Can an Orthodontist start Invisalign on me if I have a large cavity?

Question

I'm 16 years old, and I have an invisalign teen consult with an ortho tomorrow. I have a pretty simple underbite, and some crookedness. I have one large cavity in the back of my mouth. Will my ortho be able to start my invisalign treatment before I get that fixed? I'd like to start the invisalign ASAP.

Sarah Thompson, DMD · Answer

Hi there,While it is possible to place Invisalign trays over a tooth or teeth with cavities, it is really not recommended.  Having Invisalign placed on teeth with cavities is like spending time decorating a house that has a leaky roof.  It is ALWAYS most important to fix the leaks in the roof first, or you can destroy your whole investment.  Furthermore, if Invisalign is placed while a person has untreated cavities, Invisalign can actually accelerate the bacterial decay taking place.  The best option is always to treat the cavities ASAP, before the grow bigger and destroy your tooth.  Congrats on finally starting the Invisalign journey and good luck getting those caries treated.

Frank Celenza, DDS, PC · Answer

In some circumstances it may be possible to start, but if the cavity is large enough that the restoration of it will change the shape of the tooth at all, then the fit of the aligners will be affected and new impressions and re-manufacturing will be needed. That's an extra step that will add time, so you might as well just fix the cavity first.  It's not going to fix itself, and is actually the more important aspect of the treatment.  For these reasons I send patients to take care of all these preparatory things before starting.  In the end, it saves time, not to mention possible emergencies and even pain.

Jay Neuhaus, DDS · Answer

First things first! You should definitely have the cavity fixed BEFORE taking the impressions for Invisalign treatment. The shape of the "cavity" tooth will change after it is restored, and the Invisalign trays should be made to the "new" shape.

Can an Orthodontist start Invisalign on me if I have a large cavity?

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