Can you get Invisalign with Bone Loss?
Invisalign has changed the game of orthodontics in the past twenty years. No longer do we have to subject ourselves to the uncomfortable and unsightly metal wires and brackets of traditional braces.
Clear aligners are transparent, removable, more hygienic, and more comfortable than their traditional counterparts. Unlike metal braces, the clear aligners make this treatment a lot more discreet, which is quite preferable for patients of all ages. However, not everyone is a good candidate for Invisalign, which may leave Raleigh patients suffering from tooth loss wondering where they stand. Will the Invisalign treatment still work for you? Can you get Invsialign with bone loss? This short blog post from Smileplicity Dentistry has the answer!
Bone loss and missing teeth are closely connected, and understanding that connection is a big part of answering this question. When a tooth is lost, the jawbone underneath it is no longer stimulated by chewing forces, which leads it to gradually weaken over time. Our article on how dental implants support jaw bone health explains this process in more detail, and it’s worth a read for context before diving into how it affects Invisalign candidacy specifically.
Missing Teeth and Invisalign: Quick Answer at a Glance
- Can you get Invisalign with missing teeth? In many cases, yes, though candidacy depends on the cause of tooth loss and current bone and gum health.
- Should you replace the tooth before or after Invisalign? Generally after. Straightening first prevents the replacement from ending up in the wrong position.
- Is gum disease a disqualifier? Active gum disease typically needs to be treated first, since unstable gums make tooth movement unpredictable.
- What if bone loss has already occurred? Mild to moderate bone loss doesn’t automatically rule out Invisalign, but your dentist will evaluate this carefully during your consultation.
Why You Should Get Invisalign Before Replacing Your Tooth
If you’re seeking orthodontic treatment and have a missing tooth, you might not know if you can be a good candidate for Invisalign. The good news is, you might be! However, you shouldn’t replace the tooth until you’ve corrected your tooth alignment with Invisalign first.
This is because tooth loss causes jawbone loss, which leads to the surrounding teeth shifting and leaning into this space where your tooth used to be. Shifting teeth cause overcrowding, bite problems, and can even block the space where your tooth replacement would need to go. In some cases, the missing teeth can cause or even worsen the alignment problems because the surrounding teeth are shifting positions to try and compensate for the gap in your teeth. If you’ve had missing teeth for a while, you’ve likely noticed that your teeth have shifted significantly as a result.
By undergoing Invisalign treatment first, you can correct crooked teeth and an improper bite to ensure that your teeth are in the proper position before replacing the tooth. This ensures that we’ll have space to replace the tooth and it won’t be in the wrong spot. By straightening the rest of your teeth and getting them into their most optimal position, the gaps caused by the missing teeth will likely shrink, sometimes by a considerable amount. This allows you to get the perfect size crown or dental implant to replace your missing teeth.
Additionally, getting Invisalign after such restorative measures is not ideal. Attempting to shift a dental implant after it has been placed can cause damage to the surrounding bone tissue.
Invisalign First vs. Replacement First: Why Order Matters
This sequencing question comes up often enough that it helps to see the two approaches compared directly.
| Approach | What Happens | Outcome |
|---|---|---|
| Invisalign first, then replacement | Teeth are straightened, gaps are closed to their ideal size, then a crown, implant, or bridge is placed into the corrected space | Precise, properly sized replacement that fits your final bite |
| Replacement first, then Invisalign | A tooth is replaced into a gap that may shift or shrink over time | Risk of the replacement ending up misaligned, and implants specifically cannot be moved by aligners once placed |
Because a dental implant fuses permanently with the jawbone, it cannot be repositioned with Invisalign the way a natural tooth can. This is the core reason the sequencing matters so much for implant candidates specifically. Removable options like a temporary partial denture can sometimes be used to maintain appearance and function during the Invisalign phase, before a permanent solution is placed.
Not Everyone With Tooth Loss Is a Candidate for Invisalign
While patients suffering from tooth loss can be candidates for Invisalign, it depends on the cause of the tooth loss. If you’ve lost a tooth due to gum disease, it’s important that you don’t actively have gum disease and that your gums have rebuilt themselves.
Unfortunately, gum disease causes bone loss and destruction of the soft tissue in the mouth, which makes them unhealthy. If your gums aren’t healthy this means the tooth roots can move around unpredictably. To qualify for Invisalign at our Raleigh practice, you may need to undergo treatments for gum disease or the aftermath of gum disease, such as gum or bone grafts.
If gum disease is part of your history, it’s worth understanding what periodontal disease actually is and how it’s treated, since resolving active disease is typically the first step before any orthodontic evaluation can move forward.
Other Factors That Affect Candidacy
Beyond the cause of tooth loss, a few other factors come into play during your evaluation.
- Number of missing teeth. A single missing tooth is generally easier to plan around than multiple gaps across different areas of the mouth.
- Overall bite alignment. Significant bite issues alongside missing teeth may require a more detailed treatment plan, sometimes involving other specialists.
- Bone density in the affected area. Your dentist will use imaging to assess whether bone loss is mild, moderate, or severe, which shapes what’s possible.
- Age and jaw development. Adults are generally the focus of this kind of treatment, since jaw growth is complete and results are more predictable.
- Commitment to retainer wear. Since maintaining alignment after treatment requires consistent retainer use, especially with a gap present, this is worth discussing honestly during your consultation.
What Does the Treatment Process Look like?
First, you need to book a consultation to assess the current state of your dental health. The dentist will assess what caused the tooth misalignment and the missing teeth to determine the proper course of action for your specific case.
Sometimes, you might need to go through additional procedures before you can bring your Invisalign treatment. Additionally, once you complete your Invisalign treatment, you may require additional procedures to prepare the gums or even jaw for getting your missing teeth replaced. For instance, if you want to get a dental implant, you will likely need a bone graft to increase jawbone tissue. Bone mass loss is a common consequence of having a missing tooth for a very long time.
For a fuller picture of what implant placement itself involves once your alignment is corrected, our guide on everything you need to know about dental implants walks through the process from consultation to final crown.
Post-Invisalign Treatment
After you’ve completed your Invisalign treatment and corrected your tooth alignment, you will need to wear a retainer for 22 hours a day for about a year. After that, your jawbone should be stable enough to reduce the wear time of your retainers.
However, you will need to wear a retainer at least a few times a week for the rest of your life to maintain your new tooth alignment. You are also free to replace your missing tooth at this point. At Smileplicity Dentistry, we offer several tooth restorations, such as dental implants, dentures, and dental bridges.
It’s worth pointing out that even after retainer wear tapers down, missing a tooth in the meantime can still allow subtle shifting to creep back in if the gap sits unaddressed for too long. This is part of why most patients move toward their tooth replacement relatively soon after finishing active Invisalign treatment, rather than leaving the gap open indefinitely.
Frequently Asked Questions
How long does Invisalign take if I have a missing tooth?
Treatment time varies based on the complexity of your case, but it often falls in a similar range to standard Invisalign treatment, roughly 6 to 18 months, sometimes longer if significant shifting needs to be corrected.
Will my aligners have a fake tooth built in for the gap?
In many cases, yes. Aligners can include a small prosthetic tooth, sometimes called a “flipper” tooth or pontic, attached to the aligner itself to fill the visible gap during treatment.
Can I get a dental implant right after finishing Invisalign?
Often yes, though your dentist will typically want your bite to stabilize for a period before finalizing implant placement, and some patients may need additional imaging or a bone graft depending on how long the tooth was missing.
Does insurance cover Invisalign when there’s a missing tooth involved?
Coverage depends on your specific plan and whether the treatment is classified as medically necessary versus purely cosmetic. Our team can help you understand your benefits during a consultation.
What happens if I ignore the gap instead of treating it?
Left unaddressed, the surrounding teeth will likely continue shifting into the space, and the jawbone in that area will continue to weaken, both of which tend to make future treatment more complicated and costly.
Get an Invisalign Consultation in Raleigh Today
The best way to determine if you’re a good candidate for Invisalign is to come into Smileplicity Dentistry for a consultation with an Invisalign dentist in Raleigh. Contact us today to schedule an appointment with Dr. Daiana Atari. We can assess your eligibility for Invisalign and explore your tooth replacement options.
