How to Use Invisalign for Cases with Wisdom Teeth
Wisdom teeth can be somewhat frustrating when doing orthodontics, requiring several specific intricacies to ensure you’re tackling an Invisalign or clear aligners case properly. Following this, today’s guide has summarized some of the core things you should think about before starting to help inform your decision.
However, it’s worth considering here that every dentist will have their own opinions when it comes to doing clear aligners / Invisalign with third molars. As such, this may come down to personal preference – but some approaches may have higher risk attached.
Should Third Molars (Wisdom Teeth) Be Pulled?
When studying orthodontics, you’ll usually be told that third molars don’t matter, provided that they are fully erupted and don’t have a risk of decay or pericoronitis (etc). That’s generally true in braces cases, but for clear aligners, this may be a little trickier.
We should also point out that if you are consolidating spaces and moving the molars, make sure they are fully covered and there is full wrap around the back of the molars. Distilization and elastics also require full coverage.
Fully Impacted Molars
If a patient is under the age of 25 and has third molars that are ⅔ developed or greater (or are mesially erupting), they may need removing before treatment. While a lot of research will say this won’t matter, one-quarter of public opinion is much higher that this is an issue – and doing these cases without removing the third molars first could leave you at risk of complaints to the dental board (etc).
Partially Erupted Molars
If a patient has partially erupted molars, there are two main options to keep in mind. If the patient wants to start Invisalign shortly, removing them is the best bet to prevent complications from arising. Alternatively, you could wait until they are fully erupted, but there’s still no guarantee that they won’t need removal once they have erupted.
Fully Erupted Molars
In the case of fully erupted molars, if these are covered – at least ⅔ – by the tray (which may require a scan), Invisalign or clear aligners may be a safer approach. Make sure they are also fully covered if you are using Essex retainers (this is less important for Hawley or bondeds).