What can cause relapse after orthodontic treatment, and how can we prevent these unwanted teeth movements?

Let’s talk about keeping the teeth in place (also called retention) after orthodontic treatment

This problem is one of the most puzzling tasks the orthodontist encounters in everyday practice. The importance of retention is unquestionable, since nobody wants the beautiful final result of the long and costly orthodontic treatment to disappear. However, achieving perfect retention is a difficult and complex task. Both the orthodontic specialist’s professional preparedness and the patient’s cooperation are necessary for success. So, let’s look at what we can do to preserve a beautiful smile after the treatment.

What are the causes for teeth to shift after orthodontic treatment?

The basic problem is that as long as the net forces acting on the teeth are not zero, they tend to move. The oral cavity is a dynamic place. The teeth are pushed by the tongue, the lips, the teeth slide against each other while chewing, and even the neighboring teeth exert pressure on one another. Moreover, this situation changes continuously throughout our lives. Over the years, teeth wear down, the bite changes, and the bone and periodontal tissues surrounding the teeth transform. In such a dynamically changing place, it is impossible to expect that teeth left on their own will not move in some direction. Therefore, the solution is that we do not let the teeth move. In the case of the front teeth, we link them so they can mutually support each other. The position of the back teeth (molars and premolars) can be preserved with a stable cusp to furrow bite and a correctly developed occlusion. Next, we will look at the appliances that help prevent relapse after orthodontic treatment. By clicking HERE you can also read about interesting facts and the most relevant questions about orthodontics.

The removable retention plate or splint

Immediately after finishing orthodontic treatment, the bone around the teeth is still plastic and weaker than older, more established bone tissue. For this reason, during the year following the removal of fixed or clear aligner orthodontics, a device is still needed to hold the teeth in place. This is a so-called retention device. The patient only needs to wear it at night. It may seem unnecessary, but it is absolutely essential for stabilizing the teeth in their new positions until the bone around the teeth strengthens and the supporting structures of the tooth root remodel. Would you like to know what other removable orthodontic devices exist? Then click HERE to read about them!

The bonded, teeth-holding orthodontic wire, the retainer

The retainer is a tiny, thin wire that we bond to the inner (lingual and palatal) surfaces of the front teeth from canine to canine. Because of its position, it is completely invisible. We do this so that the teeth will never, under any circumstances, be able to move. However, for this to work, the retainer must remain on the teeth throughout the patient’s entire life. At this point, everyone raises their eyebrows. Let me share with you what I usually say when this happens, in order to reassure people. First of all, every single one of my patients whose teeth I have ever straightened, without exception, received their retainers at the end of treatment. It is also important for me to mention that no one has ever had them removed afterwards. If I still haven’t convinced you that this is something you can fully live with, then I will tell you one more story. My wife also has retainers on her teeth. (I did not put them on her teeth. It was another doctor.) She has proudly worn them for many years, with conviction, since she is also an orthodontic specialist. If I still haven’t managed to convince you about the importance of the retainer, then I will just say this: without it, your teeth will certainly shift after the orthodontic treatment. Unfortunately, this is what happened to my teeth. And to the teeth of many others whom I had to do orthodontics again, after a first treatment done a long time ago. After all of this, of course, it has never even occurred to these patients not to wear retainers.

Other procedures for preventing relapse

It is very important that you come for regular (every six months) dental checkups even after completing your orthodontic treatment. This not only helps you avoid more serious general dental problems but also any potential, unwanted tooth movement. Even a larger cavity can provide enough space for the teeth to move, not to mention the gap created by an extracted tooth. These should be eliminated as quickly as possible with prosthetic replacement (dental bridge or dental implant). And there is the question of wisdom teeth. Personally, I do not usually recommend removing the 3rd molars without good reason. In professional dental circles, opinions differ on whether wisdom teeth cause crowding and relapse. Besides, the retainer still protects the teeth from shifting even if this assumption is true. In my opinion, surgical removal of wisdom teeth is a risky and very uncomfortable procedure for the patient that I would not subject anyone to unnecessarily, unless there is appropriate professional justification (such as chronic inflammation) for extraction.

Our tricks at the Netfog Dental Clinic for preserving your beautiful smile

Naturally, we also apply all the above-mentioned procedures. In addition, we place special emphasis on regular dental check-ups for our patients. To ensure that no one forgets this in today’s fast-paced world, we send a reminder text message every six months about the upcoming check-up time to your phone. (You may inform us at any time that you no longer wish to receive such notifications, and we will remove your phone number from the list.) During the check-ups we examine whether the retainers have detached from the tooth surfaces. We also check whether any tooth movement has occurred. If we notice any problems, we will inform you and make recommendations for the solution. If you have not visited a dentist for at least six months, then it is high time to book an appointment for a dental check-up. You can do it easily by clicking HERE!

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