The Essential Step for Aligner Success: Compliance 

Unlike traditional braces, clear aligners are designed to be easily removed for eating and drinking. But they can't work if you don't wear them enough! We'll explain the risks of not wearing your aligners and how to understand if you might be doing things that could knock your treatment off track.

Compliance stands as the most significant factor influencing the success of orthodontic treatment with clear aligners. Active participation from a patient is paramount in achieving the desired outcome set forth during the initial consultation. While clear aligners are highly effective in shifting teeth, consistent wear is crucial. Each aligner is meticulously designed to move teeth gradually, with small changes eventually accumulating over time.

Here’s the routine: Wear your aligners for a crucial 22 hours a day, with a brief 2-hour break for eating, drinking, and maintaining oral hygiene. Your commitment to this daily regimen is the key to success, ensuring that not only are your teeth prepared for the next set of aligners but that you are properly progressing towards the final goal of straight teeth.

What is Non-Compliance?

Non-compliance in the context of clear aligners occurs when a patient does not adhere to the prescribed treatment plan, or the instructions provided by their orthodontist. Clear aligners are an excellent solution for orthodontic needs, but their effectiveness relies on consistent daily wear. Non-compliance can lead to issues such as prolonged treatment duration and additional costs, underscoring the importance of patients’ commitment to their clear aligner journey.

Common non-compliance issues include inconsistent wear time, skipping trays, missing appointments, engaging in habits detrimental to treatment, improper cleaning, and neglecting professional advice.

Missing Hours or Days of Wear

Inconsistent wear, a prevalent non-compliance issue, involves failing to wear aligners for the recommended duration each day. Although the average wear time is 22 hours, anywhere between 20-22 hours is acceptable. Maintaining the recommended wear time is crucial for successful teeth shifting. While missing a few minutes may have minimal impact, continuous disregard for wear-time can hinder the alignment progress.

Missing several hours or days of wearing your clear aligner can have lasting setbacks. Remember that your teeth are intentionally being moved little by little everyday and are even being moved when it is not visible to the naked eye. These tiny shifts are specifically designed to optimize and provide comfort during the orthodontic journey.

If you have missed several hours or worse, several days of wear, you might find that your trays fit tighter than usual or don’t fit at all. This presents challenges not only immediately but also for the future, as inconsistent wear ultimately leads to a longer treatment length. The main point is to keep wearing your aligners at least 22 hours a day and remaining consistent.

Skipping Trays

Adhering to the recommended daily wear schedule is vital as each new set of clear aligners is subtly different from the previous one. It’s also essential to progress through the aligners in increasing order. For example, if you have a total of 27 sets and have been told to change them every two weeks, stick to the treatment plan. Starting with tray #1, wear for two weeks and at the end of two weeks, place tray #2 in your mouth. Moving sequentially ensures effective treatment. You should never go back to previous trays unless you have been specifically instructed by your orthodontist.

In addition, since clear aligner systems are designed to shift teeth gradually primarily to minimize discomfort, skipping to a new set of aligners without proper guidance may cause pain and misdirected forces on the teeth. Although it may seem that moving on to a new tray may quicken results, it potentially leads to more harm than good. Skipping or advancing sets prematurely should be avoided unless explicitly instructed by your orthodontist.

Proper Fit

Ensuring your clear aligners fit properly is also of paramount importance. Make sure that your clear aligners fit snugly over your teeth and are not hurting or irritating your gums. Clear aligners are designed to fit snugly over your teeth, ensuring that all tooth surfaces are properly covered. 

Some orthodontists may even recommend using chewies or simply chewing on the bristles of your toothbrush to help aligners set into place. You may be instructed to do this when you initially place a clear aligner in your mouth. This allows the clear aligner to properly settle over your teeth and ensure there is adequate coverage for effective tooth movement.

Missing Appointments

Missing scheduled appointments with the orthodontist is a significant non-compliance factor in clear aligner therapy. These appointments allow real-time assessment of treatment progress, enabling timely adjustments if needed. Regular check-ins ensure that hours of wear are consistent, and corrections can either be caught early or adjusted accordingly.

The Impact of Non-Compliance: Added Time and Finances

So, what happens when you have been non-compliant? The question really depends on how long you have been non-compliant and for what reason.

As mentioned before, skipping a few hours a day may not seem all that bad initially, however, over time and over the course of several weeks, missing a few hours a day can have compounding effects that add up in the form of small gaps between your teeth and trays. Because each tray is designed to move one tooth at a time, it’s not possible to catch up by simply wearing your next set of trays longer. If you’ve skipped wear-time, the best thing you can do is actually stay in your current set of trays for a bit longer to allow your teeth time to catch up. 

If you don’t, you may find that trays are not fitting properly or that they are more uncomfortable to wear. At your next appointment, your orthodontist may recommend you wear your current trays for longer, or if you’ve drifted too far off course, may need to rescan your teeth and reorder a new set of trays to put you on a new treatment plan entirely, prolonging your treatment and increasing the overall cost. 

Severe cases of non-compliance result when you have completely missed or skipped clear aligner trays. If you have skipped a few weeks or even months of treatment, you may need to restart treatment from the beginning. This is always a dreaded conversation with a patient as one might initially think that skipping a week or month is not so bad. However, remember that everyday wear adds up over time. 

Ultimately, the impact of non-compliance extends beyond treatment delays and additional costs. It can also affect oral health, leading to poor outcomes and dissatisfaction with the treatment process. Patients who consistently fail to comply with the prescribed wear schedule may experience discomfort, poor alignment progress, and even discontinuation of treatment due to unsatisfactory results.

To mitigate the challenges associated with non-compliance, it’s essential for patients to prioritize their treatment regimen and adhere to the recommendations provided by their orthodontist. This includes wearing aligners as instructed, attending scheduled appointments for progress monitoring, and avoiding habits or behaviors that may interfere with treatment progress.

Consultation and Support at Fort Washington Dental Associates

At Fort Washington Dental Associates, our experienced team is dedicated to providing personalized guidance and support to ensure the success of your clear aligner treatment. We understand the importance of compliance in achieving optimal results and are here to address any concerns or challenges you may encounter along the way. Schedule a consultation with our board-certified orthodontist today to begin your journey to a straighter, healthier smile.

Book an appointment today.

Iliana Cepero
Iliana Cepero
23:13 16 Jan 24
Dr. Lee was incredibly kind, clear, and thorough when I went for a consultation. Doctors who spend time explaining things to a patient and giving them the best and most affordable options do not abound these days. He is very smart too. Strongly recommended!
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