After Braces
Orthodontic treatment is often an involved process that takes a few years and a lot of commitment. After orthodontic treatment is completed, patients are usually very pleased with their beautiful new smiles. To keep teeth looking beautiful after braces, however, there are steps must be taken. Failing to follow through with tooth care and maintenance after treatment has been completed can be a huge and costly mistake that can undermine the efforts of orthodontic treatment.

Wearing a Retainer

A retainer is a small device made out of plastic and metal that is designed to fit over the teeth. Depending on the case, orthodontists may recommend that the retainer be worn at night or for a certain number of hours per day. Instructions may change as time passes and changes in the teeth and mouth occur. It is important that patients carefully follow retainer instructions to maintain tooth placement after braces.

How Long Do Retainers Have to Be Worn?

It is common for patients to be instructed to wear retainers all day for several months after treatment, then overnight for years or indefinitely. Retainers may help to close gaps in between the teeth in addition to maintaining tooth alignment and stability. It is not possible for retainers to be worn for too long, so patients are better off continuing to wear the retainer if in doubt. Many patients are instructed to wear retainers nightly for the rest of their lives.

What if Teeth Shift?

Orthodontic treatment is not a permanent fix, as patients’ mouths undergo changes along with the rest of their bodies as they age and as teeth are used for chewing and eating. Some tooth shifting is to be expected, especially in the lower front teeth. However, more serious shifting can occur if later-than-expected growth occurs. Wearing retainers after braces will help to reduce tooth shifting, but it is important to contact an orthodontist if the changes seem more dramatic.

Dental Health and Tooth Care

While retainers can help to maintain tooth alignment, patients must brush and floss to keep the teeth looking white and clean and to maintain gum health. All efforts to keep teeth straight can be undermined if decay makes it necessary to remove teeth. A smile cannot remain beautiful for long if dental care is ignored.

Subsequent Check-Ups

Patients should visit a dentist and orthodontist regularly to keep their smiles beautiful long after braces. Dentists should be visited about once every six months for standards cleanings, examinations, and x-rays. Dentists may be able to spot orthodontic issues or relapses and recommend an orthodontic visit. Orthodontists should be visited about twice a year after successful orthodontic treatment or as recommended according to the treatment plan. If there are concerns about tooth shifting, patients should contact orthodontists to make an appointment.  

Teeth Shifting

It can be frightening and disheartening for patients that have just had their braces removed to see their teeth shifting. While wearing a retainer can help to prevent some shifting, it is normal for teeth to begin a process of “settling” that begins immediately following braces removal. It is important for patients to understand why the teeth shift, what degree of shifting is expected and accepted after braces removal, and how to tell if teeth are shifting enough to require additional treatment.

Natural Settling Process

When the braces are on, the teeth are held firmly in the position that the orthodontist desires. When the braces come off, the teeth are susceptible to the natural shifting that all parts of the body are susceptible to. The teeth are also susceptible to outside forces such as the tongue and wear from chewing. Some degree of shifting is expected and may even help the bite pattern to come into better alignment than with the braces on.

Retainer Use

Retainer use is necessary to prevent high degrees of shifting. If a patient follows the orthodontist’s directions regarding retainer use, the teeth will generally only shift slightly and no additional treatment will be needed. Retainer use is most important immediately following the removal of the braces, as this is the time when teeth are settling the most. It is usually necessary for retainers to be used nightly for the rest of a patient’s life after the initial period of continuous wear that is dictated by the orthodontist. Failure to use a retainer as the orthodontist recommends may result in additional treatment to re-correct misalignments.

Front Teeth Shifting

Shifting of the front teeth is undesirable and may lead to a need for additional treatment. If the front teeth begin to shift, the orthodontist should be notified immediately. The orthodontist may be able to correct the shifting before it becomes severe by gluing a bonded retainer to the back of teeth until the teeth stabilize. This is not possible with all patients, however. If the bite is too tight to allow a bonded retainer to be inserted behind the front teeth, the orthodontist may recommend allowing the teeth to shift to the final position and then using other means to close the gap between teeth.

Correcting Shifting

If the teeth begin to slowly shift in the weeks following braces removal, the orthodontist may be able to make adjustments to the retainer or prescribe a new retainer in order to prevent further shifting. If the orthodontist is notified quickly enough, but correction cannot be achieved simply by adjusting the retainer, it may be possible to use a clear aligner that can be worn continuously for a short period of time to correct the minor shifting. If shifting is allowed to continue for too long, it may become severe and require reinstallation of braces. It is highly recommended that patients notify an orthodontist as soon as movement is noticed to make correction as easy as possible.