Nighttime Aligners: Everything You Need to Know

Nighttime aligners are customized clear trays that fit over the teeth and are worn only at night to correct tooth and bite alignment problems. Like regular clear aligners, they are removable and use gentle continuous pressure to move teeth into their optimal positions.

Like regular aligners, night aligners are worn in a progressive series. Each tray will be worn for about two weeks before moving to the next one. After the last tray, the bite is corrected.

While they work, standard aligners worn for 22 hours daily will generally give faster and more effective results. Night-only aligners work best for mild correction issues.

Keep reading to learn more about how aligners work.

Traditional vs. nighttime aligners

Choose nighttime aligners, and you'll wear your trays for at least 10 consecutive hours, most passing while you're asleep. Opt for traditional aligners, and you'll wear them at least 22 hours a day, taking them out only to eat, drink, or clean your teeth.

Cost

Aligners are significantly less expensive than traditional braces. You'll spend less on costly materials (like glue and metal brackets), and you'll have fewer (or no) in-person visits that require expensive office space. But if you choose nighttime aligners, you'll pay more. 

A typical traditional aligner treatment plan costs $1,200 to $2,000. Nighttime aligners typically cost $2,000 or more. 

Nighttime aligners require longer treatment times. A traditional treatment plan is done in about 6 months, compared to a 10-month nighttime treatment plan. That extended time in care will cost you more. 

Wear time

The recommended wear protocol for standard teeth straightening aligners is at least 22 hours daily. You should replace each set of custom aligners every one to two weeks.

Night-only aligners are for wearing at night, and you have them in for at least 10 consecutive hours. Less wear time overall may work better for you if you find 22 hours of aligner wear too disruptive.

Length of treatment

Aligners work by applying gentle pressure to your teeth. The longer you wear them every day, the quicker they work. 

A traditional aligner treatment plan lasts for about 6 months. Nighttime aligners require 10 months. Since you wear them for fewer hours each day, your time in treatment is extended. 

Treatable conditions 

Traditional aligners push on your teeth for 22 hours per day, and they can address mild, moderate, and even some severe issues. Whether your smile is simply crooked or deeply dysfunctional, aligners could be a good option.

Nighttime aligners press your teeth for less than 50% of your day. While they’re effective, they’re made for mild smile problems. Slightly crooked or displaced teeth can be addressed with nighttime aligners, but significant issues need more help than these trays can provide.

Do night aligners actually work?

Any type of teeth straightening therapy works best if used virtually full-time. While night-only aligners work, they are less effective than traditional aligners.

Compression and tension cause your teeth to shift when you wear aligners. They’re responsible for alternating bone loss and formation during treatment. In one study, whole-day aligner users experienced 50% faster tooth movement than night-only users. 

Part-time aligners can work for some patients with mild issues, but treatment takes longer.

Benefits of nighttime aligners

Nighttime aligners come with plenty of advantages, and they can be a great option for people who want to try something a little different to improve their smile.

Known benefits of nighttime aligners include the following:

• Privacy: Your coworkers, family members, and neighbors will never know you're improving your smile. 
• Accessibility: No need to take out your aligners while you drink your morning coffee or eat your lunchtime sandwich. Since you only wear them at night, you're not required to adjust your eating and drinking routines. 
• Conversation: Traditional aligners can make talking a little tough, and the added friction can make you leery of public speaking. Nighttime aligners will only interfere if you talk in your sleep. 
• Time: You'll wear your aligners for fewer hours daily.

Risks of nighttime aligners

While the benefits of night aligners are appealing, risks exist. These include the following:

• They may be less effective. No studies published in peer-reviewed journals recommend a 10-hour-a-day clear aligner therapy (CAT) over the 22-hour treatment. 
• Less wear time may expose you to orthodontic relapse, in which the lack of optimal, continuous orthodontic pressure causes your teeth to move back to their pre-correction positions.
• Some people may be unaware that they grind their teeth at night, damaging aligners or irritating gums.

How to wear nighttime aligners to see proper results

Nighttime aligners are medical appliances that work best when used as directed by medical professionals. Here's how to use them:

1. Take impressions of your teeth at home and mail those to your nighttime aligner provider. A team of orthodontists will formulate custom aligners based on your dental impressions.
2. You may receive your custom-fit aligner trays in four to six weeks. Your orthodontic treatment can begin right away.
3. Wear your night-only aligners for at least 10 straight hours each day.
4. Wear each aligner for a week or two, with every subsequent aligner set shifting your teeth further. 
5. Unless you experience dental complications during treatment, you should achieve the smile you’ve always wanted in about 10 months.

Are nighttime aligners right for me?

You can get the smile you always wanted with nighttime aligners. These convenient, private treatment trays could be right for people with the following characteristics:

• Mild issues: Nighttime aligners work best for people with problems like slightly crooked or overlapping teeth. 
• Need for privacy: Some people don't want to wear aligners while they work or spend time with friends. 
• Poor compliance: If you know you won't put your aligners back in when you take them out to eat, nighttime aligners might be a better choice.

References

Living with Invisalign: Orthodontic Treatment Amidst the Pandemic. (2021). Annals and Essences of Dentistry.

Biological Mechanisms in Orthodontic Tooth Movement. (2015). Esthetics and Biomechanics in Orthodontics (Second Edition).

Orthodontic Treatment with Clear Aligners and The Scientific Reality Behind Their Marketing: A Literature Review. (December 2019). Turkish Journal of Orthodontics.

Aligners: The Science of Clear Orthodontics. (June 2020). International Journal of Dental and Medical Specialty. 

Clinical Performances and Biological Features of Clear Aligners Materials in Orthodontics. (February 2022). Frontiers in Materials.