Do Invisalign and Other Plastic Aligners and Retainers Cause Allergy or Illness?

Do plastic or acrylic Invisalign aligners and other types of plastic retainers make people sick? Some readers at ArchWired.com's Metal Mouth Message Board seem to think so. For more than four years, members across the country have reported getting symptoms that include sore throats, upper respiratory symptoms, fatigue, nausea, headaches, and swollen glands -- allegedly from their plastic aligners or retainers.

There is no official clinical evidence that these products contain substances that are harmful or potentially allergic. There have been no official reports or investigations into the matter. According to an article in the San Jose, CA Mercury News, in November 2010, the FDA issued a warning letter to Align technologies, stating that it could face federal fines or other penalties because it hasn't disclosed enough information about patients who suffered serious side effects after using the product. In the article, Align CEO Thomas Prescott said in an interview that he knows of only "a small handful of what appeared to be potentially allergic reactions" to the product. Nonetheless, he said, "we take this very seriously." Align Technologies provided the agency with information it hopes will resolve the matter.

Nevertheless, several ArchWired.com readers claim that they developed symptoms of illness shortly after starting Invisalign treatment, or wearing similar clear plastic retainers made by other companies.

According to Align Technologies' website, Invisalign aligners do not contain Bisphenol-A or phthalate plasticizers. Quoting the company's product FAQ, "These aligners are made with USP Class VI medical-grade, high molecular weight, polyurethane resins. Tests have been conducted to determine the biocompatibility of these materials, and show that they are biocompatible and pass all applicable regulatory requirements and thresholds for human wear in the mouth. Of course, as with any medical device, you should consult with your health professional about your aligner or retainer treatment and any applicable risks of use."

Align Technologies goes on to state, "Invisalign aligners are classified as Class II medical devices by the FDA, and Align Technology, Inc., received the necessary 510K clearance from the FDA to be able to sell and market the Invisalign system in 1998."

This doesn't mean that your aligner or retainer is beyond reproach. It's possible that there is some sort of allergy or sensitivity that the manufacturers and the FDA don't know enough about. It's also possible that some of these illnesses occur because people aren't keeping their aligners or retainers clean enough, resulting in an overgrowth of bacteria on the appliances.

If you think that your aligners or retainers are causing illness, there are several things you can do:

•  If you feel that you are having a life-threatening reaction, call 911 or go to your nearest Emergency Room.

• Tell your dentist, orthodontist, and/or medical doctor (but apparently many dentists haven't heard of such side effects)

• Make sure you keep your aligner or retainer free of bacteria by using a germ-killing retainer cleaning product, such as Retainer Brite, SonicBrite, or DentaSoak. If you're not sure what product to use, or how to kill the bacteria with home remedies, ask your orthodontist. Above all, you want to ensure that your aligner is continually free of bacterial buildup by cleaning it properly every single day. Also make sure that your hands are clean when touching your aligners or touching your mouth.

• If you keep your retainer or aligner in a case, be sure to keep the case clean, as well. If your case smells bad, that means it has an overgrowth of bacteria.

• If symptoms persist, contact Align Technologies (for Invisalign) or the manufacturer of any other type of retainer you wear, and report the problem. You may also want to contact the Federal Food and Drug Administration (FDA) to make a formal report.

• Share you concerns on ArchWired.com's message board, or other dental message boards.

• Finally, if the symptoms persist, and you truly believe that your orthodontic treatment is making you ill, consider ceasing your treatment (at least for a while to see if you improve) or getting a different type of retainer or traditional braces instead.

 Here are a few links to posts made on the ArchWired.com Metal Mouth Message Board about illness allegedly resulting from plastic aligners and retainers:

http://www.archwired.com/phpbb2/viewtopic.php?f=19&t=13809
http://www.archwired.com/phpbb2/viewtopic.php?f=19&t=37813
http://www.archwired.com/phpbb2/viewtopic.php?f=19&t=27737
http://www.archwired.com/phpbb2/viewtopic.php?f=19&t=38531

Here are a few other links from other websites concerning this issue:

http://en.allexperts.com/q/Dentistry-966/2008/3/invisalign-systemic-allergic-reactions.htm
http://en.allexperts.com/q/Dentistry-966/2008/3/f/invisalign-systemic-allergic-reactions.htm
http://escoforum.wordpress.com/2011/01/06/allergic-reactions-to-invisalign-materials/
http://allergy.hyperboards.com/index.php?action=view_topic&topic_id=17416
http://www.bracesreview.com/forums/invisalign/5155-allergic-invisalign-trays.html

SturdyFloss: Back in Stock!

For a while, we were out of stock of SturdyFloss, which is no way to begin a new year! Good news: it's back in stock!

If you're not familiar with SturdyFloss, it's a length of unwaxed floss with a stiff but bendable thin plastic tip. It easily fits around orthodontic wires or helps you to floss bridgework or bonded retainers. The great thing about this product is that the tip is bendable and re-positionable. So you can bend it one way to fit under some wires, and bend it another way to help floss some of those really hard-to-reach areas.

If you like Glide Threader Floss but wish the tip was more substantial, then you might really like SturdyFloss. Each box contains 100 individually-wrapped strands, so you can keep some with you to floss when necessary.