How Should Aligners Fit? A Practical Aligner Tracking Guide (+ Tutorial)

Written by Dr. Febin Mary George, BDS | Medically Reviewed by Dr. Shaista Salam, BDS, Dr. Zein El Hammouz, DDS, MFD/RCSI

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As you are all set to kick off your journey to a more beautiful you through clear aligners, your mind would be already boggled with doubts like “How should aligners fit?”, “Should there be a gap between the aligner and teeth or “What should be done when aligners are not fitting?”. If this sounds like you, we have got you covered as this article will explain how are aligners supposed to fit and what you should do if they don’t fit the way they should.

What is tracking in clear aligners?

Clear aligners can offer one of the best smile makeovers if worn as instructed. To make sure that the treatment is progressing in the right direction, you should ensure that the aligners are tracking well.

Tracking refers to how well your teeth movements are following the treatment plan, clinically seen as how well your aligners fit or not fit on your teeth. It is the difference between the planned teeth alignment vs the real one. Aligner tracking can be perfect, good, or bad.

Perfect tracking is when the aligners fit perfectly over the teeth without any gap between the aligners and the teeth.
Good tracking is when the aligners have a very mild discrepancy in the fit. In this case, the tooth movements are occurring as planned, and there is no need to make any major changes to the treatment plan.
Bad tracking is when the aligners are clearly not seated properly. This means that the teeth are not moving as planned, and the treatment plan will have to be adjusted mid-course.

How do I know if my aligners fit properly? (Easy Tutorial)

It should fit snugly when you wear it.

A snug fit indicates properly adapted clear aligners. Only accurately fitting aligners can ensure adequate tooth movement in the desired path. Don’t worry if the aligners feel a bit tight initially, they will fit better and become more comfortable as the teeth move over time.

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A girl tests the good tracking of her clear aligners

It should not be overextended or sharp in the gums area

Gingival coverage plays an important role in the enhancement of aligner retention on the tooth surface. (1) That’s why you may find your aligners covering the teeth from the biting surface to the gum line. However, the aligners should not be overextended or sharp on the gums. In the end, the cutline depends on the manufacturer’s/provider’s preference.

There should be no gap between the incisal edges of the teeth and the corresponding portion of the clear aligners.

A clear gap between the aligners and the incisal edges indicates bad tracking. Minor adjustments may be needed to address the issues related to tracking.

What is poor tracking in aligners?

A common question that arises is "What does it look like when clear aligners are not tracking?"

If your aligners are not tracking well, the common signs that you would notice are

The aligners don't fit back teeth or any other teeth
There will be a significant gap between the aligners and the teeth.

A girl smiles while showing her clear aligners that fit perfectly

What causes clear aligners poor tracking?

1. Non-compliance with the treatment plan

Compliance with the treatment plan is one of the key factors that determine how should aligners fit. You should wear your aligners at least 22 hours a day to ensure that your treatment is progressing as expected.(2) Show up for every follow-up visit that has been scheduled by your dentist. This helps the doctor learn the progress of your teeth movement. When you discontinue wearing your aligners, they would not fit you anymore. That is the last thing you wish to have in your journey to a beautiful, straight smile!

2. Tight contact between teeth

It is imperative to have some space between the teeth to facilitate proper movement. When teeth are overlapping with each other or have tight contacts, there is an obstruction in teeth movement. To relieve the contacts your doctor will perform interproximal reduction or IPR. This procedure will create adequate room for the teeth to move into their new positions.

3. Problems with attachments

Sometimes, you may find your aligners not fitting well around attachments. In this case, you can go back to the best fitting aligner step and continue wearing it till your next appointment. Your doctor may replace the troubling attachment with another one.

If some attachments are fractured or have debonded, your doctor will take a decision to replace it or not, depending on whether they are active or passive attachments

4. Habits like eating with aligners, and not storing them properly

You should remove your aligners and store them in a hygienic way before you eat. If you are in a habit of chewing food with your aligners on, you may cause warping or distortion of the aligners, thereby, causing an improper fit.

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A girl shows the good tracking of her clear aligners

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5. Pool Oral hygiene

Calculus build-up from inefficient brushing and flossing can prevent the aligners from fitting peroperly. Moreover, it can cause hindrance in teeth movements. Therefore, healthy dentition through good hygiene practices and regular dental checkups are important.

6. Restorative and Prosthetic dental work

If you have any crowns or fillings to be placed, you should delay for after your orthodontic treatment is complete. Since new crowns and filling will not be accounted for in the treatment plant, they can lead to ill-fitting aligners and loss of tracking.

Make sure to inform your doctor if you get any dental work done. Your doctor will have to take new impressions or scans, and perform a mid-course adjustment.

7. Chipped or fractured teeth

Aligners will not fit snugly around a chapped or fractured tooth, hence there will be loss of tracking.

How do I make my aligners fit better? Solutions for tracking issues

Chewing exercises using chewies

To improve poor clear aligners tracking, you can perform chewing exercises with the help of chewies. When you bite gently on chewies, you help the aligners seat properly through the application of suitable pressure.

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Wear the aligners for the recommended time

The recommended wear time of aligners is at least 22 hours a day. (2) When you wear your aligners as directed by your doctor you will gradually learn how should aligners fit. Hence, you will never miss any tracking-related issues like gaps in aligners.

Extend the wear cycle to 2 weeks instead of 1

If your teeth are not tracking, the wear cycle of the aligners can be extended from one to two weeks. Make sure to consult your dentist before making any such changes.

Regular follow-ups with the doctor

Routine checkups help the doctor evaluate the progress of the treatment. Therefore, you should never miss your follow-up appointments. These sessions give you the opportunity to bring up any issues related to fit or comfort that have been bothering you.

Go back to the previous aligner step

Minor poor tracking can be dealt with by switching back to a previous step. You should switch back only if you have received approval after discussing it with your doctor.

On the other hand, if the tracking is extremely poor, you may need a mid course adjustment.

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FAQS

1. Do you have to wear aligners all day?

Clear aligners need to be worn every day for a minimum of 22 hours to achieve the desired outcomes.

2. Is it normal to have a small gap between the aligner and the bottom of one of my teeth?

A small gap between the aligner and your teeth indicates that your teeth are tracking. So, you should continue wearing the aligners as planned. Your doctor might ask you to extend its wear cycle and closely monitor the case to ensure it is tracking. You can also use chewies to improve the fit of your aligners,

3. How tight should aligners fit?

You may feel an initial pressure or tight fit when you begin using your aligners. This pressure decreases over time as your teeth move into their required positions.

4. Are my aligners supposed to be loose?

Aligners should be in close contact with your teeth so they can apply the required amount of pressure and facilitate tooth movement. You may find your aligners getting loose toward the end of the wear cycle. The reason for this change is that your teeth have achieved the intended movement. That being said, aligners that are loose from the first day of the wear cycle need to be informed to your doctor.

5. Are clear aligners supposed to hurt?

No, aligners are not supposed to hurt. Initially, you may experience some pressure on your teeth hurt as the aligners exert force to bring about the necessary tooth movement. However, if you feel pain in your gums or when wearing your aligners, be sure to inform your doctor, and they will make the required adjustments.

6. Should the aligners touch the gums?

It is not necessary for the aligners to touch the gums. This is a preference that you and your doctor can request from the manufacturer, depending on your requirements. The most common gum margin designs used are (3)-

Scalloped
Straight cut at gingival zenith (gum margin)
Straight cut 2mm above the gingival zenith (gum margin)

7. Can I clench my teeth with aligners?

Aligners can be quite beneficial for those with bruxism (teeth clenching habit) as these can act as habit-breakers or nightguards. When teeth are aligned, the interferences are removed, and the bite is improved.

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References