Dental crowding and spacing are fairly straightforward for orthodontic treatments like Invisalign. But if you’ve got an overbite, underbite, or other jaw misalignments, things can start to get complicated. Moving the jaw requires powerful orthodontic appliances, plus consistent oversight to make sure everything shifts as planned. Clear aligner treatment that includes in-person care can correct many bite issues, but it depends on the specific case. Here’s everything you need to know about which conditions clear aligners can handle.

What can clear aligners treat?

This can be a tricky question, because there are multiple types and brands of aligner treatment. Clear aligners that you get from a dentist or orthodontist, like Linea, can treat most dental misalignments, plus many bite issues. Their in-person oversight allows the dentist to use supplemental attachments that can improve the effectiveness of certain movements. Plus, they can incorporate interproximal reduction (IPR)—a very common and safe procedure where the dentist removes a tiny amount of enamel from between the teeth, allowing them to move easier. Studies have shown that it is very rare for patients to report pain during the IPR procedure.

Some aligners, however, deliver everything to your home, so you won’t have any in-person appointments. These “at-home aligners” can’t incorporate attachments or IPR, so they have a much more limited scope of treatment.

Here are some of the most common issues clear aligners might treat.

Dental crowding

Crowding is the most common misalignment in orthodontics. This is when a few teeth are pushed together, sometimes so much that they overlap. Most clear aligners can handle crowding, although particularly severe cases typically require an in-office brand like Invisalign or Linea—or sometimes traditional braces.

Dental spacing

Also called “teeth gaps” and “diastema,” spacing is when certain teeth are too far apart, leaving spaces in between. This often occurs between the front two teeth, but can happen anywhere in the mouth. Like crowding, spacing is typically a simple fix for clear aligners, although at-home brands might not be able to correct severe cases.

Overbite

An overbite is when your top teeth overlap the lower teeth by more than they should. Overbites can be either dental or skeletal in nature. Dental overbites stem solely from teeth misalignments, while skeletal overbites involve the jaw and are more complicated to fix. In-office clear aligners can handle most cases of overbite, while at-home ones can usually only fix mild dental ones.

Overjet

Often confused with overbite, this is another condition that involves the upper teeth extending too far over the lower ones. But unlike overbite, overjet is when the teeth protrude outward instead of downward. This is why some people call them “buck teeth.” Clear aligners can often correct overjet, but severe cases might require a more intensive treatment.

Underbite

Another common bite misalignment, around 5–10% of people have an underbite. It’s when the lower jaw protrudes outward, so the bottom teeth stick out in front of the top ones. There are also dental underbites, which are milder and don’t involve the jaw. Like overbite, clear aligners can address many cases of underbite, although at-home aligners can only treat mild dental cases.

Crossbite

This is when some of the upper teeth sit inside the lower ones, and it can occur anywhere in the mouth. Clear aligners can correct most cases of crossbite, especially purely dental ones. Cases that require jaw shifts typically need the supervision that comes with in-office clear aligners, though.

How do clear aligners work for bite issues?

Using dental impressions or intraoral scans from your dentist, aligner companies produce a series of plastic trays designed to fit your teeth perfectly. You’ll typically wear each tray for around two weeks before switching to the next one. Each tray moves the teeth just a tiny bit, until they reach the desired positions.

Sometimes, the dentist will attach tiny buttons to your teeth, which can help direct the force of your aligners, tackling more complicated issues. For purely dental bite issues, this should be all you need.

But if the issue is in your jaw alignment, treatment will likely include other attachments, like elastics. These are small rubber bands that can pull the jaw forward or back, slowly correcting a skeletal misalignment. And only certain clear aligner brands can incorporate them—like Linea, Invisalign, ClearCorrect, and other treatments that have direct dentist oversight.

Which issues can’t clear aligners fix?

Even though clear aligners can tackle a range of bite issues, no treatment is perfect. Some misalignments are simply a better fit for a non-removable treatment like braces. These issues include:

• Extreme bite issues: Clear aligners are viable for most bite issues, but some skeletal misalignments are so significant that they require surgery instead.
• Large gaps: Any gap up to 6mm should work for clear aligners, but braces might be a more ideal solution for larger ones.
• Rotated teeth: Clear aligners aren’t especially effective at making large rotations. Invisalign, for example, can rotate teeth up to 20 – 30 degrees. Anything more than that and you might need a different treatment.
• Raised or lowered teeth: With attachments, clear aligners can put upward and downward force on your teeth, but significantly raising or lowering teeth is still a challenge.
• Small or misshapen teeth: Clear aligners might not be able to adequately fit and grip these teeth, so the dentist might recommend a crown instead.
• Permanent dental work: Technically, clear aligners can work with dental implants, bridges, crowns, and veneers. But these immovable implements might make dental shifts more complicated.

Will clear aligners work for me?

If you have one of the conditions we’ve listed as treatable in this guide, you’re likely a good candidate for Linea or other clear aligners. The best way to find out for sure? Go to a dentist or orthodontist. First of all, they have to make sure your teeth are healthy enough for clear aligner treatment, since unaddressed decay and disease might cause issues during treatment. Then, they’ll examine your misalignments and determine the best course of treatment.