Short answer: An attachment is a small, tooth-coloured bump of composite (filling material) bonded to the surface of a tooth. It helps the aligner grip the tooth and allows certain tooth movements to be carried out in a more controlled way. When treatment ends, attachments are removed and the tooth surface is polished.
What do attachments do?
A clear aligner applies force to the teeth only through contact with their surfaces. Flat and rounded tooth surfaces don't offer enough grip for some movements. Attachments create a "handle" the aligner can hold on to and are used especially for these movements:
- Turning a tooth around its own axis (rotation)
- Moving a tooth bodily, together with its roots
- Lengthening or pushing a tooth in (vertical movements, extrusion and intrusion)
- Helping the aligner seat firmly on the teeth
Not every patient needs attachments; their number, shape and position are set tooth by tooth in the digital treatment plan.
How are attachments bonded?
- The tooth surface is cleaned and prepared for bonding.
- A thin template aligner carrying the shapes of the attachments is placed over the teeth.
- The gaps in the template are filled with tooth-coloured composite and hardened with a curing light.
- The template is removed and any excess material is cleaned away.
The procedure usually doesn't require local anaesthetic and is completed in a single visit.
Are attachments visible?
Because they are tooth-coloured, they are usually not noticeable from a distance; up close they may be seen as small raised spots. Over time they can pick up some staining from tea, coffee and smoking. You can feel them with your tongue when the aligner is out; most people get used to them within a few days.
What if an attachment falls off?
Hard or sticky foods can cause an attachment to come off. A missing attachment can affect how the aligner fits and how that tooth moves. Keep wearing your aligner and let the clinic know; your clinician will decide whether it needs to be rebonded. For other possible issues, see our page on clear aligner problems and solutions.
Do attachments leave marks after treatment?
Attachments are carefully removed with special burs and the tooth surface is polished. When done with the right technique, the enamel is usually not adversely affected. Good oral hygiene throughout treatment is important to protect the area around the attachments. Once the attachments are removed, the retention (retainer) phase begins to maintain the result.
Quick answers
Does getting attachments hurt?
Bonding is done on the tooth surface and usually doesn't need local anaesthetic. In the first few days your tongue and lips may notice a rough feeling.
How many attachments will I have?
The number varies from person to person; some patients need none, while others have them on many teeth.
Are attachments affected by teeth whitening?
Composite material does not lighten with whitening. If you are considering whitening, plan the timing with your clinician.
How do you find out what suits you?
The information here is general; the right plan for you is decided through an oral examination, a digital scan and a clinical assessment. At our clinic in Oran, Çankaya, Ankara, we go through these topics and your questions during your first orthodontic examination. If you would like to see the treatment steps in advance, take a look at our clear aligner treatment process page.
