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What to Expect When Starting your Invisalign or Clear Aligner Treatment

What to Expect When Starting your Invisalign or Clear Aligner Treatment

Congratulations on beginning this journey towards your new smile! As a dental assistant, I noticed that a lot of patients found it helpful to have a bit more explanation of what’s on their teeth and what to expect in the first few days of treatment. 

What are attachments?

Attachments are tiny tooth-colored “bumps”, aka buttons that are bonded to the teeth using dental composites. Dentists place them on specific teeth to help direct the force of your clear aligner more effectively and predictably in the prescribed direction. 

With newly placed attachments or buttons, I’ve noticed patients often struggle with tooth sensitivity and soreness, and also aligner placement and removal, especially in the early stages of your orthodontic treatment plan. Here are some tips to help make your clear aligner experience better. 


When you’re moving teeth, especially for more elaborate complex cases or moderate-severely misaligned teeth, your teeth will be sore. This soreness can feel more intense on teeth with buttons or attachments since they directly connect with the aligner trays. However, there are ways to help reduce tooth soreness and sensitivity. One thing I always recommended to patients was wait to use an electric toothbrush until you are on your second or third tray. Even at their lowest setting, many find the vibrations to be very intense, so waiting until you are further along in your treatment (and the programmed teeth movements are less extreme) gives your teeth and gums time to acclimate movement and better tolerate the additional vibration from an electric toothbrush. 


Soreness is to be expected with every first 1-3 days of each new aligner tray. In general you can expect more soreness from your initial aligners because your teeth are still getting  used to the idea of them moving into new places for your new smile. 

Dentists provide chewies or the PUL System, a 2 in 1 aligner chewie & removal tool. (Alternatively, I’ve heard of other offices that provide suction tips). These tools can reduce soreness by getting the blood flowing around the periodontal ligaments around the root of each tooth while they’re moving. They also provide leverage to push the aligner trays into place. They work more effectively if you use them for 3-5 minutes every time you put your clear aligners back in.

I do want to acknowledge that the pain, sensitivity, and soreness from clear aligner treatment tends to be more unsettling and disconcerting for adults than it is for younger generations. The way I think of it is the older you are, the further away time (and memory) you are from the experience of your teeth moving around, and the longer your mouth and teeth are accustomed to their starting position before beginning treatment, and. For this reason, investing in something like the PUL system might make more sense, just to help ease some of that discomfort during your treatment time. 

Of course, if the problem persists, I would recommend alerting your own practitioners about the sensitivity issue and getting personalized support. 

Safe Aligner Removal and Choosing the Right Tool

Thoughts on Aligner Removal

We now know attachments are what allow the aligner trays to move your teeth, but that means they, by design, make removing your aliger difficult. Patients have found an aligner remover tool really helpful, especially during the early stages of each clear aligner tray. It’s critical as well that if you are using a seating or removal tool (or both with the PUL system) you use them in the areas where attachments are placed, not only to make the process as pleasant as possible, but also for the preservation of your clear aligner trays. 

You’ll find that as you near the end of your treatment time with that aligner, it’ll be a lot easier to remove (because your teeth have moved into their programmed place), so an aligner removal tool isn’t as necessary, but is definitely still helpful, efficient, and more hygienic.

Choosing the right aligner removal tool for you

There are definitely several options for aligner removal tools, and I’ve even heard of some DIY tools like a golf tee, crochet hook, or even just using fingers. However, the complaints of these makeshift options include, respectively, their lack of grip, aligner tray damage, inconvenient transport, lack of discreteness for public use, and hygienic questionability. I recommend using our original clear aligner removal tool, the PULTOOL, which I specifically developed because I saw how difficult it was for our patients to track with their dental treatment and safely remove their aligners. 

If you are doubting whether or not an aligner removal tool is worth the investment, I will say the prolific number of knock-offs of our PULTOOL speaks for itself. Of course, we hope you go with the PUL system, but whichever you choose, I’ll just be glad that you have a tool to help you along your own Invisalign / clear aligner journey. 

Happy PULing!

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