My Teeth Are Straight…So Now What?

In Ortho Tipsby Dr. Blaine Langberg

Retainers! Understanding Life After Braces

Your orthodontic treatment is complete and you now have a beautiful and healthy smile. As my teenager says, “life is lit.” Although you loved going to our office, you’re all done with treatment and don’t need to visit us again, right? There’s no need to worry about keeping your teeth straight, is there? I don’t want to disappoint you, but maintaining your new straight smile is a lifelong responsibility. 

Here’s the truth: our bodies are not set in stone. The reality is that teeth can shift and go back to how they started prior to treatment. If you started out with spacing, the spacing can reoccur. If you had crowding the teeth can crowd up again. There is even a risk that if you never had orthodontic treatment, your teeth will shift over time and crowding can develop. We cannot predict which patients are prone to teeth shifting over time (called relapse). You worked hard and invested a lot of time to get that great smile, so we do everything in our power to maintain your awesome result.

In the old days, orthodontists used to say that you should get your wisdom teeth (third molars) out and then you don’t need to come back to the office. But this notion has been debunked with research that showed that teeth shift over time (https://www.ncbi.nlm.nih.gov/pubmed/10860071). Even patients who have their third molars taken out can get teeth shifting.  The best way to keep the teeth straight is to crazy glue them together. Just joking, I wanted to check if you were still paying attention to the blog. While crazy glue would be effective, it would be hard to floss. So, the best way to keep the teeth aligned is with retainers.

There are two types of retainers that we can deliver to patients. Retainers can either be fixed or removable. Fixed retainers involve placing a customized wire on the inside of the teeth using special tooth glue, called composite. The wire is not visible when you are talking since it’s placed behind the teeth on the upper and lower front teeth. The tongue notices the retainer at first, but you get used to the glued wire over time and it becomes a part of your teeth. The pros of having a lingual wire are that you do not have to worry about wearing the retainer and you have peace of mind that a retainer will secure the teeth from moving. In addition, you don’t have to concern yourself with a fixed retainer getting lost or forgetting to wear it. The down side of the fixed retainer is that you have to floss under the retainer and you need to be careful of what you eat because it can become loose.  When the glued retainer is placed on the upper arch, the lower teeth can bite into it and wear the glue down, loosening it.

The other type of retainer is the removable retainer. These retainers can be clear plastic or acrylic with a metal wire in the front. The clear plastic retainer covers the teeth accurately, but if you do not wear it, then teeth can shift and it may not fit. Clear retainers last approximately two years. Retainers with a metal bar have colored acrylic on the inside and can last a significant amount of time, five to ten years. I still wear mine from dental school! The pros of removable retainers are that nothing is glued onto your teeth and it is easier to clean the insides of the teeth. The cons of having a removable retainer is you must wear it so your teeth will not shift over time and they can break or go missing. When we give you a removable retainer, we will remind you to never wrap it up in a paper towel or napkin because you are more prone to throw it out. Also, you need to keep your retainers away from dogs because they like the scent of the retainer and may chew it. Always keep the retainer in your retainer case when you are not wearing it. You should wear your retainer full time for three months after you finish treatment and then each night indefinitely. I like to say, “Wear them until you are a grandparent.” Crazy ways that patients have lost retainers were when, “It flew out of my mouth,” “I was yelling on a roller coaster,” or “It was run over by Dad’s lawnmower.” 

There is a third protocol for retainers that we employ in our office. We like to deliver the lingual retainers on the inside of the teeth and then, as an insurance policy, we deliver a removable upper clear retainer. It is like wearing belt and suspenders. Both are keeping your pants from falling down. In our case, both the glued retainers and the removable retainer covering your top teeth keep your teeth from shifting. 

While I am optimistic about the stability of our result, we are dealing with the human body, so nothing is guaranteed in life, including the alignment of the teeth. But, by customizing the retainers for each patient, we do everything in our power to help protect the valuable investment of your time and finances to maintain that beautiful and healthy smile.