The most exciting day of orthodontic treatment is the day the braces come off. The teeth look and feel amazing. Getting straight teeth, however, is only half the battle. The other half is keeping them that way. On the day treatment ends, my assistants and I instruct our patients that they must wear their retainers every night for the rest of their lives, or their teeth will move. Although new retainers may feel “snug,” they should snap into place cleanly and not cause any pain. We check every retainer for comfort on the first day and remake any that are not right.
The Only Way to Keep Your Teeth Straight is Wearing Your Retainer
From decades of clinical research, we have learned that no matter how we straighten the teeth, they tend to move after treatment has ended. The only way to preserve the results is by wearing retainers… FOREVER! Although our patients acknowledge this on removal day, forever is a long time and for a variety of reasons, many discontinue wear at some point.
A Retainer That Hurts Usually Means that Your Teeth Have Moved
When a patient returns to our office with a retainer that hurts when they wear it, there are only two possible explanations. Either the retainer has changed, or the teeth have moved. Generally, it is simple to determine which has occurred. In some cases, retainers are damaged, distorted, or “wear out” with daily use. In most cases, however, the retainer is fine, but the teeth have shifted.
Not All Post-Treatment Tooth Movement is Bad
Following orthodontic treatment either by braces or aligners, the teeth naturally “relax” without the wires or plastic to prevent their movement. This slight change in tooth position is good when it results in the improvement of the bite. We call this beneficial relaxation “settling.” When the movement happens up front where people can see it, we call this “relapse.” The goal of orthodontic retention is to allow desirable settling while minimizing unwanted relapse.
What Are the Options If Your Teeth Have Moved?
If the movement that has occurred is minor, sometimes merely wearing your retainer full-time for several weeks will realign the teeth (similar to how clear aligners work). If the relapse is too much for your retainer to correct, however, you will probably need a new one. Even desirable settling can make your retainer uncomfortable or not seat all the way. In these cases, you will also need a new retainer, even if you’re happy with the way the teeth look and feel. If your teeth have shifted so much that you are not satisfied with their appearance, you may an orthodontic “tune-up” (additional treatment) to realign them. Your orthodontist can help you decide what is best for you.
Everything Sags and Wrinkles in Time
Although some are surprised to hear that they will need to wear their retainers every night for the rest of their lives, few deny that everything else on the body sags and wrinkles in time. Retention is forever, and if you do not wear a retainer, your teeth will eventually move. When they do, the retainers you received on the day your braces came off won’t fit comfortably anymore.
NOTE: The author, Dr. Greg Jorgensen, is a board-certified orthodontist in the private practice of orthodontics in Rio Rancho, New Mexico (a suburb on the Westside of Albuquerque). He was trained at BYU, Washington University in St. Louis, and the University of Iowa. Dr. Jorgensen’s 28 years of specialty practice and 10,000 finished cases qualify him an expert in two-phase treatment, extraction and non-extraction therapy, functional orthodontics, clear aligners (Invisalign), and multiple bracket systems (including conventional braces, Damon and other self-ligating brackets, Suresmile, and lingual braces). This blog is for informational purposes only and is designed to help consumers understand currently accepted orthodontic concepts. It is not a venue for debating alternative treatment theories. Dr. Jorgensen is licensed to diagnose and treat patients only in the state of New Mexico. He cannot diagnose cases described in comments nor select treatment plans for readers. The opinions expressed here are protected by copyright laws and can only be used with the author’s written permission.