Can Invisalign Bring Teeth Down? Complete Guide to Tooth Movement with Clear Aligners
If you’re wondering “can Invisalign bring teeth down,” the answer depends on what you mean by “down.” This common question can refer to two different types of tooth movement, and understanding the distinction is crucial for setting proper expectations about your treatment.
When patients ask about bringing teeth down, they might mean:
- Making teeth appear longer or lower in the smile line (extrusion movement)
- Making teeth appear shorter or higher in the smile line (intrusion movement)
The good news is that Invisalign can achieve both types of movement, though with varying degrees of success and predictability. This comprehensive guide will explore how Invisalign can bring teeth down in both senses, helping you understand what’s possible for your specific situation.
Understanding “Bringing Teeth Down”: Two Different Movements
Extrusion: Moving Teeth Outward (Appearing Longer/Lower)
Extrusion means moving teeth out of the jawbone, away from the root tip. This movement:
- Makes teeth appear longer in your smile
- Brings teeth down toward the biting edge
- Can lower the position of teeth in your smile line
- Helps teeth that appear too short or uneven
Intrusion: Moving Teeth Inward (Appearing Shorter/Higher)
Intrusion means moving teeth deeper into the jawbone, toward the root tip. This movement:
- Makes teeth appear shorter in your smile
- Brings teeth up away from the biting edge
- Can raise the position of teeth in your smile line
- Helps teeth that appear too long or create a gummy smile
Can Invisalign Bring Teeth Down Through Extrusion?
Yes, Invisalign is highly effective at extruding teeth (making them appear longer/lower). Extrusion is actually one of Invisalign’s most predictable and successful movements.
Why Extrusion Works Well with Invisalign
Biological advantage: Moving teeth out of bone works with natural eruption patterns, making it more predictable than intrusion.
Mechanical efficiency: Clear aligners can effectively grip and pull teeth in the extrusion direction using attachments and precise aligner geometry.
Success rates: Studies show Invisalign achieves 85-95% of planned extrusion movements, making it one of the most reliable tooth movements with clear aligners.
Common Reasons for Extruding Teeth
Patients seek extrusion treatment to:
- Lengthen short teeth: Making teeth appear more proportional
- Level uneven teeth: Creating a uniform smile line
- Correct deep bites: Bringing lower teeth down to proper contact
- Address impacted teeth: Helping teeth that haven’t fully erupted
- Fix worn teeth: Restoring length lost to grinding or wear
- Improve aesthetics: Creating better tooth-to-gum ratios
Invisalign Extrusion Capabilities
Amount of movement: Invisalign can typically achieve 3-5mm of extrusion, sometimes more in favorable cases.
Predictability: Extrusion is highly predictable with success rates of 85-95% for planned movements.
Speed: Extrusion occurs relatively quickly, often faster than other movements.
Tooth types: All teeth can be extruded, though anterior teeth (front teeth) show the most predictable results.
Can Invisalign Bring Teeth Down Through Intrusion?
Yes, but with more limitations. Invisalign can intrude teeth (make them appear shorter/higher), though not as predictably as extrusion.
Intrusion Challenges with Invisalign
Biological resistance: Moving teeth into bone works against natural eruption tendencies.
Force requirements: Intrusion requires precise, light forces that are challenging to achieve with removable aligners.
Success rates: Studies show Invisalign achieves approximately 65-75% of planned intrusion movements.
When Intrusion is Needed
Patients seek intrusion treatment for:
- Gummy smiles: Reducing excessive gum display
- Over-erupted teeth: Teeth that appear too long
- Deep overbites: Moving lower front teeth up/back
- Uneven gum lines: Creating symmetrical gum heights
- Bite correction: Improving functional relationships
Invisalign Intrusion Limitations
Amount of movement: Typically limited to 2-3mm of intrusion.
Predictability: Less predictable than extrusion, with 65-75% success rates.
Relapse tendency: Intruded teeth tend to relapse more than extruded teeth.
Retention requirements: Longer, more intensive retention needed.
Factors Affecting Invisalign’s Success in Bringing Teeth Down
Patient-Related Factors
Age: Younger patients typically respond better to both extrusion and intrusion movements due to higher bone remodeling capacity.
Bone density: Affects how quickly and predictably teeth move in either direction.
Root anatomy: Longer, well-formed roots generally move more predictably than short or malformed roots.
Periodontal health: Healthy gums and supporting structures are essential for safe tooth movement.
Compliance: 20-22 hours daily wear is crucial for achieving planned movements.
Case-Related Factors
Amount of movement needed: Smaller movements are more predictable than extensive changes.
Direction of movement: Pure extrusion or intrusion is more predictable than combined movements.
Tooth type: Front teeth generally move more predictably than back teeth.
Existing bite relationship: Complex bite issues may limit movement options.
Technical Factors
Treatment planning: Proper case selection and realistic goals are essential.
Attachment design: Strategic placement enhances control for both extrusion and intrusion.
Staging: Gradual movement in small increments improves success rates.
Force vectors: Proper force direction is crucial for predictable results.
Treatment Process: How Invisalign Brings Teeth Down
Initial Consultation and Assessment
Your orthodontist will evaluate:
- Clinical examination: Current tooth positions and desired changes
- Digital imaging: X-rays, 3D scans, and photographs
- Bite analysis: How teeth fit together functionally
- Aesthetic goals: What you want to achieve with treatment
Digital Treatment Planning
3D modeling: Using advanced software to simulate tooth movements
Movement staging: Breaking larger movements into smaller, manageable steps
Attachment planning: Designing optimal attachment placement for control
Timeline estimation: Predicting treatment duration based on planned movements
Active Treatment Phase
Aligner progression: Receiving new aligners every 1-2 weeks
Regular monitoring: Check-ups every 6-8 weeks to assess progress
Adjustment protocols: Making changes if teeth don’t move as planned
Refinement options: Additional aligners to perfect results
Extrusion vs. Intrusion: Which is Right for You?
Choose Extrusion When You Want To:
- Make teeth appear longer
- Lower the position of teeth in your smile
- Level uneven teeth that are too short
- Correct a deep bite
- Address worn or damaged teeth
- Improve tooth proportions
Choose Intrusion When You Want To:
- Make teeth appear shorter
- Raise the position of teeth in your smile
- Reduce a gummy smile
- Level teeth that appear too long
- Correct over-erupted teeth
- Improve gum line symmetry
Mixed Movements
Many cases require both extrusion and intrusion of different teeth to achieve optimal results. Invisalign can combine these movements effectively when properly planned.
Success Tips for Both Types of Movement
Maximizing Extrusion Success
- Consistent wear: Maintain proper aligner wear time
- Gentle forces: Allow gradual movement to prevent complications
- Attachment care: Keep attachments clean and intact
- Progress monitoring: Regular check-ups to ensure proper movement
Maximizing Intrusion Success
- Extended treatment time: Intrusion often takes longer
- Excellent compliance: Even more critical for intrusion cases
- Realistic expectations: Understand movement limitations
- Comprehensive retention: Plan for longer retention periods
Alternatives When Invisalign Cannot Achieve Desired Results
For Complex Extrusion Cases
Traditional braces: May provide better control for extensive extrusion
Surgical exposure: For severely impacted teeth
Restorative options: Crowns or veneers for worn teeth
For Complex Intrusion Cases
Traditional braces with TADs: Mini-screws for predictable intrusion
Surgical options: Crown lengthening or orthognathic surgery
Periodontal procedures: Gum contouring for aesthetic improvements
Realistic Expectations and Timeline
Extrusion Timeline
- Simple cases: 6-12 months
- Complex cases: 12-18 months
- Rate of movement: Typically faster than intrusion
- Retention: Standard retention protocols usually sufficient
Intrusion Timeline
- Simple cases: 12-18 months
- Complex cases: 18-24+ months
- Rate of movement: Slower and less predictable
- Retention: Extended retention often required
Cost Considerations
The cost of Invisalign treatment for bringing teeth down varies based on:
- Case complexity: Simple movements cost less than complex cases
- Treatment duration: Longer treatments require more aligners
- Geographic location: Costs vary by region and provider
- Additional procedures: Attachments, refinements, or combined treatments
Typical ranges: $3,000-$8,000, with most cases falling in the $4,000-$6,000 range.
Choosing the Right Provider
Key Qualifications to Look For
Invisalign experience: Look for Preferred or Elite providers
Orthodontic training: Board-certified orthodontists typically have more expertise
Case portfolio: Ask to see before/after photos of similar cases
Treatment planning: Comprehensive consultation and digital planning
Questions to Ask Your Provider
- Can you show me similar cases you’ve treated?
- What percentage of the planned movement do you expect to achieve?
- How long will treatment take for my specific case?
- What are the alternatives if Invisalign doesn’t achieve my goals?
Maintenance and Long-Term Care
Retention Requirements
Extrusion cases: Standard retention with removable or fixed retainers
Intrusion cases: Often require longer retention periods due to relapse tendency
Lifetime commitment: Some form of retention typically needed indefinitely
Monitoring and Follow-Up
Regular check-ups help ensure:
- Stability of tooth positions
- Healthy gum and bone response
- Early detection of any relapse
- Proper retainer fit and function
Conclusion: Your Path to Bringing Teeth Down with Invisalign
Can Invisalign bring teeth down? Absolutely yes – and it can do so in multiple ways depending on your specific needs and goals.
Whether you want to make teeth appear longer and lower through extrusion, or shorter and higher through intrusion, Invisalign offers effective solutions for most cases. Extrusion movements are highly predictable and successful, while intrusion movements are achievable but require more careful planning and realistic expectations.
The key to success lies in:
- Proper case selection by an experienced provider
- Realistic expectations about outcomes and timelines
- Excellent compliance with wearing instructions
- Comprehensive retention to maintain results
Ready to explore how Invisalign can bring your teeth down? Schedule a consultation with an experienced Invisalign provider who can assess your specific situation, explain your options, and create a personalized treatment plan to achieve your smile goals. Whether you need extrusion, intrusion, or a combination of movements, the right provider can help you understand what’s possible and guide you toward the best solution for your unique case.