Attachments are small tooth-coloured shapes bonded to some teeth during aligner treatment. This guide explains what they do and what the procedure involves.
Key points
- Attachments are small tooth-coloured bumps made of composite resin, bonded to the surface of some teeth during aligner treatment.
- They help with movements that are harder for plastic trays, such as rotating a round tooth, moving a tooth up or down, holding a tooth in position and improving the grip of the tray.
- Placement usually takes a short appointment, does not need an anaesthetic and should not hurt.
- Attachments collect plaque like brackets, so brush carefully around them, and expect the trays to fit more tightly.
- Attachments are removed at the end of treatment, and retainers are then needed to hold the result.1
If you are told you need attachments with your aligners, it can be a surprise: clear aligners seem to suggest nothing is fixed to the teeth. In fact, many aligner plans use small additions to the teeth to help the trays work. Here is why, and what to expect.
What attachments are
Attachments are small bumps made of tooth-coloured composite resin, bonded to the surface of some teeth. They are shaped to give the aligner something to grip, and each has a precise position planned in the treatment software. Not every tooth needs one, and some patients need few or none.
Why they are used
Plastic aligners can tip and turn teeth predictably, but some movements are harder. A systematic review of Invisalign found that it can level, tip and turn most teeth predictably, but that its effectiveness was limited for widening the arch by bodily movement, closing extraction spaces and correcting larger front-to-back or vertical problems.2 Attachments help an aligner push or hold in a way that a smooth tooth would not allow, for example:
- rotating a round tooth, which has nothing to hold on to;
- moving a tooth up or down in its socket;
- holding a tooth in position while others move;
- improving the grip of the tray on short or smooth teeth.
Some problems need additional techniques, such as fixed appliances, alongside aligners.1
How they are placed
- Planning. The software decides which teeth need attachments, and where.
- A template. A clear tray with small wells, made to match the plan, is filled with resin.
- Preparation. The teeth are cleaned, and the surface may be lightly roughened and treated so the resin bonds.
- Bonding. The template is placed over the teeth, and the resin is hardened with a curing light.
- Finishing. The template is removed and the attachments are checked and smoothed.
The procedure usually takes a short appointment and does not need an anaesthetic. It should not hurt.
What you may notice
- The teeth feel slightly bumpy, and the tongue will notice them first.
- The aligners fit tighter, because they snap onto the attachments. This is how they work.
- They are tooth-coloured, so are less visible than braces, though some people can see them on close inspection.
- The tray may be harder to remove at first. Take it out gently, beginning at the back.
Cleaning around attachments
Attachments collect plaque, like brackets, so brush carefully around them. Take the aligners out to eat, and brush before putting them back in. Our guide to oral hygiene during orthodontic treatment explains the routine. NHS patient information advises an interdental brush every day for people with fixed braces,4 and the same principle of thorough cleaning applies here.
Removal
When treatment ends, the attachments are removed. The resin is polished off, and the enamel is checked. Removing leftover glue can roughen and thin the enamel with any bonded attachment, which is why careful polishing matters, and a review of 41 papers found that multi-step polishing with discs and pumice was the most predictable way to leave the enamel smooth.3 Ask how your dentist removes attachments.
Do attachments make aligners work better?
For the movements that need them, yes, they are part of the plan. The research on aligners supports them for mild to moderate problems in people who have stopped growing and do not need extractions, and a proper orthodontic assessment, diagnosis and treatment plan is essential.12 Attachments are a tool, not a promise.
If an attachment comes off
Contact your dentist. A missing attachment can reduce the way an aligner fits. Keep wearing the trays unless you are told otherwise, and bring the aligners to your appointment.
After treatment
After any aligner treatment, retainers are required so that the teeth keep their corrected positions.1 Read about why wear retainers after orthodontic treatment.
More on aligners
Our pages on Invisalign and clear aligners, and our guide to how Invisalign works, explain the whole process. If you are choosing between aligners and braces, see our comparison.
Questions people often ask about the look
Attachments are tooth-coloured, but the colour is matched to the tooth, so some people can notice them in bright light. They are small, and most people find they are far less obvious than braces. If appearance matters a lot to you, ask how many attachments are planned and where, and ask to see the plan before they are placed.
How attachments fit into the treatment plan
The planning software places attachments to produce specific forces. This means that attachments are not decoration, and they are not interchangeable. If one comes off, the planned movement may not happen as expected. That is why it is worth telling the clinic when you lose one, rather than waiting for your next visit.
Looking after the trays with attachments
- Take the trays out gently, beginning with the back teeth.
- Clean the trays daily with a soft brush and cool water.
- Do not chew on the trays or bite them in to seat them, which can crack them.
- Bring spare trays to appointments, in case a review needs them.
- Do not use hot water, which can warp the plastic.
When attachments may not be needed
Some people have simple plans that need no attachments, for instance when only a few teeth need a small tilt. Others need many. The research on aligners supports them for mild to moderate problems that need no extractions,2 so the number of attachments relates to the difficulty of the movement, not to how good the aligners are.
Retention afterwards
When the attachments are removed and treatment ends, retainers hold the result.1 If your teeth feel rough after the attachments come off, ask your dentist to polish them.
Attachments compared with brackets
| Attachments | Fixed brackets | |
|---|---|---|
| Material | Tooth-coloured composite resin | Metal or ceramic, with a wire |
| Role | Help the aligner grip and move particular teeth | Hold the wire that moves all the teeth |
| Number | Only on teeth that need them | One on each tooth |
| Visibility | Tooth-coloured, less visible | More visible, especially metal |
| Removal at the end | Polished off | Removed, glue polished off |
| Daily care | Take the trays out to eat, brush around the bumps | Brush and clean around brackets and wires |
Attachments are a lighter touch than full braces, but they are not decoration. They are placed because the plan needs them.
Questions to ask about attachments
- Which teeth will have attachments, and why?
- Will the attachments be visible, and how are they shaded to match?
- How long will they stay on, and what happens at the end?
- What should I do if one comes off?
- Do they change how I clean my teeth?
- Could the plan work without them, and what would change?
A clear explanation, ideally with a view of the planned movements, shows that attachments are part of a thought-out plan.1
Pain and comfort with attachments
Placing attachments does not hurt, though the surface of the tooth may feel tight when the template is removed. Afterwards, the trays fit more snugly, which can make them feel tighter for the first days. A new tray with attachments may feel firm each time you change, and soreness is usually mild and short-lived.
If a bump rubs your lip or cheek, tell the clinic, because they can smooth it. If a tray is hard to remove, take it out gently from the back, using your fingertips, and do not pull from the front. Avoid chewing on the trays to seat them, because this can crack the plastic.
Frequently asked questions
Do attachments stay on for good?
No. They are removed at the end of treatment.
Do attachments hurt?
Bonding is not painful. The teeth may feel tender when aligners are first fitted over them.
Do all aligner treatments need attachments?
No. It depends on the movements planned.
Can I eat with attachments?
Take the aligners out to eat. The attachments are small and fixed, and you can chew with them as normal.
Can I whiten my teeth while I have attachments?
Whitening does not change the colour of the resin, so the attachments may show up against whiter teeth. It is better to ask your dentist and usually to wait until treatment ends.
Do attachments make aligners harder to remove?
At first, yes, because the tray grips them. It becomes easier with practice.
Will attachments damage my teeth?
Removal needs careful polishing, because removing leftover glue can roughen and thin the enamel with any bonded attachment.3
Can attachments be removed before treatment ends?
Only if your dentist agrees. Removing them early can stop the aligners doing what the plan needs, so talk to the clinic first.
Will attachments stain?
Composite resin can pick up stain over time, as with other tooth-coloured materials. Keeping your teeth and trays clean and limiting staining drinks helps, and the dentist can polish the attachments at a check-up.
About the author
Dr Anupam Sinha, BDS, MDS – Orthodontics. BDS (2002), KLE Vishwanath Katti Institute of Dental Sciences, Belgaum. MDS in Orthodontics (2006), SDM College of Dental Sciences, Dharwad. His thesis work won a national research award in 2005, and he holds a certification in aesthetic dentistry. He sees patients at Orion Dental Clinic in Greater Kailash 1, South Delhi. Read the full profile of Dr Anupam Sinha.
Sources
- British Orthodontic Society. Clear aligners (patient information leaflet). https://www.bos.org.uk/Public-Patients/Patient-Information-Leaflets/Clear-Aligners
- Papadimitriou A, Mousoulea S, Gkantidis N, Kloukos D. Clinical effectiveness of Invisalign orthodontic treatment: a systematic review. Progress in Orthodontics, 2018;19(1):37. https://pubmed.ncbi.nlm.nih.gov/30264270/
- Janiszewska-Olszowska J, Szatkiewicz T, Tomkowski R, Tandecka K, Grocholewicz K. Effect of orthodontic debonding and adhesive removal on the enamel: current knowledge and future perspectives, a systematic review. Medical Science Monitor, 2014;20:1991-2001. https://pubmed.ncbi.nlm.nih.gov/25327612/
- NHS website. Braces and orthodontics (patient information). Page review date 29 June 2026. https://www.nhs.uk/conditions/orthodontics/
Medically reviewed by Dr Anupam Sinha, BDS, MDS – Orthodontics, on . General information for patients from Orion Dental Clinic, last updated 23 October 2026. It is not advice for one person, so ask a dentist what suits you. To report an error, contact us.