Clear Aligners and Bite Problems: What They Can Change
For adults asking if aligners can change their bite: what studies measured for deep, open, Class II and Class III bites; elastics, precision cuts, buttons, bite ramps and refinements; and skeletal limits. The British Orthodontic Society says aligners are not well suited to correcting problems like prominent upper front teeth. A 2026 open bite review found reported changes fitted tooth-and-bone compensation better than predictable jaw correction, at very low certainty.
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Medical disclaimer: This page is for general information only. It does not replace an examination or treatment by a dentist.
What does UK guidance say about aligners for bite problems?
The British Orthodontic Society's (BOS) current FAQs say aligners are not well suited to correcting problems like prominent upper front teeth (see protruding front teeth).
They add aligners can be very effective when aligning mildly irregular teeth is all that is required. For other suitability factors, see the options in this section. In more severe cases, notably where extractions are needed, aligners lack the control needed for reliably good outcomes and often lead to disappointment, BOS says. It adds that aligners are very effective in selected cases, but their scope is limited.
What have aligner studies measured for a deep bite?
A 2025 retrospective study of 36 patients aged 11 to 45 with deep bites found aligners achieved on average 61% of planned bite opening.
Overbite averaged 5.03 mm; 3.23 mm of opening was planned and 2.00 mm achieved before any refinement. All had one aligner system, no extractions, 19 with bite ramps and 14 with elastics; uncooperative patients and overbites over 8 mm were excluded. The authors judged accuracy moderate.
A 2026 Vietnamese trial allocated 60 people with a deep bite (aged 11 to 51, no extractions) alternately to aligners or braces. At the end of active treatment, overbite reduced 1.8 and 2.0 mm and overjet 1.9 and 2.2 mm respectively, neither significantly different, nor did any X-ray measure differ once corrected for multiple comparisons. Molar and canine relationships shifted towards Class II in both groups, with no significant difference. See deep bite, and fixed braces compared with aligners.
What have aligner studies measured for an open bite?
A 2025 review found aligners closed adult open bites by 2.76 mm on average, mostly by front teeth moving further out of their sockets.
It pooled 12 of 14 studies (to August 2024; 13 at moderate risk of bias), found no significant back-tooth intrusion or lower-jaw angle change, and rated confidence high for the bite change and both tooth findings, low for the jaw angle. A 2026 review of 10 studies of mainly adult patients (to April 2026; 9 at serious risk of bias) pooled 5 studies (206 patients) at 3.07 mm in an exploratory analysis, with substantial variation, rating certainty very low. See open bite.
What have aligner studies measured for a Class II bite?
In a 2025 Class II study, adults treated with aligners and elastics all reached Class I molar relationships, but bone gaps over front-tooth roots increased.
Its 30 adults in Nanjing (mean age 26), selected for completed treatment and good compliance, had no extractions, one aligner system and elastics for 11.7 months on average. On scans before and just after treatment, bone dehiscences rose from 28.1% to 47.4% of root surfaces, especially on the lip side of the lower front teeth. It was retrospective, with no comparison group, and its authors say the scans may overstate such defects.
To ask about orthodontic treatment, book online or call 0114 288 2121.
What do elastics, precision cuts and buttons do with aligners?
Elastics are rubber bands between upper and lower teeth; with aligners, studies attached them to precision cuts in the aligner and to bonded buttons.
In the 2025 Class II study, each ran from a precision cut at the upper canine to a button on the lower first molar. A 2015 review of 11 studies (patients aged 13 to 72, one aligner system), judging their quality too low for evidence-based conclusions, said aligner treatment requires auxiliaries (attachments, elastics between the jaws, IPR or slimming the sides of teeth, and altered aligner shapes) to make tooth movement more predictable. See aligner attachments, or browse this section on daily life.
Do bite ramps help aligners open a deep bite?
In a 2022 retrospective study, precision bite ramps did not appear to significantly improve how predictably a newer aligner material opened the bite.
Its 39 adults with ramps on that material achieved on average 43.4% of planned overbite reduction, judged against a published same-material group without ramps; 29 on an older material without ramps achieved 55.1%. All were non-extraction, with one aligner system; deeper bites fell further short. In the 2026 Vietnamese trial, ramps were designed to push front teeth in, let back teeth come further out, or both.
Do aligner refinements improve a deep bite?
In a 2024 study, most bite opening came with the first aligner set, and refinements did not significantly improve deep bite opening.
Its 20 US adults (mean age 33, overbite 5.1 mm), selected for good compliance, with one aligner system, achieved 1.25 of 3.27 mm planned in the first set and 0.17 of 2.00 mm in the second; the 15 who finished reached 38.5% of the original plan. It was retrospective and small.
What are the skeletal limits, and when may aligners need extra techniques?
A 2026 open bite review concluded reported changes fit compensation in the teeth and their bone better than predictable skeletal correction.
It rated certainty very low and found the evidence insufficient to confirm predictable skeletal correction, meaning jaw-bone change, or a single way the bite closed. An archived 2014 BOS page offers examples where aligners may require extra methods, fixed appliances among them, for an ideal result: severe crowding, treatment involving extractions or complex tooth movements, and jaw problems arising from an underlying jaw size or position discrepancy.
The 2026 Vietnamese trial and the 2025 deep-bite study of 36 patients both excluded people needing jaw surgery.
Who is orthodontic treatment at Deepcar Dental Care for?
Orthodontic treatment at Deepcar Dental Care is for adults only.
The main aligner page covers straightening teeth with removable aligners at the practice.
Frequently asked questions
Can clear aligners fix a crossbite?
One 2025 study did not measure crossbite outcomes, but found widening the arch seemed less predictable with a back-tooth crossbite. Its 98 adults, treated without extractions by one Barcelona clinician with one aligner system, were measured at the first refinement; large planned widening also seemed less predictable. It was retrospective. See crossbite.
Do aligners finish a bite as well as braces?
A 2019 review of 8 studies said aligners might trail braces in bite contacts, torque, arch widening and retention. Ages averaged 15.5 to 35.2; one aligner system. Pooled across two very different studies, finishing grades did not differ significantly, but fewer aligner cases passed in both: 21% against 48% (significant) and, with extractions, 67% against 75% (not).
What has a trial of aligners for an underbite found?
Tooth changes, in a 2025 randomised trial analysing 30 adults with a moderate Class III bite. All had aligners, Class III elastics and arch widening; the group also moving lower molars back improved the bite more. Both groups gained overjet and overbite by treatment end, about two years on, and upper front teeth tilted forward in both. See underbite.
Do bite changes made with aligners last?
Follow-up is limited. The 2026 deep-bite trial measured only to the end of active treatment, and the 2026 open bite review called for studies with long-term retention endpoints. An archived 2014 BOS page says retainers will be needed once any aligner treatment ends, to hold teeth in corrected positions.
Does age affect how well aligners open a deep bite?
Not in one 2025 study. Among 36 patients aged 11 to 45 with one aligner system, bite-opening accuracy showed no significant link with age; only first premolar levelling grew less accurate with age. The study was retrospective, excluded uncooperative patients and measured before any refinement.
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