Aligners - How to Insert

For information regarding how to insert aligners, refer to the following:

• Overview
• Techniques for inserting aligners
• Additional Information

Overview

When a patient tries on an active aligner for the first time, it's not going to exactly match the position of their teeth. (Obviously—that's how aligners work.)

Ideally, aligners should fit snugly at first, then loosen up over a couple of days as the teeth move into position. Sometimes, however, variables in patients' dentition or other factors such as flaring, inclining, or proclining teeth can cause discomfort for the patient or make the aligners difficult to insert.

Techniques for inserting aligners

If you have trouble inserting aligners, here are some techniques that you can try:

Front to back

Use this technique when the anterior teeth are excessively proclined (tipped forward) or excessively crowded.

• Insert the aligner on the anterior teeth.
• Then push the tray down over the posterior teeth.

Back to front

Use this technique when all of the teeth are relatively upright.

• Insert the aligner on the posterior teeth first.
• Then push the tray down over the anterior teeth.

Side to side

Use this technique when the posterior teeth are excessively inclined lingually.

• Insert one side first, coming forward to insert the anterior teeth.
• Then press down on the other side.
• Cautiously, press the aligner on using the fingers; do not bite the aligners on with teeth.

Sectioning the aligners prior to insertion

Use this technique when there is excessive anterior proclination or excessive posterior inclination.

• Cut the aligner in half along the midline.
• Insert one side of the aligner fully into place, then insert the opposite side.
• After a couple of stages, it probably will no longer be necessary to section the aligners prior to insertion.

Anterior then lingual or buccal

Use this technique when the teeth are flared either lingually or bucally.

• Insert the aligner on the anterior teeth.
• Then push the tray down on the side that is flared, for example, if the teeth are flared lingually, push the tray down on the lingual side. If flared bucally, push down on the buccal side. (If the aligners are inserted in the most difficult area first, the rest of the area should be easy to insert.)

When you get the aligners on, they should snap into place. If they don't, or if there is a small incisal gap, you can give the patient a couple of Chewies to bite on for a few days. These should help the aligners to fully seat.

Additional Information

For additional help with aligners not seating, we have a few articles that may be helpful to you:

• Aligners Don’t Fit – Incisal gaps
• Aligners Don’t Fit – Too Big or Too Small
• Aligners Don’t Fit – Rocking (fits one side but not the other)
• Short clinical crowns
• Undercuts

Source: Dr. Ken Fischer, DDS based on his collected clinical experience treating cases with clear aligner therapy.