Upon completion of your active orthodontic treatment there is much to celebrate. However, all of the work is not done. Regardless of your age, the positions of your teeth remain responsive to the application of pressure. This is the mechanism that allows us to move your teeth with orthodontic appliances. The ability of the teeth to respond to outside forces generally lasts throughout life. This is a benefit for patients that decide to undergo orthodontic treatment later in life. Unfortunately, there are many forces outside of orthodontic treatment forces that act on the teeth. These forces include pressures exerted by the tongue, cheeks or lips, habits and biting forces.
We do our very best to place the teeth in the positions that will be most stable. Unfortunately, since these non orthodontic treatment forces vary tremendously for each and every patient, it is virtually impossible to assure that that the teeth are placed in a position of balance with regards to all the forces acting on them. This is why long term retention is critical to maintaining the treatment result.
When the retainers are initially placed, following completion of the orthodontic treatment, they provide the very important function of holding the teeth in one position for a period of time. This allows the surrounding bone and gum tissue to “tighten up” and adapt. Generally 12 hours per 24 hours period is required during this phase, which lasts approximately 12 months. Compliance during this “active wear” phase is critical to allow you to successfully move to the next phase.
Once the “active wear” phase of the retainers is complete, you will generally only need to wear the retainers “enough to keep fitting”, which may be one or two nights per week for most patients.
One exception to this is the occasional use of an active or functional retainer, such as a series of clear aligners or a tooth positioner. These types of retainers will sometimes be used to fine tune tooth alignment of allow functional “settling-in” of the bite.
Faithful wear of your retainers will ensure that you enjoy a long term benefit from your orthodontic treatment. It is also important to know that, even with full compliance to your recommended retainer regimen, some small amount of movement is considered normal.
The retainers are also not capable of restraining or controlling jaw growth and will not be able to prevent the effects of adverse jaw growth of the bite relationships. Fortunately, this type of adverse jaw growth rarely occurs. This can be a concern for patients who have a tendency for excessive lower jaw growth or for patients with asymmetrical jaw growth. We will generally continue to monitor the stability of your orthodontic result for approximately one year following completion of the active treatment. If the result is stable at that point we will dismiss you from our routine care and we will see you on an “as needed” basis. If we are not able to decide on the disposition of your third molars, or “wisdom teeth”, during this time frame, we will ask your family dentist to continue to monitor these teeth.