Contrary to Align Technology’s claims, aligners are NOT invisible. Attachments and precision cuts can be very unsightly and often patients are looking for a night-time only aligner. Buyer be warned, though. The elusive “night time only” aligner is more of a myth or legend than an actual clinical fact.
That said, an important trade-off to keep in mind is treatment duration. Let’s say you have a very simple case, with a maximum of 2-3 mm of crowding. Normally, teeth can move 0.25mm per aligner so I can treat this case with less than 10 aligners or so if it is worn 24 hours a day. With weekly changes, this means it would be completed in a maximum of just 10 weeks.
If you want to go just the night time route, it doesn’t mean that you only wear them when you sleep; you need to wear them during the “night,” which means a minimum of 12 hours a day. Also, that 10 aligner plan would be slowed WAY down to probably 20 to 30 aligners to make up for the missed time. So in essence, you are paying double or more for something that could be done quicker by skipping the luxury of wearing it just at night. I have had success with my own patients doing night-time only aligners this way. There is nothing novel or special about this. Any aligner can be turned into a night time only aligner.
For the cheapest and most accurate night time only aligner, you should consider the “OG” custom positioner.
Positioners have been around for 50+ years and are the most overlooked but most effective retention solution. They can either be custom or semi-custom and have excellent retention, not only in the Phase 1 to Phase 2 period, but also long-term, comprehensive retention. Although they are bulky, they are very effective and can only be worn at night. If a minor relapse occurs, the positioner will correct it. Positioners also help to guide unerupted teeth between Phase 1 and Phase 2 (eruptive guidance) and encourage nasal breathing and proper airways.

Drawbacks to Nighttime Aligners
At this point, nighttime-only aligners might sound too good to be true, but they’re not without flaws. Before you make your final decision, it’s important to understand the drawbacks that come with this unique treatment schedule.

1) Treatment Takes Forever

2) The Pain!
The see-saw movement to night time only aligners isn’t healthy for your teeth. The instant you remove the aligners, your teeth start to shift back to their original positions. The longer you go without them each day, the more your teeth shift. Not only does this slow down treatment, but it also puts additional strain on your teeth, constantly shifting them in and out of their new position. This may carry a small, added risk of injuring your tooth roots. Since there has been no published clinical research on the risks for this, I don’t recommend it.
3) Only Suitable for Minor Cases
In general, at-home aligners are better-suited for milder cases of crowding and spacing. I would recommend less than 3 mm of crowding or spacing.
Plus, because of the additional back-and-forth wiggling involved with Nighttime Aligner plans, your teeth may be more likely to shift back to their original positions after you wrap up treatment. This is an especially big risk if you don’t consistently wear your post-treatment retainer – which is a good habit no matter which provider and treatment you choose.
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