“I had braces in primary school and I am 21 now…
…I am worried my teeth have moved and will continue to move and go all over the place again. I am not sure what to do?”
– Question from Sam of Stafford in Brisbane
Dr David Kerr replies:
A great deal depends on your level of comfort with the current cosmetic appearance of your smile. Following orthodontic treatment (particular a long time after) some people can experience different levels of relapse.
Braces 20 – 30 years ago? The good old days of Orthodontics
In the ‘old days’ of orthodontic treatment, retention was approached in a completely different way to now. It’s not unusual that patients were told: “wear this retainer full time for 6 months and then throw it away.” We have since realised that that approach to retention just does not work.
Today the trend is toward long-term ‘life-time’ retention. This will help Orthodontic patients get the longest life out of their Orthodontic treatment.
So does that mean I have to get braces again?
It depends on how severe the relapse is as to whether I would recommend a repeat Orthodontic treatment, ie getting braces or an alternative Orthodontic treatment, or simply commence some more active retention.
There is a common misconception with Orthodontic treatments that they end once the braces come off. That is not the case, when the braces come off then the treatment moves to a more passive form of treatment.
For my patients in this situation I will usually start with retention, which can be done in a number of different ways including:
- bonding a wire to the back of the teeth
- a clear overlay plate similar to those used with Invisalign
So does that mean I have to wear a retainer forever?
Not at all. When approaching a situation like this with a patient I would start by telling them to wear a retainer full time for three months, then we have another look and see what has happened, how it feels and how good they have been at wearing it.
Then, if we are achieving good progress at this stage then we might drop back the frequency and only wear the retainer at night time for the next three months. Then we take another look, see if it is tight and lessen the amount of time they wear it again.
Ultimately, we want to keep on top of it for that individual and what frequency suits their mouth best. As a rule of thumb I would recommend that if your retainer is getting tight then you should start to wear it a little more regularly.
So who is returning to Orthodontics now?
I am now seeing a number of patients who are ‘returning’ to Orthodontic treatment. This can be for a number of reasons:
- Didn’t follow up their original treatment: some patients, when they were younger just didn’t wear their retainers as requested after their original treatment
- Some people are more prone to teeth movement: while the main period of movement is when we are young and the jaw and mouth are growing there are other reasons why teeth can experience movement after your twenties:
o Loss of a tooth which leaves a gap
o Tooth grinding and clenching
o Bad habits such as chewing pens and pencils or sucking thumbs
o Those with large jaws can also be prone to movement
Though ultimately most of the people I see now returning for orthodontic help are those that could have been helped by applying a longer term approach to Orthodontic retention.