Before You Choose Clear Aligners: Essential Advice from a Periodontist and an Orthodontist

In this eye-opening episode of The Gum Guru Podcast, periodontist Dr. Macon Singletary and orthodontist Dr. Mary Morgan Keyser discuss the real story behind one of the fastest-growing dental trends: clear aligners.

They might promise a straighter smile without the brackets or wires—but are aligners safe for every adult mouth?

Many people don’t know that gum disease, bone loss, medications, recession, or even everyday pressure from clenching can complicate orthodontic treatment. And with clear aligners, where the patient controls the “on and off switch,” the stakes can be even higher.

In this episode, you’ll learn:

• What clear aligners really are—and why adults love them
• Why aligners are only a tool and not always the safest choice for every mouth
• The crucial difference between moving teeth through teen bone vs. adult bone
• How medications (like osteoporosis drugs) can impact bone movement
• Functional, non-cosmetic reasons adults may need orthodontics
• Why many adults now need retreatment decades after childhood braces
• The hidden risks for patients with gum disease, inflammation, or bone loss
• When to involve a periodontist before starting clear aligner therapy
• Warning signs that it may be the wrong season of life to start aligners
• The top questions every patient should ask before beginning treatment

Key Takeaways:

• Healthy gums first. Straight teeth second.
• Clear aligners require serious discipline—they only work if you wear them 20–22 hours a day.
• Adults need more monitoring, not less, especially with bone changes and medication considerations.
• If you have gum recession, thin tissue, or bone loss, you absolutely need a periodontal evaluation first.
• Retainers are for life—“nighttime for a lifetime” really is the rule.

Clinician Wisdom in One Sentence:

• Dr. Singletary: “Beauty is in the eye of the beholder.”
• Dr. Keyser: “A straighter smile should never come at the cost of a healthy one.”

If you’re considering a clear aligner system, this episode gives you the essential questions to ask—and the red flags you should never ignore.