An Invisalign attachment fell off. What do I do?

What does an attachment do?

The glossary of the American Association of Orthodontists (opens in a new tab) (AAO) describes attachments as tooth-colored “bumps” placed on teeth during clear aligner treatment that “help move the teeth while a patient wears aligners.” Align calls its version SmartForce attachments, which it says are also known as “Invisalign buttons” and work like handles that give the aligner something to push on; it adds that only your orthodontist can say for sure whether you need them. A 2025 review in the Turkish Journal of Orthodontics lists buttons as a different auxiliary from attachments, and small anchors bonded on teeth are where some plans hook rubber bands with Invisalign.

At Carvalho & Roth Orthodontics, whether your plan uses attachments, and on which teeth, is decided by the orthodontists from your scans and photos.

Why did it come off?

Align says using your teeth as tools can loosen attachments, asks patients to follow the orthodontist's instructions for removing aligners safely, and adds that brushing and flossing can help preserve the bond. In a 2021 study in BioMed Research International, Yaosen and colleagues found that all 94 lost attachments came off while aligners were being removed, said each insertion or removal adds a dislocating force, and judged most of the risk factors they identified to be patient-related and avoidable with better education. Its authors also linked chewie use to more attachment loss, a contested finding the Invisalign chewies page sets beside the maker's purpose. The Turkish Journal of Orthodontics review adds that attachment composites wear gradually and that unwanted debonding should be kept to a minimum.

At the replacement visit, how you take your trays out is worth going over with your orthodontist.

Should I keep wearing my aligners?

Whether to keep wearing your current aligner after an attachment comes off is a question to put to the office; we found no AAO or Align guidance on it. Your orthodontist knows which tooth the attachment was helping to move and what your next aligner expects, so the instruction comes from your orthodontist.

Who puts it back, and how?

Align says your orthodontist will schedule a time to replace a lost attachment, and describes how attachments go on: the teeth are cleaned and dried, tooth-colored composite resin is loaded into a template aligner set over the teeth, and a special light hardens the material. How soon that visit happens is set when you call; we found no timeline for it in the AAO's or Align's pages.

Is a loose attachment urgent?

The practice's emergency information page reserves true orthodontic emergencies for trauma to the mouth or face, unmanageable pain, and infection or swelling, and the AAO notes that things occasionally happen to aligners that may require a call or an unforeseen visit. For a loose attachment, the step is to call the office and let your orthodontist decide when you come in.