Wearing Smile Happy Clear Aligners with Cavities

There are a variety of benefits to choosing Clear aligners as a method to straighten your teeth, including a shorter treatment period and the ability to remove trays for meals and beverages. In addition, the process is often less costly and more affordable than other treatments.

However, you still have to be incredibly mindful of cavities (also called dental caries) before, during, and after the alignment process. Wearing Clear aligners doesn’t mean that decay, erosion, and enamel damage don’t happen. In fact, wearing the aligners is only beneficial if you maintain a high level of dental hygiene throughout the process.

Here are a few things you need to know about cavities and Clear aligners treatment.

Can I Still Get Clear aligners If I Have a Cavity?

One common question we hear from patients is whether they can still get Clear aligners treatment if they already have an existing cavity. In theory the answer is yes, but in practice the answer is no. Dentists strongly recommend treating the cavity with a filling before being fitted for your aligners

In most cases, the cavity itself is a much more serious issue that takes higher priority over misalignment. Having the cavity fixed prior to Clear aligners treatment is always a better option, as it is impossible for the cavity to heal itself while using the trays.

Furthermore, having a filling during the Clear aligners process is a recipe for disaster. Treating a cavity with a filling can change the shape of the tooth. In turn, this usually requires a whole new set of aligners, which adds extra cost and causes time delays. For most patients, this is an unnecessary frustration that can be rectified by having the cavity treated at the very beginning.

So, while it is possible to start Clear aligners treatment if you have a cavity, it isn’t a good idea. Instead, work with your dentist to have the cavity dealt with first and then start the conversation about adding aligners to your treatment plan.

What If a Cavity Develops During Clear aligners Treatment?

Developing a cavity during Clear aligners treatment is a real possibility for many people.

Just as it is important to have any cavities treated prior to using the aligners, it is also vital to have any new ones handled as soon as they are noticed. Your dentist will bring the issue to your attention and help you come up with an action plan that takes your Clear aligners treatment into consideration. From there, it will be decided whether you should have the cavity filled or seek other options.

In many cases, a trained dentist can possibly recreate the size and shape of the tooth by using the aligner to shape the filling. This eliminates the need to have new aligners made. Other instances may be minor enough that the dentist opts to just monitor the cavity and stresses the importance of proper hygiene to the patient. In this scenario, the hope is that the cavity doesn’t worsen during the remaining time period of Clear aligners treatment.

Does Clear aligners Cause Cavities?

There are plenty of anecdotal stories out there where patients claim Clear aligners caused their cavity woes. The simple backstory is that the aligners themselves didn’t cause the problem—the wearers did.

If this sounds a little harsh, it is important to look at how the aligners work. Clear aligners braces sit tightly against the teeth when they are appropriately in position. In turn, this easily traps food particles beneath the aligners, making them an easy snack for decay-causing bacteria. Since the aligners are worn for most of the day, damage to the tooth and various forms of decay can happen while they are in use.

Essentially, this means that the patient has to exercise exceptional dental hygiene all the time. Remembering to brush, floss, and appropriately clean aligners is the only way to keep the potential for cavities from happening while undergoing Clear aligners treatment. This must happen each and every single time you eat, as bacteria thrive on small particles of food.

Another way to keep this from happening? Reduce your intake of candies, popcorn, and sodas before and while wearing the aligners. Also try to keep sugar consumption as a whole down during the process including things like sweetened iced coffees, juices, teas, or hidden sugars such as condiments and sauces.

One argument with more merit is that Clear aligners prevent contact between the teeth and saliva. And, as you probably already know, the main job of saliva is to typically combat harmful bacteria that cause decay and enamel damage. However, this can be overcome by increasing your intake of water throughout the day. This makes up for the reduced contact between saliva and teeth while wearing the aligners. It also helps rinse the mouth and remove any additional particles of food left behind after meals.

What we’ve learned from our own Clear aligners treatments is that patients are less prone to cavities, both during treatment and in the long term. Clear aligners wearers are necessarily mindful with their eating and dental habits during treatment and carry this knowledge and experience with them post-treatment.

Clear aligners vs. Other Brace Types

Clear aligners aligner trays are frequently preferred to metal or ceramic braces. Not only are they custom-designed to the patient’s teeth, but they are also nearly invisible when worn. There are fewer overall appointments with the dentist and the overall treatment often takes much less time.

That said, dental hygiene is an absolute must with these aligners. Traditional braces do allow more saliva to be in contact with the surface of the teeth although, as they are not removable, they make brushing and flossing more complicated, no matter how strict a wearer is with their cleaning routine.

When it comes to looking at the difference between traditional braces and Clear aligners treatment, there are correlations and risks with both. However, most people find the comfort and look of the clear aligners to be preferred—even if it means having to take extra precautions to prevent cavities and other damage.


In short, taking care of an active cavity is always more important than undergoing Clear aligners treatment. Trapped food particles and bacteria beneath the aligners could cause an existing cavity to worsen or new ones to appear. However, proper dental hygiene and a strict regimen of brushing, flossing, and rinsing after eating can help keep cavities from occurring.

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