Invisalign aligners can be used by a skilled orthodontist to address a variety of jaw alignment issues. 

Invisalign aligners can be used by a specialist in orthodontics (orthodontist) to address teeth and jaw alignment in a variety of situations.  These include:

• Elimination of Tooth Interferences:  Tooth interferences, should they be the cause of improper jaw alignment, can be addressed with aligners when treatment has been properly planned and executed, thus eliminating the alignment issue.
• Aesthetic Camouflage:   In some cases, aligners may be employed to aesthetically camouflage imbalanced jaw alignment when the tooth movements necessary are physiologically possible and will result in a stable bite/occlusion. 
• Imbalances Requiring Surgical Intervention:  Aligners may be employed by the orthodontist to place the teeth in the proper position preceding surgical intervention during which the skeletal jaw alignment is addressed.  The orthodontist coordinates this treatment with an oral surgeon who adjusts the jaw position or positions, if upper and lower, to match the bite setup provided by the orthodontist.  To diagnose and treat surgical cases successfully, the orthodontist must be able to anticipate the changes that will occur to the face post-surgically and correctly visualize the positions in which the teeth will need to be in order for the surgery to successfully result in a balanced facial result.   The experience and skill of the orthodontist is highly relevant to success.

Although it would be tempting to think that treatment with Invisalign aligners can in and of itself address structural imbalances of the face, the truth is that Invisalign, i.e., the Invisalign brand of clear aligners, is not a treatment modality but a tool in the hands of an experienced orthodontist.  This is the most misunderstood fact about orthodontic treatment. 

Pro Tip: The scanning and software associated with the Invisalign brand of aligners is highly limited and incapable of assessing anything other than the positions of the teeth; no structural or soft tissue information, including jaw misalignment, is recorded.  The rudimentary treatment plan created by the Invisalign software is not biologically sufficient except in rare cases requiring minimal movement, but such cases are neither discernible by the software nor by general dentists.  What appears simple is most often complex.  Orthodontists (specialists in orthodontics) never employ an automated Invisalign treatment plan for this reason. 

Can Invisalign Clear Aligners Fix an Underbite?

Structural imbalances of the face, including underbite (underjet) and other jaw imbalances, must be assessed using photographic X-rays and evaluated by an orthodontist during a comprehensive examination. The orthodontist will determine the impact of structural imbalances upon the bite, smile, and face. He or she will also assess the likely effect on the bite, smile, and face of treatment options, including surgical changes to the jaws and/or the movement of teeth to accommodate the imbalance. 

An orthodontist can assess what should and should not be attempted and the correct way to either achieve or approach the goal of the patient given biological limitations. 

The use of Invisalign clear aligners may or may not be indicated in the treatment of an underbite or other jaw misalignments or asymmetries, but in many cases, Invisalign aligners can play a role in such treatment.

How Orthodontists Use Invisalign Aligners to Treat Jaw Alignment Issues

To properly diagnose and treatment plan, orthodontists conduct a comprehensive visual, physical, and photographic examination of the head, face, and teeth, taking into consideration familial facial forms, age with associated growth patterns, soft tissues, and the underlying structural relationships of the facial bones, in order to determine the best course of treatment for each individual.  This level of detailed assessment is vital to correct diagnosis and treatment planning for all cases, especially when the patient wishes to correct a misaligned or asymmetrical jaw, including underbites (underjets) and overjets (when the lower jaw is recessed and a substantial horizontal gap exists between the upper and lower central incisors, i.e., front teeth). 

When using Invisalign aligners to address jaw alignment or otherwise, orthodontists control the patient’s treatment in fine detail by utilizing the dashboard of the Invisalign software to specify each aligner and related attachments to create the correct vector of forces to conform to the correctly diagnosed and sequenced treatment for that individual’s face, smile, and bite. The goal is a stable occlusion with the proper relationships between the teeth that not only improve appearance but also prevent tooth wear, chipping, and loss throughout life. 

Orthodontic treatment may be combined with surgical intervention, as described above, when the jaw misalignment is such that tooth movement alone cannot result in a stable and pleasing bite and smile.

Does Invisalign Move Your Jaw? 

Invisalign aligners act on the teeth only.  They do so by exerting force in the directions specified by the orthodontist and often by grabbing small attachments placed on the teeth by the orthodontist for that purpose.  In some cases, the movement of teeth can eliminate interferences in the bite that are preventing the jaws from aligning properly.  The aligners, however, which function as intraoral tools/appliances for use by the orthodontist, do not affect the jaws directly.  Aligners may be employed by the orthodontist when treating misalignments, however, including overjets and underjets, as noted above.

Conclusion

While Invisalign aligners can be utilized as part of the orthodontist’s treatment plan to address jaw alignment, underbites, and overjets, they do not directly act on the jaws themselves.  Orthodontists, who are specialists in the field of orthodontics, perform comprehensive examinations that go beyond the teeth to include the bone structure and soft tissue of the face, the familial facial form, and the anticipated growth and change of the face and head throughout life in order to properly diagnose and treatment plan for the most stable and pleasing outcome for each patient’s unique bite, smile, and face.  The manner of addressing misaligned jaws will depend upon the structural cause of the misalignment and the necessary actions to achieve or approach the patient’s goals given biological limitations.  Coordination with an oral surgeon is not unusual and requires the orthodontist to be highly skilled in diagnosis, treatment planning, and execution, all of which dictate the surgical procedure and ultimate effect upon the patient’s face and appearance. 

Orthodontic Examinations

Orthodontic examinations are typically free of charge, therefore, if you or your child are experiencing jaw misalignment, underbite (underjet), or overjet, I recommend seeking an examination with more than one orthodontist in your area.  During your or your child’s appointment, you should expect a thorough visual, physical, photographic, and, if acceptable, low-dose radiographic examination of the teeth, face, and head followed by preliminary treatment recommendations, including the appropriate appliances, whether Invisalign aligners, braces, or, an option in my practice, the invisible, behind-the-teeth Brava device, and the advisability of surgical intervention.  The appliance recommendation will depend upon the movements that must be accomplished and the related strengths and weaknesses of each appliance at the orthodontist’s disposal.  Surgical intervention will be recommended if the alignment issue is primarily skeletal and cannot be addressed with tooth movements alone. 

If you reside in the Seattle area and would like to seek an examination in my office, use the buttons below to contact my practice or access the online scheduler.  I would be happy to provide a comprehensive examination and preliminary diagnosis to assist you in assessing your options.