When we remove your braces, we begin the retention stage of your treatment. It is normal for teeth to be slightly mobile when orthodontic appliances are first removed. Retainers hold the teeth in their new positions while the bone stabilizes around the roots. Remember to remove your retainers before brushing, and brush your retainers before placing them back into your mouth.
RETAINERS – Do we really HAVE to wear them?
The day the braces come off is exciting for both the patient and the orthodontic staff. However, keeping that beautiful smile still takes a lot of work on the part of the patient. The time after the braces are off and the retainers are in is called “retention”. Essentially we want to “retain” the teeth in proper alignment or, to put it simply, we want to “keep the teeth straight”. Believe it or not, there is science behind wearing the retainers.
The teeth are connected to both the bone and soft tissues (gums) by many different types of fibers. After orthodontic treatment, most of those fibers reorganize and stretch to accommodate the new position of the tooth. However, some of the fibers still “remember” the previous position of the tooth, especially if the tooth started out very rotated. So, for some patients, it may only take a few days without wearing retainers for the teeth to get “crooked” again. Generally speaking, it takes about a year or so for all of the fibers to finish reorganizing into the post-orthodontic position of the teeth. Therefore, it is very important for patients to be diligent with their retainer wear during that first year, while the teeth are still susceptible to adverse movement. Those patients that follow our recommended guidelines for retainer wear will find that they have fewer problems with their teeth shifting in future years than those that do not wear their retainers much during that first year. In general, we have our patients wear their retainers full time for the first month and then gradually work up to night time wear n the months following. Retainers are worn at night because teeth erupt at night and this is when we expect the most tooth movement.
You may have heard that the wisdom teeth, or third molars, are responsible for crowding later in life. However, many studies that evaluated patients missing wisdom teeth have shown that this is not the case. What actually causes crowding of the lower front teeth is what we call late mandibular growth. What this means is that the lower jaw grows with the body and this can lead to growth up to age 17+ for girls and 21+ for boys. As the lower jaw grows, the teeth will move to accommodate the new position of the jaw. This is why we encourage patients to wear their retainers during the late teenage years. In addition, during the aging process, teeth will shift subtly over time. Wearing retainers periodically, even once or twice a month can prevent unwanted tooth movement as the years progress.
There are many different types of retainers available and all have their advantages and disadvantages. We use a removable spring aligner in our office. This is a retainer that can accommodate slight movements of the teeth over time, and can be adapted to move the teeth back in to the correct position if there is minor shifting. Some patients prefer a fixed retainer that is cemented to the backs of the teeth and is quite reliable. However, it becomes a hygiene issue because it requires daily flossing which can be difficult due to the presence of a fixed retainer. In general, we will want to remove this type of retainer and move to a removable one at some point. You may have also seen the “clear” retainers. These are great for a temporary retainer, but they do not allow the teeth to “settle” into occlusion due to the presence of plastic on the biting surfaces of the teeth. In fact, these retainers can actually cause the back teeth not to touch for a period of time.
So, now you know why you need to wear your retainers after the braces are removed. At our office, we pride ourselves in creating beautiful smiles to last a lifetime. However, keeping the teeth healthy and straight requires cooperation from everyone.