Upon completion of the active phase of orthodontic treatment, the patient begins the period called retention. Most orthodontic patients believe that their teeth, once straightened, will remain straight forever. Unfortunately, this is not true. Teeth, the surrounding bone, gums, lips, and tongue are living tissues, and are constantly subject to change. This is why orthodontic treatment works. When the orthodontist applies the proper forces to the teeth, the teeth move and the surrounding tissues adjust.
Knowing this, it is easy to understand that when braces are removed and the teeth are subjected to natural forces, the teeth are inclined to react to the pressure and move. Such forces include tongue and lip pressure, chewing food, and nervous habits such as nail biting, pencil chewing, etc.
Does this mean that wearing braces is useless? Of course not! Eighty-five to ninety percent of the original orthodontic problems are permanently resolved with treatment. Problems involved with the biting relationships of the teeth are corrected, and the cosmetic appearance of the teeth is enhanced and returned to normal.
To help minimize the potential for tooth movement after braces are removed, we move into the retention phase of treatment. “Retention” is the term used to identify the time period during which the patient is wearing retainers. The advice given to every patient is to wear the upper and lower removable retainers 24 hours a day (with the exception of eating, brushing, or vigorous physical activity) during the first 6 months after the braces are removed. Then, the retainers are to be worn at night indefinitely.
Experience has taught us that if retainers are discontinued, the majority of cases will experience a slight amount of shifting. This usually involves rotation of the lower front teeth, and sometimes rotation of the upper front teeth. The more severe the original problem, the greater the tendency for shifting. Some shifting is the body’s natural response to change as we experience the aging process. Patients should not be discouraged! Teeth can be kept straight. However, continued use of the retainer(s) is required. Appointments will be scheduled to monitor the patient’s progress for the first two years after the braces are removed. These appointments are included in the total treatment fee. However, should a retainer become lost or broken, a replacement fee will be charged. After the two years of active retention, the patient will be “graduated” with instructions to wear the retainers every night during sleep to maintain a passive fit of the retainers.
After “graduation” it may be necessary to return to our office if the patient experiences any changes or shifting of their teeth that concerns them. In some cases, the eruption of the third molars or wisdom teeth may require monitoring. Depending on the nature of the problem, an office charge may be required. It may be necessary to have new retainers made every five years or so, but that is a small price to pay to keep your teeth straight. With careful care and consistent wear, retainers can often last much longer. Remember, as with other changes with age, the teeth tend to shift as time goes on. We are here to help you prevent and control that shifting. It is often said that “nothing is forever,” but we say, “RETAINERS MAY BE!”