Invisalign Does Not Cause Dizziness
Invisalign clear aligners are not a recognized cause of dizziness or vertigo in the medical literature, and there is no established mechanism by which orthodontic aligners would produce vestibular symptoms.
Why This Question Arises
The confusion likely stems from patients experiencing dizziness coincidentally during orthodontic treatment, but the two are unrelated:
- Dizziness has well-established causes that are either peripheral (inner ear) or central (neurological), none of which involve dental appliances 1, 2
- Orthodontic aligners work mechanically on teeth and surrounding bone structures, with no anatomical connection to the vestibular system 3, 4
Actual Causes of Dizziness to Consider
If a patient wearing Invisalign reports dizziness, evaluate for these common conditions:
Most Common Peripheral Causes
- Benign paroxysmal positional vertigo (BPPV) accounts for 42% of vertigo cases in primary care, with brief episodes (seconds to <1 minute) triggered by head position changes 2
- Vestibular neuritis presents with acute prolonged vertigo lasting 12-36 hours with severe nausea but no hearing loss 1, 2
- Ménière's disease causes episodic vertigo lasting 20 minutes to 12 hours with fluctuating hearing loss, tinnitus, and aural fullness 2
Critical Central Causes Not to Miss
- Posterior circulation stroke can present with isolated vertigo in 75-80% of cases without focal neurologic deficits, particularly in patients with vascular risk factors 2
- Vestibular migraine causes vertigo attacks lasting hours, often with photophobia and a history of migraines 1
Clinical Pitfall to Avoid
Do not dismiss isolated vertigo as benign simply because there are no focal neurologic findings—11% of patients presenting with acute persistent vertigo have acute infarct on imaging 2. This is especially important in elderly patients who may describe "vague dizziness" rather than true spinning vertigo even with significant pathology 2.
Known Invisalign Side Effects
The documented effects of Invisalign treatment are limited to:
- Root resorption (affecting 41.81% of teeth, though typically <10% of root length) 5
- Discomfort from tooth movement 3
- Compliance-dependent outcomes 3, 6
- Limited control over specific tooth movements 3
None of these involve vestibular or neurological symptoms.