As soon as the braces come off, many people feel that the hard work in getting a new smile is all done. But wait! There's one critical piece of the process that remains: the orthodontic retainer. What makes this little device so important?
To understand that, let's look at how your teeth are attached, and how they may move. A tooth isn't anchored into the jaw like a screw in wood — it's joined to its bony housing by a unique, hammock-like suspension system called the periodontal (“peri” – around; “odont” – tooth) ligament. The periodontal tissues are living, constantly changing and renewing themselves.
Orthodontic appliances like braces are designed to apply just enough pressure to move the teeth slowly and steadily into new positions. As the teeth are moved, the periodontal tissue gradually re-forms around them, helping to hold them in their new locations.
But tooth, bone and gum tissues also have a “memory” which, if left alone, tends to move the teeth rapidly back to their original places. This unwanted movement gradually lessens, but it can be an issue for a long time after treatment. That's where the retainer comes in.
This little device holds the teeth steady in their new positions until the bones and ligaments have had enough time to re-form — a development that can take several months. It brings the entire process of moving the teeth to a gradual close, helps to prevent trauma and to maintain proper tooth location.
Once, all retainers were made of plastic and wire, and all were removable. These are still popular, and are usually worn 24 hours a day at first, then less often, until (after a period of time) they're only worn at night. Alternatively, in many cases a thin wire can be bonded to the inside surfaces of the front teeth. This type of retainer doesn't show, and it doesn't have to be removed.
How long will you have to wear it? It's hard to say. Teeth are kept in position not only by bone and ligament, but also by a balance of forces between the tongue, lips and cheeks. They aren't permanently fixed in place, but can move over time in a way that's unique to every person. Depending on the type of tooth movement done, we can recommend what type of retainer is right for you, and how often to wear it. Having the right retainer will help ensure you get the best result: a great new smile.
If you would like more information about orthodontic retainers, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Why Orthodontic Retainers?” and “The Importance of Orthodontic Retainers.”
We'd like to take a moment to clarify why it is so important to wear the retainer(s) given to you after your orthodontic treatment. These devices, which literally “retain” your teeth in their new and improved positions, are not just for kids. Anyone who has recently had their teeth moved through orthodontics needs to wear them for the prescribed length of time. Here's why:
Though your teeth may now look perfectly aligned, research has shown that there is no “right” position for your teeth to be in that can assure they don't move again — no matter what age you are when treated for malocclusion (“mal” – bad; “occlusion” – bite). In fact, most people will see changes to their bite and tooth alignment as they get older, with or without orthodontic treatment.
For one thing, there is a natural tendency for bottom front teeth to undergo a gradual “uprighting” with age. This can cause them to crowd as they move toward the tongue. And it happens regardless of whether wisdom teeth are present.
In the case of teeth that have been straightened recently, a type of “memory” of their original position may cause them to drift back to it. This tendency gradually lessens, but it may be a problem for up to 18 months.
That's why it's crucial to follow our instructions for wearing retainers. Keep in mind that the plan we have given you is designed to achieve the best possible results in your individual case. Some people will need to wear retainers 24 hours per day, some just at night, and still others on an as-needed basis. You may have received a removable retainer or one that is secured to the back of your teeth. The important thing is to secure the results you've worked so hard to achieve.
You can read more about this topic in the Dear Doctor magazine article “The Importance of Orthodontic Retainers.”
On the day when braces come off, most people feel that their orthodontic treatment is over. When they are then asked to wear retainers, they may wonder what this additional requirement will accomplish. Wasn't the work of moving their teeth to desired positions already completed? To understand the answer to this question, you need to understand how orthodontics works.
Although they give the appearance of being stable and unmoving, teeth and their surrounding structures (gums, jawbones, and ligaments) are living tissues and are actually in a constant state of change.
Teeth are rooted in bone and are attached by a fibrous tissue called the periodontal ligament (from peri meaning around and odont meaning tooth). One side of the ligament attaches to the cementum (part of the tooth's root) and the other side is attached to the bone, with the tooth suspended in between.
These tissues are constantly remodeling themselves, but pressure from the lips and cheeks on one side and from the tongue on the other create a balance that keeps the teeth suspended in the same location. When mild forces are placed on the teeth, such as the forces from the wires used in orthodontic treatment, the tissues slowly adapt and rebuild, resulting in a new position for the teeth.
Orthodontic retainers are devices usually made of a clear plastic section that is fitted to the roof of the mouth, with thin wires that fit over the teeth.
The remodeling process keeps going after the orthodontic treatment stops, so time is needed for the teeth to reach a new balanced state. The retainer stabilizes them in their new position so that bone and ligament can reform around the teeth and hold them there. This works well for adolescents, whose jaws are in a state of growth, but adults may need outside assistance to stabilize their teeth for a longer time. They may be asked to wear retainers indefinitely to make sure their teeth do not move from their new positions.
If you don't wear your retainers, your teeth are likely to return to the positions they had prior to your orthodontic treatment. This can happen fairly rapidly, underscoring the importance of wearing retainers as instructed.
Most retainers are removable devices as described above. For people who require long-term use of retainers, thin retainer wires can be bonded to the inside surfaces of their front teeth. Such wires are usually left in place for several years, relieving them of the need to remove and replace their retainers.
Contact us today to schedule an appointment to discuss your questions about orthodontics and retainers. You can also learn more by reading the Dear Doctor magazine article “Why Orthodontic Retainers?”
The much anticipated day has arrived: your child's braces have been removed. You are really happy with the way your son's or daughter's smile looks now. All the time, money, and discomfort of having teeth straightened have been well worth it.
But did you know that the teeth could relapse into their old positions if your child doesn't wear a retainer every night?
Why is wearing a retainer necessary?
It is important for both you and your child to understand the reason for wearing a retainer. It has to do with how orthodontia works in causing teeth to move to more satisfactory positions.
The reason that orthodontia (“ortho” – straight, “odont” – tooth) works is that the tissues holding teeth in place are living and keep remodeling themselves. Teeth are suspended in the jawbone by the periodontal ligament (“peri” – around, “odont” – tooth), which suspends the tooth by extending from the cementum of the tooth on one side into the bone on the other. Cementum is the thin layer of calcified tissue covering the dentin of the root. When light forces are placed on it, the periodontal ligament can reform itself and adapt to the pressures it is under.
Orthodontists know how to keep the pressures during orthodontic treatment light enough to cause movement that is slow and steady but not so strong that the tissues are damaged. If too much force is applied, the process can cause damage to the periodontal tissues and tooth roots.
When the teeth have moved to their desired positions, they will continue slowly moving. The purpose of a retainer is to stabilize the teeth in their “finished” position. They must be retained in this position long enough that the bone and ligament can completely re-form around them, a process that can take several months.
Make it clear to your child that a retainer won't have to be worn forever. Once your child understands that it is very important to wear the retainer for a few months in order to stabilize that attractive new smile, it should be easy to convince him or her to use it nightly.
If you are planning orthodontic treatment for yourself or your child, you may have heard about different types of orthodontic appliances (braces) and you may be wondering which type is best for you.
Orthodontic treatment is the process used to improve the positioning of your teeth and bite so that you look better and your teeth function properly. Movement of the teeth is accomplished by harnessing the natural regenerative powers of the body to remodel living tissue, in this case, the bone, which adapts to the new position into which the teeth are moved. Orthodontic appliances accomplish the movement by placing small light and constant forces on the teeth to move them into new and better positions.
There are currently three main types of orthodontic appliances to move your teeth. After careful analysis of your bite and needs, we can help you select the best option for your particular situation.
Fixed appliances, commonly known as braces, so-called because they are fixed to the teeth thereby bracing them together, small brackets are bonded to the teeth and light flexible wires are threaded through them. Controlled tension on these wires pulls or pushes the teeth into position.
Clear brackets are a second, more aesthetic type of fixed appliance. While they are less visible, they tend to be more fragile.
Use of fixed appliances, whether brackets are metal or clear, is usually recommended in more complex cases because they enable the orthodontist to accomplish more complex three-dimensional tooth movements in the most efficient and predictable manner. Please note that, during treatment, you should avoid eating hard foods or participating in extreme contact sports so you will not damage your teeth or the appliances.
Clear aligners are a third, more recent option for repositioning teeth. They are removable appliances, generally used in situations that are milder in nature and easier to correct. After careful assessment, a series of computer-generated, custom made clear plastic trays are made to move the mal-aligned teeth. Tooth movement is progressive with each successive aligner or tray, moving the teeth minutely, until the new desired position(s) is achieved. Clear aligners are usually used for simpler or tipping movements of teeth.
With any of these options, simple movements of teeth may take a few months, and more complex movements take up to two or three years.
Orthodontic treatment is an ingenious scientific discovery that has allowed the dental profession to accurately and precisely move teeth for improved aesthetic appearance and functional position. Contact us today to schedule an appointment or to discuss your questions about orthodontics. You can also learn more by reading the Dear Doctor magazine article “The Magic of Orthodontics.”