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Medical Forum / General / Dentistry / February 2007Adult asks: must I wear a retainer for life?
I am in my late 30's and had braces removed 10 years ago. I faithfully wore the retainer for years, then gradually allowed more time between inserting it. I have not worn it at all for maybe two months now, and my teeth have moved noticeably. I read another post talking about adult bone growth and shifting through the years, but I'm wanting to know if it is expected that a retainer should be worn for life? I was hoping that a decade would be sufficient. Thanks. retainer must be worn for life or your teeth will shift to some other position. You should wear your retainer for about a week or two it will move your teeth back some. then ask a dentist to make you a permanent bonded retainer. > I am in my late 30's and had braces removed 10 years ago. I faithfully > wore the retainer for years, then gradually allowed more time between [quoted text clipped - 7 lines] > > Thanks. Thank you, Dr. Vasserman. > retainer must be worn for life or your teeth will shift to some other > position. I wish I knew about this before getting braces! >then ask a dentist to make you a permanent bonded > retainer. May I ask the brief definition of a permanent bonded retainer? it is usually a very thin wire bonded on the back of your teeth starting from one eye tooth going to the next. usually it is enough to have it on the lower jaw. Your situation is not hopeless and if it has only been 2 months you can still correct it. Not all ortho can be accomplished with stable results because many times you are not fixing the original culprit that caused your teeth to be crooked for example mouth breathing, tongue thrusting, airway obstruction, etc... Any orthodontist that says they can guarantee lack of relapse is lying through their teeth and you should run the other way. Orthodontics will improve your facial appearance and is sometimes necessary for the health of the other teeth. These days orthodontists are moving away from extraction as much as possible but at the same time they are expanding the arches with caution and only on patients that need this to prevent TMD or occlusal dysfunction. > Thank you, Dr. Vasserman. > [quoted text clipped - 7 lines] > > May I ask the brief definition of a permanent bonded retainer? Thanks for the good info Steven; I'm glad to hear that some can dispense with the retainer. I'm sure every case is unique. It makes me wonder that if I had braces as a child, then my teeth would have been better set by now, with less proclivity to shift? Dr. Vasserman DDS wrote: > Your situation is not hopeless and if it has only been 2 months you can > still correct it. My retainer still fits; when I put it in it is very tight, but loose enough by morning to be easily removed. One concern is, does such back-and-forth movement on the teeth actually weaken their setting in the jaws? > Not all ortho can be accomplished with stable results because many > times you are not fixing the original culprit that caused your teeth to > be crooked for example mouth breathing, tongue thrusting, airway > obstruction, etc... I'd like to know more about this, if you know of any online resources. I was under the impression that teeth shifted because of a genetic predisposition. The Dr. that applied my braces did say that I was probably 'grinding' at night, and there are tiny vertical cracks on some teeth. The orginal purpose for braces was not so much appearance as to relieve occasional 'popping' in my jaws. Thanks. > Thanks for the good info Steven; I'm glad to hear that some can > dispense with the retainer. I'm sure every case is unique. > > It makes me wonder that if I had braces as a child, then my teeth would > have been better set by now, with less proclivity to shift? I'm treading lightly now, as I don't want to overstep my expertise. If you'd had orthodontic treatment before your growth was complete, your othodontist would very likely have you in retention at least until growth is completed. My impression is that age at which orthodontic treatment has little to do with ultimate stability of the result, but that growth can change the result, so that the situation will have to be monitored into adulthood. Otherwise, I see no particular reason why starting earlier in itself would have led to a more stable long-term result. Steve  SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 had a patient that after having ortho as a child and having perfect straight teeth to age 26 after the next four years she developed an open skeletal bite. She now needs orthognathic surgery otherwise she can not put her teeth together. Point is just because "growth stopped" does not mean the jaws will not change. This is not a guarantee. Teeth continue to move throughout the alveolar process in response to muscle pull. I have also ran into a dentist that was able to get orthopedic movement in an adult without surgery. So nothing is in stone. "Alexander Vasserman DDS" <purple543210@yahoo.ca> wrote ................ I have also ran into a dentist that was able to get orthopedic > movement in an adult without surgery. So nothing is in stone. You would have to show me the money on that one. carabelli > had a patient that after having ortho as a child and having perfect > straight teeth to age 26 after the next four years she developed an [quoted text clipped - 4 lines] > pull. I have also ran into a dentist that was able to get orthopedic > movement in an adult without surgery. So nothing is in stone. I have heard of this happening in trauma cases, and also in severe rheumatoid arthritis cases. But in any case, it seems there should be an explanation for significant skeletal changes after growth has ended. Do you know any back story on this? Steve > I am in my late 30's and had braces removed 10 years ago. I faithfully > wore the retainer for years, then gradually allowed more time between [quoted text clipped - 7 lines] > > Thanks. There are orthodontists who actually aim for a stable result. Sometimes this isn't achievable, but most of the time my ortho buddies tell me it is. After a couple of years wearing a retainer, it will often be possible to dispense with it and see no significant drifting. Sometimes this is not possible, but I think most orthodontists will know when a result is not going to be stable much of the time. For instance, if an arch length analysis is done and there is insufficient space in the jaws, orthodontists will sometimes recommend extraction or arch expansion. If the patient or parent objects, the orthodontist will have ways to work around this restriction. But it is a compromise, and often the compromise is stability. I do no orthodontic treatment myself and cannot say how often relapse can be predicted--but I'd bet it's often predictable. In any case, it is clear to me that many orthodontic patients stop wearing their retainers without having significant shifting. Steve |
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