If someone has just told you that your Invisalign plan needs attachments, you are almost certainly picturing something far bigger than the thing that actually goes on your teeth. They are little bumps of tooth-coloured filling material, no bigger than a grain of rice, and most people stop noticing them.
Attachments, chewies and elastics are the three bits of kit people ask about most, and each one does a completely different job. Here they are side by side, and then we will take them one at a time.
| The kit | Where it lives | What it is actually doing |
|---|---|---|
| Attachments | Bonded to some of your teeth | Giving the smooth aligner something to grip and push against |
| Chewies | A squashy cylinder in your bag | Pressing the aligner fully down so it can work |
| Elastics, or rubber bands | Hooked between top and bottom | Moving the bite, one whole arch against the other |
What are Invisalign attachments, and why do some teeth need them?
An aligner is a smooth sheet of plastic wrapped around a row of smooth, rounded teeth. Think of unscrewing a jar lid with wet hands: plenty of squeeze, nothing to catch on. Squeezing is enough while a tooth only has to lean over a little, but the moment it has to twist round on the spot, or come down out of the gum, or stand upright from a tilt, the plastic needs a ledge to press on.
That ledge is the attachment. It is a small piece of composite, the same tooth-coloured material used for bonding, set on the front of the tooth in a particular shape, and the shape is chosen for the direction that tooth has to travel. A tooth being rotated gets a different one from a tooth being lifted, because the aligner has to push on it from a different angle.
Getting them on is gentler than nearly everyone expects, because nothing is cut. Your dentist cleans the tooth, puts on a gel so the composite grips the enamel, then presses a clear template tray over your teeth, with a tiny well moulded into it wherever an attachment belongs. A blue light sets the composite hard, the tray comes off, and the bumps stay behind. No drill, no injection.
Here is the part that surprises people. Not every attachment is there to move the tooth it sits on. Some hold a tooth still so it can be the fixed point the others are pushed against, the way you plant your back foot before shoving a heavy door. Which teeth get one is decided when the plan is built, and that plan is on screen at the free Invisalign consultation before anything is stuck to anything.
Do Invisalign attachments show?
From normal talking distance, no. They are matched to the colour of your teeth, they are small, and for twenty to twenty-two hours a day there is a clear aligner over the top, catching the light far more than the bumps do.
Up close is a different story: in a mirror, at arm’s length, in good light, you will find them. So will anyone standing that close, if they are looking at your teeth rather than at you. The ones on your front teeth are the only ones in the running; nobody ever sees the ones further back. You notice them most at a meal, with the aligner out and the shine gone, and even that fades as your eye stops looking.
Do attachments hurt or rub, and what helps?
They do not hurt in themselves, because nothing was drilled or trimmed to put them there. What does happen, to almost everyone, is that your tongue finds them and cannot leave them alone for a day or two. It is exactly like a new filling that feels the size of a paving slab on Monday and completely normal by Friday. Your tongue is simply the most sensitive thing you own.
The other thing people feel is the inside of the lip catching on an edge while the aligner is out. If a corner is genuinely sharp rather than simply new, say so, because it can be smoothed in a moment. Orthodontic wax over the edge settles it in the meantime. The first days as a whole, the tightness of each new set and what eases it, have their own article.
Attachments also make the aligner harder to pull off in the first week, which is the grip doing exactly what it was put there to do. It gets easy once your fingers learn the order: unhook the back teeth on both sides first, then come forward.
What are Invisalign chewies for, and how do you use them?
A chewie is a small soft cylinder of springy plastic that you bite on, and its whole job is seating: getting the aligner properly home on the teeth.
You see, when you press an aligner on with your fingers it can look on while it is not quite on. A thin gap is left between the plastic and the biting edge of the tooth, and it matters because an aligner only moves a tooth where it is actually touching it. Wearing one that has not seated is like walking about in a boot with your heel not pushed down. It is on your foot, and it is doing none of the things a boot is for.
Biting on a chewie closes that gap. Bite gently and keep moving it along, round both sides and across the front rather than clamping on one spot, because you are after even pressure everywhere. How long and how often is worth asking your dentist, since it depends on what your plan is asking your teeth to do. Many people find it takes the edge off the tightness of a fresh set as well.
Keep one with your aligner case, and swap it when it stops springing back, because a flat chewie has nothing left to push with.
What do the elastics and rubber bands do?
Elastics and rubber bands are the same thing, so if your dentist says one and the leaflet says the other, nothing has changed.
An aligner is one piece of plastic wrapped around one arch of teeth, so the tooth it pushes and the teeth it braces against all sit in that same row. That is what makes aligners so good at tidying teeth up within their own arch. What a tray cannot do on its own is change how the top row meets the bottom row, because that needs a force running from one arch to the other, and a small elastic stretched between them is exactly that force.
They hook onto a small button bonded to a tooth, or onto a notch cut into the edge of the aligner. Which teeth they run between depends on your bite. Forward, back, or across: the direction of the pull is the treatment.
They feel like a steady, gentle tug, and the ache in the first days sits in the jaw muscles more than in the teeth, because your jaw is being asked to rest slightly differently. They go in with the aligners, come out for meals, and get swapped for a fresh pair every day, because rubber that has been stretched all day has lost most of its pull. A tired elastic looks like it is working and has very nearly stopped.
An elastic only pulls while it is on, and doubling up is no shortcut, so ask before you change anything about how you wear them. Plenty of people never need them at all, mind you, because whether they are in your plan is decided by what your bite needs.
When are the attachments removed, and what is that like?
They come off at the end, once your teeth are where the plan put them.
Because the composite sits on the surface of the enamel and nothing was cut to fit it, taking it off is polishing rather than drilling. A polishing tip and some water buzz the bump down flush, and the enamel is smoothed over. There is no injection, because there is nothing to numb: the hard outer shell of a tooth has no feeling in it the way the inside does.
It feels like vibration, a bit of buzz and a bit of water, much like the polish at the end of a hygiene visit. Your tongue is the best inspector in the room afterwards, so if a spot still feels rough, say so and it is smoothed there and then.
One thing to expect, because it catches people out: the enamel under an attachment has been covered up while the rest of the tooth was out in the world. It can look very slightly different for a while, and then it evens out on its own. It is also why whitening waits until the attachments are off, since the gel needs to reach the whole surface of the tooth.
One does come off early now and then, usually thanks to something hard or sticky. Tell the practice if that happens, because the aligner has lost the grip point it was designed around.
How do you clean attachments and aligners, and what stains them?
You already take the aligners out to eat and drink, and brush or rinse before they go back in. Attachments give that rule a second reason. Their edges catch plaque the way the corner of a tile catches dust, and once the aligner goes back over the top, whatever is sitting there is held against your tooth for hours. So brush around each bump, not only across the fronts.
Remember what an attachment is made of. Composite is the same material as a white filling, and it takes up colour a little more readily than your own enamel, so coffee, tea, red wine, curry and smoking show on the bumps first. If your morning coffee is non-negotiable, and and it usually is, drink it with the aligners out, rinse, and brush when you can.
The aligners themselves want cool water, never hot, because heat warps the plastic and a warped aligner no longer matches the tooth it was made for. Clean them with a soft brush and something clear and unscented instead of toothpaste, since most toothpastes are mildly abrasive and scratch the plastic, and scratches are what turn a clear aligner cloudy. Cloudiness is what really makes people notice you are wearing them, far more than the attachments ever will.
Written out on a page it sounds like a lot of equipment. In your life it is a few small bumps you forget about, a squashy cylinder in your bag, and, if your bite needs it, a pair of elastics. Every bit of it is there to make your teeth do in real life exactly what you watched them do on the screen.
