Sometimes it can be hard to tell if a case is better suited for braces or aligners. However, there are a few cases in which you should avoid putting in Invisalign or other non-Invisalign clear aligners. These cases either put yourself or the patient at risk, or they simply cannot be done.

Let’s discuss which cases are a “Flat Out Avoid” for providers who treat patients using aligners.

First and foremost, do not take any anterior open bite cases with Invisalign or other clear aligners. Whether the anterior open bite is large or small, or someone tells you it’s possible, avoid these cases at all costs. Just because people say it can be done doesn’t mean it should be done. The reason why these cases should be fully avoided is that they are unpredictable in nature.

Anterior open bite cases always have an underlying etiology that needs to be found. Now, this doesn’t mean that patients with anterior open bites can never get Invisalign – it’s just better to seek treatment for this issue before aligners.

Secondly, class two and class three patients should only be taken if they have their wisdom teeth out and healed. Having the wisdom teeth out and healed provides enough room to safely move the teeth around, so these patients should wait until then to receive clear aligners. You should also have a Ceph and Ceph number before starting this case.

And lastly, posterior crossbite cases in adults. You can take these cases, but you won’t be able to fix their posterior crossbite. This opens you up to having to do paperwork with the patient so that they understand risk-benefit and alternatives and that the posterior crossbite will remain even after Invisalign treatment.