How does wisdom teeth affect treatment planning for Invisalign?

Doctor's Answers (1)

Dr Jaclyn Toh

"Dentist with an interest in comprehensive dentistry."

Usually wisdom teeth are not aligned during Invisalign unless the teeth are fully erupted an in function (you are using it to chew).

I do not routinely ask my patients to remove their wisdom teeth prior to Invisalign as we do not usually require the space that the wisdom teeth occupy for alignment.

In certain specific cases, the upper wisdom teeth may need to be removed to allow distalization (where all the teeth are moved backwards in the arch) as part of a camouflage treatment.

Where the wisdom teeth are impacted (growing crooked) and causing pockets for food trapping, I would advise removal of the wisdom teeth to allow for good hygiene. Food trapping increases the chances for infections in the area and decay to affect the adjacent teeth.

If you do proceed with Invisalign without first removing partially-erupted impacted wisdom teeth, having the aligners in your mouth for long stretches of time (22 hours daily)  increases the chances of food collecting around the wisdom teeth.

This means that some patients get flares of gum infections around the wisdom teeth (pericoronitis) while on Invisalign. The swollen gum may make it impossible for you to wear the aligners and this will compromise your treatment.

Ultimately, the decision to extract the wisdom teeth prior to Invisalign will depend on the case and the position of the wisdom teeth. In certain cases, we may even want to preserve the wisdom teeth instead of removing them.