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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 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.
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.