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The Environmental Burden and Sustainability Challenges of Clear Aligners: Implications for Public Health, Practice, Policy, and Future Research-A Scoping Review.
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Clear aligners (the clear plastic teeth-straighteners many adults and teens use instead of metal braces) may come with hidden downsides: this review of existing research found that they can shed tiny plastic particles and chemicals into your mouth, plus generate a lot of plastic waste since they're replaced every one to two weeks. While researchers don't yet know exactly how much this affects your health, the paper calls for safer materials, better testing, and clearer rules so this popular orthodontic option doesn't come at the cost of your health or the environment.
BACKGROUND: Malocclusion is a major global oral health concern and has driven the rapid adoption of clear aligner therapy (CAT) as an esthetic and removable alternative to conventional fixed appliances. However, the widespread use of CAT has raised important concerns regarding its environmental footprint and potential public health implications, including waste generation, chemical leaching, and the release of microplastics. This scoping review aimed to systematically synthesize the available evidence on the environmental and public health implications of CAT and identify key areas in practice, research, and policy to advance toward sustainable oral healthcare services in alignment with the World Health Organization's Global Oral Health Action Plan 2023-2030. METHODS: This scoping review was conducted in accordance with Arksey and O'Malley's framework and reported in line with PRISMA-ScR guidelines. Eligible sources were identified through a search across four databases, namely, PubMed, Scopus, Web of Science, and Embase, to identify literature addressing environmental or public health aspects of clear aligners, published in English, either in print or online ahead of print, between January 2005 and December 2025. Data charting was conducted, followed by qualitative analysis using ATLAS.ti to identify the key themes emerging from included sources relating to the research question. RESULTS: A total of 61 sources were included. The major themes which emerged from this scoping review included material toxicity and chemical exposure, microplastic and nanoplastic release, environmental burden of CAT, technological transitions in the form of 3D/4D aligners, strategies toward sustainability and governance, regulation, and research gaps. CONCLUSIONS: CAT must be recognized not only as an orthodontic innovation but also as an emerging public health and sustainability challenge, highlighting the need for stronger evidence, safer materials, improved waste management, and clearer regulations to align future orthodontic care with Sustainable Development Goals 3 (Good Health and Well-being) and 13 (Climate Action).
More Papers Like This
Orthodontic Clear Aligners as a Potential Source of Microplastic Exposure: Implications for Human Health and Environmental Sustainability
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If you're using clear plastic aligners to straighten your teeth (like Invisalign), this review of existing research suggests that everyday wear and tear from chewing and saliva may cause them to shed tiny plastic particles into your mouth. Scientists don't yet know how much this affects your health, but it adds to growing concerns about microplastics — tiny plastic fragments already found throughout the human body — while also raising questions about the environmental waste from millions of discarded aligners. More research is needed before we know if this is something to actually worry about.
Microplastics Release From Clear Aligners: A Scoping Review of Current Evidence, Health Implications, and Policy Directions.
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If you're using clear aligners (like Invisalign) to straighten your teeth, this review of existing research found that these plastic trays can shed tiny plastic particles called microplastics into your mouth. Scientists don't yet know how much this actually affects your health, but the finding is prompting calls for more safety testing and the development of safer aligner materials. Bottom line: it's worth knowing about, but not a reason to panic—just a signal that more research is needed.
Towards Sustainable Orthodontics: Environmental Implications and Strategies for Clear Aligner Therapy
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This review examines the environmental footprint of clear dental aligners, which are made from plastic polymers and generate significant waste since patients use multiple sets over treatment. The manufacturing and disposal of aligners contributes to microplastic pollution, and the paper suggests the dental industry should adopt more sustainable materials and recycling programs to reduce this impact.
Clear aligner therapy beyond esthetics: oral health, polymer materials, and the environmental cost of digital orthodontics
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Clear aligners (like Invisalign) can be gentler on your gums than metal braces, but this review of existing research shows they're not risk-free: bacteria and fungi can build up on the plastic, and poor cleaning habits may still lead to cavities or worn enamel. There's also a bigger-picture concern—aligners may shed tiny bits of microplastic while you wear them, and the plastic used to make millions of these trays isn't easily recycled, adding to environmental plastic pollution. The takeaway: aligners can be a good choice for your teeth if you keep them clean and follow your dentist's guidance, but the health
Assessing the environmental impact of clear aligner therapy: a scoping review
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This review of existing research found that clear aligners (like Invisalign) create plastic waste, microplastics, and greenhouse gas emissions across their production and disposal, something many patients don't consider when choosing this popular teeth-straightening option. While researchers are exploring greener alternatives like biodegradable materials and recycling programs, these solutions aren't widely available yet, meaning the environmental footprint of your smile makeover is bigger than you might think.
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