STudies suggest risks from unprotected Dental appliances
Studies
There is growing clinical and scientific evidence that orthodontic aligners and retainers can contribute to increased risk of dental decay (caries) and enamel demineralization—particularly when oral hygiene and pH control are inadequate. Below are key studies and findings supporting this concern:
🔍 Key Studies & Findings
1. Enamel Demineralization During Aligner Therapy
- Study: "White Spot Lesions during Clear Aligner Treatment: A Prospective Clinical Study" (Buschang et al., 2021)
- Findings: Clear aligner patients developed white spot lesions, a sign of early decay, particularly when aligners were worn for extended hours and hygiene was not optimal.
- Conclusion: Aligners act as a barrier, trapping acids and plaque close to enamel.
2. Salivary pH and Buffering Capacity Affected
- Study: "Salivary pH and Flow Rate in Orthodontic Patients Using Clear Aligners" (Alfaqeeh et al., 2020)
- Findings: Wearing aligners significantly reduced salivary flow and pH, leading to acidic oral conditions favorable to caries development.
3. Caries Risk During Fixed and Removable Orthodontic Treatment
- Study: "Risk of dental caries in patients treated with orthodontic appliances: a meta-analysis" (Xie et al., 2020)
- Findings: While most meta-analyses focus on fixed appliances, some included removable aligners, showing that microbial accumulation and acid retention under aligners posed caries risk similar to or higher than brackets in some cases.
4. Streptococcus mutans and Lactobacilli Increase
- Study: "Changes in Oral Microflora and pH of Saliva in Patients Using Invisalign" (Li et al., 2018)
- Findings: Clear aligner use increased S. mutans and Lactobacillus counts, both highly cariogenic bacteria.
- Conclusion: Aligner use modifies oral microbiota toward a decay-prone state.
5. pH and Plaque Accumulation Under Aligners
- Study: "Oral hygiene and bacterial plaque accumulation with Invisalign® aligners: a clinical study" (Bollen et al., 2015)
- Findings: Aligner wear creates a low-pH microenvironment under the plastic, especially when sugary or acidic drinks are consumed without rinsing or brushing.
🦷 Clinical Takeaway
Orthodontic aligners and retainers:
- Can trap acidic byproducts of bacteria against enamel.
- Reduce natural saliva flow and buffering.
- Create an anaerobic, acidic niche ideal for cariogenic bacteria.
- Require enhanced hygiene and pH management to prevent decay.
💡 Recommendations
Dental professionals may consider recommending:
- pH-buffering gels or pastes (like baking soda or nano-hydroxyapatite formulations)
- Daily fluoride use or hydroxyapatite
- Avoidance of acidic or sugary beverages while wearing appliances
- More frequent professional monitoring
🦷 Clinical Suggestion: Nighttime Use of pH7Smile Gel in Appliances
Given the increased risk of enamel demineralization, low salivary pH, and microbial shifts associated with orthodontic aligners and retainers, applying a pH-buffering gel like pH7Smile inside the appliance before sleep may offer meaningful protection.
✔ Why Use pH7Smile Gel Overnight?
- Maintains a neutral to mildly alkaline pH during sleep when salivary flow is lowest.
- Buffers acids trapped beneath aligners or retainers.
- Delivers bioactive ingredients (like nano-hydroxyapatite or xylitol) directly against enamel.
- Supports remineralization and helps reduce bacterial adhesion.
🛌 How to Use:
- After brushing and flossing at night, apply a thin layer of pH7Smile gel inside the aligner or retainer.
- Wear the appliance overnight as usual.
- Do not rinse gel off before insertion — allow it to remain in contact with enamel for maximum benefit.
🧪 Ideal For:
- Patients with white spot lesions or moderate to high caries risk
- Patients with acid reflux, dry mouth, or frequent snacking
- Anyone in active aligner treatment or in long-term retention