Those little bumps on your teeth: What are attachments and elastics used for?
If you're undergoing treatment with aligners and have noticed small, tooth-colored bumps on some of your teeth, don't panic. These are attachments, and they're a normal part of many treatment plans. Here's what I tell my patients when they ask me about them.
What is it, exactly?
Attachments are small dots made of dental composite material that are bonded directly to the surface of the tooth; they’re roughly the same color as your enamel. Their purpose is to provide the aligner with an additional anchor point so it can grip the tooth securely and apply the force needed to achieve the desired movement.
Without an attachment, an aligner rests only on a smooth surface. For certain movements, such as rotating a round tooth (a premolar or canine, for example), that simply isn’t enough grip. The attachment gives the aligner something to “grip onto.”
Why Some Teeth Need It and Others Don't
It depends entirely on the movement required for that particular tooth. Attachments are especially useful for:
Rotations, especially on teeth with rounded surfaces
Extrusions: When a Tooth Needs to Be Moved Downward in the Dental Arch
Translations: when a tooth needs to move while maintaining its straight axis
Your treatment plan is calculated from the outset based on the movements required for each tooth. That's why two patients undergoing treatment may have very different numbers of brackets, even if their treatment goals are similar.
What about the rubber bands?
Elastic bands (sometimes called "elastic buttons") work a little differently. They connect two points—often between the top and bottom of the mouth—to help correct the position of the jaw or bite, not just the position of a single tooth. They are prescribed only when the treatment plan calls for them, and the length of time they need to be worn varies from person to person.
Does that change your routine?
A little, but nothing major:
Taking the mouthguard out and putting it back in may take a little extra effort at first, until you get used to it.
Brushing around the attachments requires a little more attention to prevent plaque buildup.
If an attachment comes loose, it's not an emergency, but please let our team know so we can reattach it when the time is right.
That doesn't mean something is wrong
This is a question that comes up often: Does having attachments mean that my case is more complicated or that the treatment isn't working well? Not at all. It's simply one more tool in the toolbox to ensure that the intended movement occurs in a predictable manner. Many treatments include them; this is no exception.
Do you have questions about your treatment plan? Our team in Côte-des-Neiges and St-Hubert can answer them in detail during your next appointment.