When people picture Invisalign, they usually imagine a set of smooth, clear trays that slip on and off the teeth. For many patients, though, treatment also involves small tooth-coloured bumps on some teeth called attachments. They’re one of the most common things patients ask us about, so here’s what they are, what they do and what to expect.
What Are Invisalign Attachments?
Attachments are small shapes made from tooth-coloured composite resin, the same material we use for white fillings and bonding. They’re bonded to the surface of selected teeth for the duration of your treatment.
Each one is only a few millimetres in size. Because they’re matched to your tooth colour, they’re designed to blend in, and most people won’t notice them in everyday conversation.
Why Do You Need Them?
Clear aligners move teeth by applying gentle, controlled pressure. On their own, smooth aligners are good at tipping teeth and making some simple movements. Other movements need more grip, though, and that’s where attachments come in.
Attachments act like small handles. The aligner fits snugly around them, giving it something to push against. This allows the aligner to apply force more precisely, in the right direction and at the right point on the tooth.
They’re especially useful for movements such as:
Rotating teeth, particularly rounded teeth like canines and premolars
Pulling teeth down (extrusion) or pushing them up into the gum line (intrusion)
Moving roots, not just the crowns of the teeth, so teeth sit upright in the bone
Closing gaps while keeping the teeth parallel
Correcting bite problems, such as overbites and deep bites
Helping the aligners stay in place, so they seat firmly and work as planned
Attachments come in different shapes and sizes. Each one is planned for the specific movement a tooth needs. Some are rectangular, some are angled, and some are custom-shaped by the treatment planning software.
Does Everyone Need Attachments?
No. Whether you need attachments, and how many, depends on how your teeth need to move. Simple cases may need very few or none at all. More complex treatment usually needs more.
Your attachments are mapped out during digital treatment planning, before your first aligner is made. At that stage, we’ll show you which teeth will have them so you know exactly what to expect.
How Are Attachments Placed?
Placing attachments is a quick, comfortable process that usually happens at the appointment where you receive your first aligners.
We clean and prepare the teeth. The surfaces of the selected teeth are cleaned, and a mild gel is applied to help the composite bond.
We fill a template aligner. A special template tray has small pockets in the exact shape and position of each attachment. We fill these pockets with composite.
We fit and set the attachments. The template goes over your teeth, and a curing light hardens the composite in place.
We tidy up. The template is removed, and any excess material is smoothed away.
There’s no drilling, no needles and no anaesthetic. Most patients find it no more uncomfortable than having their teeth polished.
What Do They Feel Like?
At first, your tongue and lips will notice the small bumps. Most people get used to them within a few days.
Aligners also fit more snugly with attachments, so they may feel tighter and be a little harder to remove at the start of each new tray. This snug fit is exactly what allows the aligners to work. We’ll show you the easiest way to take them in and out.
Caring for Your Attachments
Looking after your attachments helps your treatment stay on track and keeps your teeth healthy.
Brush carefully around each attachment. Plaque can collect around the edges, so take extra care at the gumline.
Take your aligners out to eat, and brush before putting them back in.
Limit staining drinks such as coffee, tea and red wine. Composite can pick up stains over time.
Avoid biting directly into very hard foods, such as ice or hard lollies, which can chip or knock off an attachment.
Don’t try to remove or file down an attachment yourself.
What If an Attachment Falls Off?
It occasionally happens, and it’s easy to fix. Let us know, and we can replace it using your template. In the meantime, keep wearing your aligners unless we advise otherwise. A missing attachment can affect how well the teeth move, so it’s worth having it replaced promptly.
How Are Attachments Removed?
At the end of your treatment, we gently polish the attachments off the teeth with a dental instrument. It doesn’t hurt and doesn’t need anaesthetic. The teeth are then smoothed and polished so they feel as they did before. You’ll then move on to retainers to help hold your new smile in place.
Can You Whiten Your Teeth With Attachments?
Whitening gels don’t change the colour of the composite. If you whiten during treatment, the attachments may stand out slightly. Whitening also won’t lighten the small areas of enamel under the attachments while they’re in place. For this reason, many patients choose to whiten after treatment, once the attachments are removed.
As a dentist in Brighton who has been caring for local families for over 50 years, we find that attachments raise a lot of questions early on. Once patients understand what they do, most find them a small trade-off for more predictable results.
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