How Many Hours a Day Do You REALLY Need to Wear Invisalign?

To achieve successful results with Invisalign treatment, you need to wear your aligners 20-22 hours per day. The 22-hour rule is the gold standard. At Bryn Mawr Dental Care, Dr. Dillon helps Main Line PA patients understand that consistent wear time is the single most important factor in preventing treatment delays, poor aligner fit, and the need for costly refinement trays.

If you’re considering Invisalign treatment here in Bryn Mawr or if you’ve already started wearing clear aligners, you’ve probably heard about the importance of wear time. Here’s the truth: the success of your Invisalign treatment doesn’t just depend on the skill of your dentist or the sophistication of the technology. It depends on you. Specifically, it depends on how many hours a day you actually keep those aligners in your mouth.

Hi, my name is David Dillon, and I have owned a dental practice, Dillon Family Dentistry, on the Main Line for more than 50 years. I have personally observed many of my patients who have used Invisalign achieve amazing results after adhering to the wear time for their aligners. However, I have also witnessed the havoc caused by failing to wear the aligners long enough, and it is not a good thing. Here are some facts that you will want to keep in mind regarding the wear time for your aligners with the well-known 22-hour rule, and how to utilize this in your busy life in Bryn Mawr, Pennsylvania!

The 22-Hour Rule: Not a Suggestion, It’s Your Blueprint

Let me make it very clear: Invisalign treatment will only be effective if you wear the aligners for 20-22 hours per day unless otherwise approved by your orthodontist/orthodontic practice (usually), due to the fact of what orthodontists have said in clinical studies & based on years’ worth of clinical studies.

So why the 22-hour rule? It’s that simple; just like with braces – they apply continuous (but gentle) forces on your teeth to make them move – except these are removable.

The difference between traditional braces & Invisalign is that an aligner set is designed to move your teeth a tiny amount at a time (around .25mm). What most people/clients don’t realize is that if you remove the aligners for extended periods of time, your teeth don’t receive enough constant force to consistently be shifted into position, and then your teeth begin to drift backwards when reinserted until you eventually reach a point where no progress is made towards completing treatment.

I advise all my patients in the Bryn Mawr, Villanova, and Ardmore areas to think of Invisalign treatment similar to preparing for a marathon. If you skip half of your training runs, you cannot expect to finish strong; the same holds true for your success with Invisalign treatment. If you wear your aligners only 16 or 18 hours per day, your teeth won’t move as fast as they should and you will experience additional delays, discomfort, and possibly need refinement trays (which we all want to avoid).

What Happens If You Don’t Wear Invisalign Enough?

Life tends to be hectic. You may be coaching your son’s soccer team at Harriton Park, stopping by the Bryn Mawr Film Institute for coffee, or attending a Rotary Club meeting in Ardmore. It can be very tempting to “forget” to wear your aligners for a few extra minutes. Here’s what happens if you do not wear them for the full 22 hours:

Treatment Delays

The hour skipped is added to the total. If the habit of doing so continues. If you wear your aligners for 18 hours every day. Your teeth will not shift as anticipated; therefore, you should wear your aligners for longer periods of time than intended. For example, if treatment was originally planned to be 12 months, and you’ve made multiple mistakes consistently, your total treatment time will be increased to 14-16 months.

Busy professionals and busy parents here in Bryn Mawr will now have to add to their workload by needing to commit to treatment beyond what they intended!

Poor Tray Fit and Tracking Issues

All the time, I get patients who say, “Dr. Dillon, this new tray fits so tight; is that normal?” Sometimes…Yes, sometimes…No! If you did not wear the last tray long enough for the teeth to completely shift into position, then when you attempt to move to the next tray, the new tray will not fit properly. The aligners do not “track” correctly, which means that they are not seated flush against the teeth. This causes discomfort, and sometimes we have no choice but to send you back to the last tray and start again.

Need for Refinement Trays

If you experience an unexpected change in your dental alignment, we could potentially need to create a new set of refinement trays to continue to get your teeth in the proper position. This will result in added time and cost. One of the biggest contributing factors to needing refinement trays, according to Align Technologies (the company that manufactures Invisalign), is not wearing your trays as instructed. Therefore, it would be advantageous for you to simply wear the trays as directed.

Relapse Risk

The “memory” of teeth means that after you wear your aligners occasionally (as opposed to daily), they will eventually begin to revert to their pre-alignment positions; this is referred to as relapse and can undo months of improvements! I’ve experienced multiple patients having long-term interruptions from their use due to a vacation or wedding, returning to a point where their aligner would no longer fit; therefore, new impressions and a subsequent tray were needed – no fun!

Can You Wear Invisalign Less Than 22 Hours a Day?

You can wear them less than 22 hours per day, but you shouldn’t. I get that 22 hours seems extreme. It only leaves 2 hours of the day for eating, drinking anything besides water, and brushing your teeth. That’s not much time at all! But the reason for this is simply that the whole purpose of Invisalign is that they are removable aligners that are going to work almost as well as traditional braces, and if you want to achieve this goal, then you must wear them as long as possible.

Some patients ask me, “What if I wear my aligners for 20 hours a day?” The answer is that some people can certainly accomplish this, especially with mild cases. However, anything less than 20 hours per day is a gamble. There are studies that indicate that if a patient does not wear their aligners for at least 20 hours, they have a much higher risk of negative results. Most people believe that they wear their aligners for 20 hours, when in fact they actually wear them closer to 18 hours. We oftentimes underestimate the amount of time that we leave our aligners out of our mouths.

If you are finding yourself consistently struggling to get 20-22 hours per day, please come and see me so we can work together to troubleshoot the issue. Maybe we need to adjust your eating schedule, or maybe you need some help managing discomfort. One way or another, winging it and hoping for the best never goes well.

Do You Sleep with Invisalign In?

Yes! This is a big deal. One of the simplest methods to accumulate wear time on your aligners is by sleeping with them in. Consider this – if you sleep 7 to 8 hours a night, that is almost a third of your daily wear requirement already completed. There is no effort on your part; simply place the aligners in prior to going to bed and keep them there all night long.

Some people have concerns regarding the comfort level of the aligners; however, in general, it only takes most people a few nights to adjust to having them in their mouths. 

A great tip, especially when switching to a different tray, is to do so just prior to going to bed. Since you will be sleeping during this time, you have less awareness of the pressure applied to the aligners initially while sleeping. 

Additionally, if you tend to grind your teeth at night, wearing the aligners while sleeping will help protect your teeth from excessive grinding. The aligners will serve as a protective barrier between your upper and lower teeth, thus minimizing wear and tear from grinding. Overall, that is a win-win!

Invisalign Compliance Tips: How to Actually Hit 22 Hours

Okay, so you know the goal. Now let’s talk strategy. Here’s how my most successful Invisalign patients, the ones who finish on time with beautiful results, make it work:

1. Stick to a Meal Schedule

Plan three meals and perform each one as efficiently as possible. Breakfast in fifteen minutes, lunch in thirty, and dinner in an hour. That is a total of one hour and forty-five minutes, with an additional fifteen minutes left over. I know families are busy in Bryn Mawr, but schedules help. Use Sundays for meal preparation. Pack lunches the night before. Whatever it takes to avoid having to snack all day, which cuts into your wearing time.

2.