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Patient information

1. What is the purpose of this information?

In the following, we tell you how our transparent braces (known as ‘aligners’) work, what they are made of, how comfortable they are to wear and what result you can expect from them. You also learn how to use and maintain the aligners, how long a treatment lasts on average and what potential risks can occur when wearing them.


2. How do the aligners work?

Aligners are used to treat misaligned teeth. The misaligned teeth are corrected in several steps; individually adapted aligners are made for each of these steps. The gentle pressure that the aligners exert on the teeth and the natural dentition directs and moves the teeth into the desired ideal position.


3. What success can you expect?

We will discuss the results that are possible with you at the start of the treatment. However, everyone has a very individual response to dental braces – how they respond depends on the health of the teeth and the degree of the misaligned teeth, to name but two examples. Therefore we cannot guarantee that the treatment will be a success. The misaligned teeth may not be corrected. For optimal treatment, it is important that you use the aligners as soon as possible after receiving them, stick to the treatment plan and wear the aligners for at least 22 hours each day. How long treatment lasts is individual and depends particularly on the degree of the misaligned teeth. Generally speaking, treatment lasts between three and twelve months.

To secure and stabilise the achieved tooth position, we will send you a retainer splint along with the aligners. You should wear it every night for six months once treatment is complete and then at least three nights a week so that your teeth remain in their new position.

Not following the instructions of your bestsmile dentist, wearing the aligners for less than the required number of hours per day, having poor oral hygiene or wearing broken aligners can affect the treatment time and the quality of the final result. In addition, any medication you are taking and your general health condition may also have an influence on the treatment. Unusually shaped teeth can affect the treatment, e.g. short clinical crowns can cause problems with aligner retention and slow down or prevent teeth movement.


4. Usage and care instructions

Chewing, drinking hot, acidic or alcoholic drinks or smoking can deform or discolour the aligners, which is why they should be removed beforehand.

If you consume sugary, cloudy liquids or food, you should clean your teeth afterwards before using the aligners again.

Rinse the aligners under cold running water as much as possible every time you take them out – preferably several times a day. You can also gently clean the aligners with a toothbrush. We also recommend regularly soaking the aligners in a special cleaning agent that you can get from the pharmacy.

If you do not clean your teeth and aligners properly, you are at a greater risk of developing caries, periodontitis or gingivitis.

Grinding can damage the aligners. Doctors call dental grinding a ‘parafunction’ as the masticatory apparatus activity it triggers does not serve any real purpose. Nevertheless, people who grind their teeth press or push their teeth together with very high pressure, causing the masticatory muscles to work with a stronger bite force than during normal chewing.


5. What are the aligners made of?

The aligners are made of thin transparent plastic. They are made of medical PET (polyethylene terephthalate)/PU (polyurethane). They do not contain any plasticisers and are therefore free from bisphenol A (BPA).


6. How comfortable are the aligners?

The aligners are generally very comfortable to wear as they are very thin and easy to remove at any time.

Unfortunately, we cannot guarantee that they will be completely comfortable to wear. Despite everything, the aligners are foreign bodies that are placed on and exert gentle pressure on the teeth. Please arrange an appointment with us if the aligners are not sitting as desired. This will allow us to check how we can make them even more comfortable to wear.


7. Slicing/Stripping

Slicing is used for moderate crowding. The tooth enamel is minimally ground down to create space so that the teeth can be brought into the desired position.

Where the enamel is to be reduced and by exactly how much is calculated with the 3D scan and recorded in the treatment plan.

Slicing takes place when the first aligner is used for the first time and, depending on the quantity, is also divided among the other aligners (usually the next two). The enamel is ground manually (using stainless steel strips) and/or by means of oscillation (with Oscident Strips). The gaps are then polished and fluoridated with Elmex Fluid so that the enamel surface is smooth again and predilection sites for caries are prevented.


8. Attachments

Attachments are tooth-coloured composite abutments (knobs) that may be necessary to perform certain tooth movements more efficiently. Where the anatomical shape of the teeth does not allow sufficient force to be transmitted from the splint to the tooth, attachments provide an additional point of attack for more targeted force transmission and thus the desired tooth movement.

Attachments are glued to the teeth before treatment starts and they remain there throughout the aligner treatment. At the end, they are polished from the teeth without leaving any residue.

The following must be observed during treatment with attachments:

  • When inserting and removing the aligners, greater care must be taken to ensure that the attachments are not removed. If an attachment is lost, it can be reattached to the tooth at a check-up appointment.
  • If you attend an oral hygiene appointment during aligner treatment, the dentist must refrain from polishing the attachments.

9. Risks and Side effects

If you experience pain when wearing the aligners, or if other health problems occur, discontinue using the aligners. Please contact us immediately if you experience any problems so that we can arrange an appointment immediately.

The following risks and side effects may occur:

General:

  • The aligners exert pressure on your teeth to change their position. This may cause pain or be unpleasant. During treatment, increased sensitivity of the teeth and oral mucosa may occur – especially at the beginning of the treatment and during the transition from one aligner to the next.
  • The aligners may have a slight impact on your pronunciation, but you get used to the braces quickly. A longer-term impediment is a rare occurrence.
  • You may salivate more or have a dry mouth. Certain medications may increase this.
  • Caries, periodontitis, decalcification (permanent tooth marking) or inflammation of the gums may occur if proper oral hygiene is not maintained.
  • The aligners can initially irritate the inside of the mouth or the lips, which, although rare, can lead to wounds.
  • Allergic reactions to the material are extremely rare when wearing braces, but they can occur.
  • Wearing aligners can impact dental health. Although this is a rare occurrence, additional dental treatment such as endodontic treatment or other restorative treatments may be required, the life of the teeth may be shortened or, in extremely rare situations, individual teeth may be lost.
  • Root resorption (shortening) can also occur in natural, untreated dentition but, above all else, is a regular side effect of orthodontic treatment. Some of the root resorptions are repaired, but larger defects remain after treatment. Most root resorptions are so small that they are undetectable in panoramic X-ray images and are never noticeable in life or result in any damage. In about 20% of patients treated with braces, changes in the panoramic X-ray image can be seen on closer inspection. However, they only become significant in later life in rare cases. While tooth loss due to root resorption would be conceivable, it is described extremely rarely in all the scientific literature.
  • Existing tooth restorations such as crowns and bridges may be affected by wearing aligners. They can come loose and require re-cementing or, in some cases, replacement. Contact your bestsmile dentist before replacing or adding dental prostheses as they may affect the fit of your aligners.
  • As the braces are worn in the mouth, accidental swallowing or inhaling of all or part of the aligner can occur. To prevent this, the condition of the braces should be checked regularly; do not continue wearing damaged braces under any circumstances.
  • Where multiple teeth are missing, it is more likely that the braces will break. If they do break, you should contact your bestsmile dentist as soon as possible to replace them.
  • Problems that cause joint pain, discomfort, headaches or ear problems can also occur in the temporomandibular joint – but these are extremely rare. Inform your bestsmile dentist of such problems immediately
  • When taking an x-ray, the risks involved must be considered

Stripping/Slicing

  • The narrowing of the interradicular space can lead to Increased disposition to caries, increased adherence of plaque, hypersensitivity of the teeth and increased susceptibility to periodontal disease

Attachments

  • Attachments may temporarily interfere with harmony when biting.
  • In exceptional cases, attachment removal may also remove some healthy enamel.
  • It is possible that the attachments, or parts of them, are accidentally swallowed or aspirated.
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