Can I get Invisalign with missing teeth and what are possible complications?

Doctor's Answers 2

Invisalign is a removable form of orthodontic appliance which is especially popular with adults, as many patients feel embarrassed about the "braces look" and think that braces are a thing for youngsters. They are virtually invisible and facilitate oral hygiene, with less restriction of food choices and most importantly, more comfortable.

When my adult patients come to me for orthodontic treatment, it is more uncommon for some of them to have other dental issues and missing teeth. Orthodontic treatment in these cases often require detailed examination and diagnosis, and treatment plan for these cases may involve multidisciplinary management.

For the management of missing teeth, in particular, the orthodontist will have to examine the facial profile, teeth position and surrounding structures, and treatment may involve closing the missing teeth space or adjusting teeth position to allow for a restorative replacement of missing tooth with an implant or other prostheses. This can be done with braces, and in most cases with Invisalign.

However, in cases whereby teeth may have been extracted for a prolonged period of time and adjacent teeth have tilted into the empty spaces, up-righting of such severe tilted teeth may be more difficult with the Invisalign system alone and may require some help with a short phase of braces.

As with any Invisalign patients, the success of the treatment will depend highly on the experience of your orthodontist in the Invisalign system, proper treatment planning as well as patient cooperation. Optimal wear of 22 hours/day, biting of chewies as prescribed by your orthodontist as well as close monitoring by your orthodontist will help to ensure the treatment goes smoothly and successfully, without unnecessary lengthening of treatment time.

Invisalign treatment can still be done if there is a missing tooth/teeth. The treatment plan usually involves closing the space or even opening or maintaining the space for a future implant or bridge placement. This will ensure the size and shape of the implant, crown or bridge is as ideal as possible.

During the treatment, a tooth coloured material can be placed into your aligner to conceal the empty space such that there are no obvious gaps while you are wearing your aligner.

However prior to starting your Invisalign treatment, it is important to consult your attending dentist to identify the cause of your missing teeth - is it due to gum disease or extensive decay? All issues should be addressed before starting your Invisalign journey to ensure a successful outcome.

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