Common Invisalign Issues and What to Do About Them

Clear aligners are designed to be the low-drama way to straighten teeth, but small hiccups still happen. A lost tray, a popped attachment, an aligner that suddenly feels too tight. The good news: almost everything that comes up between appointments is easy to handle at home, and most issues won’t slow down your treatment. Here’s your quick guide to the most common clear aligner issues, what to do about each one, and when it’s time to actually call us.

True clear aligner emergencies are rare. Most issues, even a lost tray or a missing attachment, can wait until the next business day without putting your treatment off track. Call us right away only if:

• There’s been significant trauma to the face or mouth
• Severe pain isn’t responding to over-the-counter medication
• You see swelling or signs of infection in the gums or face

Everything else? Take a breath – most aligner issues have simple, at-home fixes. Use the guide below, and call our office during business hours for anything that needs a professional touch.

1. Lost or Broken Aligners

This is perhaps the most common “emergency” call. Patients often lose trays, especially when wrapping them in napkins during meals. Trays can crack, particularly if they are removed improperly (e.g., pulling from one side only) or if the patient grinds their teeth.

Solution: Call us and revert back to the previous set of trays to prevent teeth from shifting while a new tray is ordered. Not an emergency, but something you should let us know about right away during business hours.

2. Missing or Broken Attachments

Attachments (or buttons) are small tooth-colored bumps bonded to teeth to help the aligner move them. These can fall off when taking the aligners out, or break due to biting hard foods.

Solution: While not always an emergency, this warrants a call during business hours to determine if the attachment needs immediate replacement to stay on track.

3. Aligner Not Fitting Properly (“Tracking” Issues)

The patient notices a gap between the plastic of the aligner and the edge of the tooth, often referred to as “not tracking.” This means the tooth is not moving as planned.

Solution: First, get your wear time back up to the full 20–22 hours per day. Use chewies for 5–10 minutes a few times a day to help the aligner seat fully against your teeth. Try this for 2–3 days before calling. Most tracking issues resolve on their own with consistent wear. If the gap is still there after that, give us a call so we can take a look.

4. Excessive Pain or Discomfort

While mild discomfort is normal, patients often call about:

Sharp Edges: The edge of the aligner causing sores on the gums, tongue, or inside the cheek.

Solution: Apply orthodontic wax to the rough spot, or carefully smooth the edge with a clean emery board. Wax is usually enough to get you comfortable until the issue resolves on its own.

Soreness: Some pressure is normal during the first 24–72 hours of a new tray – that’s the aligner doing its job.

Solution: Take ibuprofen or acetaminophen as directed, stick to soft foods, and use cold water rinses if it helps. Call us if the pain is intense, unrelieved by medication, or lasts longer than a few days.

5. Difficulty Removing or Putting on Trays

Patients, particularly beginners, find it hard to remove the aligners, especially when they are “sticky” due to attachments, or if the teeth have become tender.

Solution: Start at the back molars on one side, gently lift the aligner away from the teeth, and work your way forward. If your aligners feel especially stubborn, an aligner removal tool (sometimes called an “Outie”) makes a big difference and is available online for just a few dollars. Trays are always tightest in the first day or two of a new set – they’ll loosen up as your teeth move into position.

6. Issues with Elastic Hooks or Buttons

If your orthodontist is using elastics to correct the bite, the small button or hook attached to the tooth or tray may break.

Solution: Stop wearing the elastics on the affected side until we can replace the hook or button. Continue wearing your aligners as scheduled – they’ll keep your teeth on track while we get you in. Call the office during regular business hours to schedule a non-emergency repair.

Clear aligners are low-maintenance, but they aren’t no-maintenance, and now you’ve got a game plan for the bumps along the way. The biggest favor you can do yourself? Wear your trays the full 20–22 hours a day, always store them in their case (not a napkin!), and use your chewies regularly. For anything you can’t troubleshoot at home, give the office a call during regular business hours and we’ll get you in for a quick fix. We’ll see you at your next visit.