For everyone that has had braces, had them removed, and had that joyful feeling of mouth “freedom,” nothing is more frustrating than noticing (sometimes immediately) that your recently perfected teeth are already shifting! Is this normal? What can be done? Did I do something wrong? I thought I did everything right?!
Remember the chemistry lesson where you learned about the law of entropy? The law of entropy states that everything in the universe naturally changes from a state of organization towards a state of chaos. Guess what? You’re a walking example of entropy every day! And your shifting teeth certainly fall under that chaotic umbrella. Every part of your body, unfortunately, will eventually sag, wrinkle, or simply weaken with time. But that’s okay! The extraordinary, miraculous elements that make up our bodies, like anything else, are designed to change over time. It’s not realistic to prevent all movement, but the goal of orthodontic retention is to minimize changes after the braces come off.
Teeth will typically “settle” after braces are removed. Often, this settling results in a bite that is even better than when the braces were in place. Any movement from front teeth, however, is undesirable to both the patient and the orthodontist, so we want to prevent that as much as possible. During treatment, while the braces are on, the orthodontist carefully positions each tooth to be held tightly in place. Once the braces are removed, we no longer have this control. The forces of occlusion, wear, and the tongue all return as issues to which we must pay attention. Even if a bonded retainer is placed in the mouth, the position of teeth can still change over time.
Retainers are critical in preventing tooth shifting. Immediately after your braces are removed is the most important time to really be a stickler about wearing it. The length of time retainers must be worn fulltime varies, since everyone is different. Each patient should monitor their teeth and wear their retainer as prescribed, or even more if necessary. No one wants to end up in a situation of having to repeat treatment because they failed to wear their retainer. Yikes!
If you wear your retainer faithfully, but your teeth are stubborn and still shift, your orthodontist may resort to implementing a bonded retainer for a while until they become more stable. If you have a particularly tight bite, there may be no room for a bonded retainer. In those cases, your orthodontist may suggest your primary care dentist do some bonding and/or veneer work after teeth have settled. At that point, the goal would be to change the actual size of the teeth instead of trying to move them again.
If minor, but progressive, changes occur in the days or weeks after your braces are removed, your retainer may need to be simply adjusted or replaced. The sooner you notice something happening and report it to your orthodontist, the more likely a simple solution will ameliorate the situation. Clear aligners are another solution that may help correct minor movements. These may then be worn as permanent retainers after the realignment is achieved. Bigger movements may require brackets to go back on the teeth for a short time. Again, the more quickly you communicate any issues to your orthodontist, the less invasive a corrective solution will be.
Slight changes after braces removal are completely normal. Your orthodontist will speak with you about having realistic expectations about how straight your teeth will remain after removal. Just remember, if you wear your retainers as instructed, and unacceptable changes still occur, let us know immediately. We can work together to achieve a beautiful result that will fill a lifetime with SMILES!