Can I get clear aligners treatment without removing my wisdom teeth?

Upper wisdom teeth usually do not affect orthodontic treatment (braces/clear aligners) except in certain cases.

Since you are an adult (non-growing) Class II (this may be skeletal or dental) with an overjet, you may need to consider 3 possible camouflage techniques to reduce the overjet:

1) IPR (slimming down the teeth to gain space)

2) Extraction of upper premolars

3) Distalization of the upper arch

Each method has different effects on your facial profile and vary in complexity and overall treatment time.

Distalization requires space behind the upper molars so that the upper teeth can be shifted backwards to reduce the overjet. This scenario requires that your upper wisdom teeth be removed.

Distalization with clear aligners is successful at moving the very last tooth backwards by about 2mm. However, this method can be unpredictable and is a slow process. You can get larger amounts of distalization using mini screws and using micro-osteoperforations to assist the aligners.

The photos I have attached in this post are of a case (mid-treatment) to reduce overjet using distalization with Invisalign.

Pre-treatment overjet

Mid-treatment overjet

Have a thorough discussion of all the options with your dentist.

There are no hard and fast rules as to whether extraction of wisdom teeth are mandatory.

However, the nature of clear aligner treatment requires the best wrap around of the plastic to fit and move the teeth in a predictable fashion. Depending on the severity of your overjet AND the angle of the wisdom teeth, these wisdom teeth may need to be extracted.

The priority is that there is no obstruction from the wisdom teeth. This is illustrated below:

As you can see, if the plastic at the back needs to be cut to accomodate an impeding wisdom tooth, this compromises the overall wrap around of the clear aligner. We want the optimal fit and grip to allow for predictable tooth movements so for most cases, I do recommend wisdom teeth extractions before starting on clear aligner treatment.

Hope this helps!

Regards,

Dr Beth