, Ar et al. “Dentin hypersensitivity: etiology, diagnosis and treatment; a literature review.” Journal of dentistry (Shiraz, Iran) vol. 14,3 (2013): 136-45.

Miglani, Sanjay et al. “Dentin hypersensitivity: Recent trends in management.” Journal of conservative dentistry : JCD vol. 13,4 (2010): 218-24

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