Short answer: When an attachment falls off, first check whether your aligner still fits fully on your teeth and let the clinic know. Your dentist decides whether you should keep wearing the aligner and whether you should move on to the next one. A lost attachment is usually bonded again at a check-up appointment.
What is an attachment, and why can it fall off?
Attachments are small, tooth-coloured bumps bonded to the surface of certain teeth. They help the aligner grip the tooth better and transfer the planned movement to the tooth. We explain what they are and why they are used in detail in our article what are clear aligner attachments?
Although attachments are bonded firmly to the tooth, they can occasionally come off. Biting into a hard food, using too much force when removing the aligner, clenching or grinding the teeth at night, or wear of the bonding surface over time can cause this. An attachment falling off does not mean the treatment has failed; it is enough to notice it and tell your dentist.
What should you do, step by step?
- Check how the aligner fits. Put the aligner in and look in the mirror: does the aligner sit evenly over all the teeth? Is there a gap or a bulge between the aligner and the tooth where the attachment came off?
- Let the clinic know. Tell them which tooth the attachment fell off and which aligner number you were wearing. If possible, send a clear photo of the tooth and of how the aligner fits.
- Continue as your dentist advises. In most cases you will be asked to keep wearing your current aligner; however, this decision is made by the dentist.
- Do not move on to the next aligner on your own. Without the attachment, the aligner may not grip the tooth well enough. Even if the date has come, ask your dentist first.
- Rebonding at the check-up. The attachment is usually bonded again with the same template at the next check-up appointment, or at an earlier date if the dentist considers it appropriate.
What does it mean if the aligner does not fit?
If the aligner does not sit fully on the tooth in the attachment area, this may show that the tooth is lagging slightly behind its planned position. In that case it may be necessary to rearrange the aligner change schedule, go back to the previous aligner or make an additional plan. All these decisions depend on the dentist's assessment. For other situations where the aligner does not fit, see our clear aligner problems and solutions page.
Should I keep the attachment that fell off?
It is usually not possible to reuse the small piece that came off; the attachment is shaped again with new material. Still, if you have found the piece, there is no harm in bringing it to your check-up. If a small piece is swallowed, it usually causes no problem; however, if symptoms such as coughing, shortness of breath or difficulty swallowing appear, seek emergency help without delay.
If more than one attachment falls off
Several attachments falling off at the same time, or the same attachment falling off again and again, may be related to bite force, a clenching habit or the way the aligner is removed. Be sure to tell the clinic about this. After assessing the cause, the dentist may review the position or shape of the attachment or the recommendations for wearing the aligner. Do not change the aligner schedule on your own, and ask how you should use your current aligner until you receive the dentist's advice.
How can you reduce the chance of attachments falling off?
- When removing the aligner, start from the back teeth, not the front teeth, and take it out slowly.
- Do not eat with the aligner in; when eating without the aligner, avoid biting very hard foods with your front teeth.
- If you have a habit of clenching your teeth at night, tell your dentist.
- Do not use a hard brush or abrasive toothpaste when brushing the attachment surfaces.
What information should you share when contacting the clinic?
- Which tooth the attachment fell off (for example, the upper right canine)
- Which aligner you are currently wearing and how many days ago you switched to it
- Whether the aligner fits the tooth in that area, and whether you feel tightness or a gap
- Whether there is any additional problem such as pain, poking or a crack in the aligner
- A close-up photo of the tooth taken in good light and a photo taken with the aligner in
This information helps the dentist tell you more quickly whether you can wait, whether you should keep wearing the aligner and when you need to come to the clinic.
Is the aligner change schedule affected?
When an attachment falls off, aligner change dates may sometimes be shifted. To keep your own schedule organised, you can use our aligner change calendar page. For the general change routine, take a look at our article how often are clear aligners changed? If you want to see quickly what to do for each problem, our problem guide can also help.
Frequently asked questions
Do I need to go to the clinic urgently when an attachment falls off?
In most cases it is not urgent; however, it is recommended to let the clinic know on the same day or soon after. The dentist decides when you need to come in.
What should I do if an attachment falls off while I am travelling?
Check how the aligner fits, inform the clinic with a photo and continue according to the advice you receive. To prepare before a trip, you can look at our travel checklist.
Is the tooth harmed when an attachment is bonded again?
Rebonding is a procedure similar to the first bonding and usually takes a short time. The tooth surface is prepared appropriately by the dentist.
How can you find out what suits you?
The information here is general; the right plan for you is determined through an examination and the dentist's assessment. At our clinic in Oran, Çankaya, Ankara, we discuss your questions with you during the first orthodontic examination.
