Is It Possible to Have Elastics Placed Inside of the Teeth With Invisalign?

For many patients, elastic wear is crucial to an excellent result with Aligner wear if their posterior bite is off. Elastics are generally worn off of buttons directly bonded to the teeth, or off of hooks that are milled into the aligners directly. But in all cases, elastics are worn on the outside of the aligners. Your doctor will tell you how often you should wear you elastics, but proper wear is important to treatment success.

Wearing elastics on the outside of the aligners is most common useage and yes, they may make the trays slightly more noticeable, but by whom?  Most often the things that you are aware of are not noted or of concern to the public.  If they are noticed, they are likely aware you are doing something special for yourself by wearing something to improve your smile.

It is certainly possible to hook-up elastics on the "tongue-side" of the teeth.  When you speak, those elastics are still going to be seen, stretching from top teeth to bottom, so I'm not sure this solves your issue.  In fact, adding "buttons" or notches for the elastics on the inside of the trays may be more uncomfortable and irritating to your tongue.  You may wish to ask your orthodontic specialist to "notch-up" a pair of your last aligner trays to give it a try before altering new sets to find out you can't tolerate this "hidden" approach.  

Most importantly, the concept of any orthodontic treatment being absolutely and completely inconspicuous is somewhat unrealistic and actually ruins some of the fun.  You are obviously excited to be able to improve your smile, that enthusiams can be contagious and other folks may elect to do the same for themselves just from your influence.

Hi Liz,

Please note, my answer here only reflects some of the innovations at our office which may not be part of what invisalign teaches nor may be known to any other doctors  unless if they have met me when discussing such possibilities:

You may be using elastics for many different reasons: You may be using them to extrude a tooth (pull the tooth away from gum and bone into the aligners) or rotate a tooth or correct a class II or class III bite with elastics and buttons.

In all cases, we are able to place the elastics lingualy inside the teeth with various innovative techniques and/or use different elastic than what is commonly used with invisalign to stretch and hide the elastic so it’s not visible!

Keep in mind, if you are using elastic to correct a bite from upper teeth to lower teeth, it may be harder for your doctor to place the buttons on the inside and a bit harder for you to hook the elastics.  We have done this before to accommodate our models, actors, actress patients and business people who had to always speak in front of an audience.

Furthermore in some cases, direction of proper force may be changed or may not be that ideal.  For example in a class II bite which is also in cross bite, it may be best to have buttons and elastics start on the inside of the upper front teeth and end up on the outside of the lower back teeth.  Various other combinations may be needed as well depending on the specific situation.

If you are using elastic to pull teeth into the aligner, its best to use a thin clear elastic and pull it as much as possible to make it disappear.  Commonly this is not possible since invisalign providers are taught to use the aligner edge only as a hook. With this method, if you pull the elastic too hard, it will bend the plastic hook!  Instead we use a resin button and a tiny hole in the aligner to overcome this issue.  Patients can now stretch the elastic as much as possible without breaking anything which helps make the elastic invisible and yet the force stronger! 

Note: Aligners need to be manually cut by your invisalign provider where buttons go or a button cut out needs to be programmed on clincheck computer model before aligners are ordered.

Without knowing your case and without showing specific images of our technique, this answer may be a bit confusing for doctors and patients alike but I will be happy to explain further if anyone needs more info.

***Online Answers should NEVER be substituted for a complete clinical exam and following advice of your treating doctors based on proper and full diagnosis and treatment planning.   There is no way anyone can properly diagnose and treatment plan a patient online without an in office exam.

Maybe.

 

Often the forces generated when elastics are on the inside of the teeth are not in the direction that is desired, so I would say it would be the exception and not the rule that elastics can be worn the way you describe.