Orthodontic Retainers, Why They Are Needed

 

Orthodontic Retainers

Orthodontic Retainers

Orthodontic Retainers, why they are needed.  Everyone needs some kind of retainer after they finish up with their braces or Invisalign treatment.  Your teeth have memory, and for most people, their teeth want to move back in the direction they came from.  The amount of movement varies from person to person.  Some people are lucky and their teeth don’t move very much.  Others see a more significant amount of movement.

When asked by my adult patients why retainers are needed, I pose them this question.  ”Can you name one part of your body that hasn’t changed over the last 30 or 40 years?”  Our bodies change as we age, and that includes your teeth.  They are not set in stone.  You can generate a lot of force when you bite down.  These forces are transmitted to the teeth and they can move the teeth around.  This is especially true for people that grind their teeth (brux) in their sleep.

The most common reason I see people in their 30′s or 40′s to get their teeth straightened for a second time is because they stopped wearing their retainers and their lower teeth crowded up.  It is for this reason I typically use a bonded (fixed) retainer on the inside of the lower front 6 teeth after we are done with treatment.  It is not visible to others and after a day or two people really don’t notice them that much.  Those bite forces I mentioned earlier have a tendency to make the lower canine teeth collapse inward toward the tongue over time.  As the canine teeth drop back, the lower front teeth (incisors) tend to crowd up.  With the lower bonded retainer in place this can’t happen.  Of course, if someone doesn’t want this type of retainer, I will make them a removable retainer.

For most of our patients, we make a removable upper retainer.  This is either a traditional retainer that has the wire that goes across the front teeth, or a clear plastic retainer that is form fitted to the teeth.  Both types have their advantages.  The nice aspect of a traditional retainer is that the orthodontist can move teeth with it (we can with the clear retainer as well, but on a much more limited basis).  If a tooth moves, I can put a bend in the wire and move it back.  Having said that, whenever possible, I do like to use the clear retainer.  It’s clear!  People can’t really see it, and patient compliance is higher with this type of retainer.

When we have a patient that started out with a very large gap between their upper front teeth, in addition to the removable upper retainer, we may also bond the upper two front teeth together to prevent the gap from opening again.

People will often ask, “How long do I have to wear my retainer?”.  The answer is “How long do you want your teeth to stay straight?”  It is a long term proposition.  Now that certainly doesn’t mean you have to wear it all the time forever.  We start people off with full time wear (take it out to eat, brush, and for sports).  As soon as we can we start to cut back on the number of hours a day it needs to be worn.  For most of our patients, we have them wearing it just at night within about six months.  Eventually, we like to get to the point where people are just putting it in a night or two a week to keep things straight.

Check out our retainer video on youtube to see images of different kinds of retainers.

Orthodontic Correction Lower Crowding Time Lapse Video

Orthodontic Correction Lower Crowding Time Lapse Video

This video shows the treatment results on a patient that had significant crowding of the lower teeth, with a blocked out lower canine.  The orthodontic treatment was done with braces on the upper and lower teeth.  The results were achieved without the removal (extraction) of any teeth.

In most cases these days, we are able to treat patients without having any teeth extracted.  That can be a challenge in cases like this where the person has significant crowding and there is one tooth that is completely blocked out of the dental arch.  There are several techniques we use to make enough room for blocked out teeth like this.  We expanded both the upper and lower dental arches.  Basically, this means we uprighted the side teeth and widened them a little bite.  This widening makes more room for the teeth.  The lower front teeth were also very upright.  Looking down at the lower front teeth from above you can see more of the front surface of the teeth than the back side of the teeth.  For teeth to fit normally, the front teeth should actually be angled forward.  We angled the front teeth forward for this patient, and that also made more room.

The final technique we used is called interproximal reduction of some of the lower teeth.  This is a fancy way of saying we went in between some of the lower teeth and made them a little bit skinnier.  Usually we use a sanding disk in between the teeth to do this.  This technique is very effective in allowing us to straighten the teeth without having to resort to dental extractions to make enough room.  This interproximal reduction is pretty quick, the patient does not need to be numbed up to have it done, and it stays well within the enamel of the teeth so there isn’t any sensitivity afterwards.  The use of these three techniques allowed us to make enough room for all the teeth to fit.

For more patient education videos, check out our YouTube Page.

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Orthodontic Correction of Lower Crowding Time Lapse Video

Orthodontic Correction of Lower Crowding Time Lapse Video

 

Impacted Maxillary Canine Diagram

Impacted Maxillary Canine Diagram.  This is a patient educational hand-out from the American Association of Orthodontists.  It shows from start to finish how an impacted canine in the palate is moved down into it’s proper position.  The way this technique works is we send the patient over to the oral surgeon.  The surgeon numbs up the area and then exposes the tooth.  An attachment is bonded on to the tooth and this attachment has a tiny chain coming off of it.  We see you in our office about once a month tie tie a fresh rubber band onto this chain.  Over time, this slowly moves the impacted canine down into it’s proper position.  The time it takes to bring the canine down into place varies from person to person  and it is also dependent on where the canine is initially positioned.  The farther away it is from it’s ideal spot, the longer it will take to bring into place.  We have more patient information at our website.  Check it out!

Impacted Upper Canine Image

Impacted Upper Canine Image

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Upper Crooked Teeth Time Lapse Video: Kyger Orthodontics

Upper Crooked Teeth Time Lapse Video: Kyger Orthodontics

This video shows the correction of some very out out place teeth in the upper jaw.  This treatment was done with traditional braces and no teeth needed to be removed to accomplish this result.  At the end of the video we show a facial morph as well, so you can see how the patient looks at the end.  Check it out!

Upper Crooked Teeth Time Lapse Video: Kyger Orthodontics

Upper Crooked Teeth

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Dental Trauma, What to do with a Broken or Loosened Tooth

Dental Trauma- Broken or Loosened Tooth.

This is a patient education brochure from the American Association of Orthodontists on what to do if you or your child has an dental trauma and what to do with a broken or loosened tooth.

Dental Trauma-Broken or Loosened Tooth

Dental Trauma-Broken or Loosened Tooth

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Dental Trauma- Knocked Out Permanent Tooth

Dental Trauma- Knocked Out Permanent Tooth Education Flier.  This is a publication by the American Association of Orthodontists to help educate you on what to do in case a permanent tooth is knocked out.

Dental Trauma- Knocked out Permanent Tooth

Dental Trauma- Knocked out Permanent Tooth

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Orthodontic Problems to Watch for in Adults

Orthodontic Problems to Watch for in Adults.

Here is a publication by the American Association of Orthodontists showing some examples of bite problems you should be looking for.  These photos show examples of the following:

  • Crowding
  • Spacing
  • Anterior Crossbite
  • Tooth Wear/Bruxism
  • Periodontal Problems
  • Impacted/Tipped/Missing Teeth
  • Protrusion
  • Open Bite
  • Deep Bite

If you feel you need an exam please contact our office:

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Orthodontic Problems to Watch for in Adults

Orthodontic Problems to Watch for in Adults

 

 

Orthodontic Problems to Watch Out for in 7 Year Olds

Orthodontic Problems to Watch out for in 7 Year Olds

The American Association of Orthodontists recommends that children get their first orthodontic check up at age 7.  Here is a publication by the AAO showing some examples of orthodontic problems to watch out for in 7 year olds.  As they say, a picture is worth a thousand words.  It is a lot easier to look at these pictures to understand what an orthodontic problem looks like than to read a description.  These photos show examples of an anterior crossbite, posterior crossbite, crowding, open bite, protrusion of the upper front teeth, ectopic eruption of a first molar, an underbite, spacing, and a finger habit.  If you feel you need an exam please contact our office:

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Orthodontic Problems to Watch for in 7 Year Olds- Photos

Orthodontic Problems to Watch for in 7 Year Olds- Photos

How Orthodontic Braces Work

Metal Braces

Metal Braces

Clear Orthodontic Braces

Clear Orthodontic Braces

How Orthodontic Braces Work

Orthodontic braces work by using brackets that are glued onto you teeth.  These brackets have small slots in the front surfaces of them and it is into these slots that the orthodontic wires fit into place.  These wires are held in place by small elastic ties that fit around the brackets.  Over time, these wires put pressure on your teeth and this moves your teeth into their proper positions.

The brackets (braces) that most orthodontists use these days are not all the same.  Each of your teeth has a different size and shape to them.  The brackets do as well.  So, for instance, a bracket that is made for an upper front tooth (incisor) would not fit correctly on a lower side tooth (bicuspid).  Each of these brackets is custom made for the particular tooth it is supposed to fit on.  They have different thicknesses, and the slots that the wire fits into are made at just the right angle for that particular tooth.

This system of making the braces to fit individual teeth and to have the slots made at just the right angle to move the teeth to their ideal final positions was developed by an orthodontist named Lawrence (Larry) Andrews in the 1970′s.  He is a really smart guy, and very nice by the way.  Anyway, this is the type of system that most orthodontists use these days.  Before Dr. Andrews developed this system, all of the brackets had the same sized slot cut into them.  That meant that the orthodontist had to put individual bends into the wires for every individual tooth in the mouth.  That system worked, but it was a total pain for both the orthodontist and the patient.  It takes a long time to put all those bends into the wires, and it hurts when one of these wires with all these bend on it is pushed into the brackets.

The other aspect to how braces move your teeth is the wires that are used.  Back in the day, orthodontists had stainless steel wires and that was about it.  These days, orthodontists have a number of different high-tech wires to use that move your teeth faster and more comfortably.  The first wire or two that an orthodontist will use on your teeth are very flexible.  They almost feel like rubber.  This is beneficial in a number of ways.  These flexible wires put a more regulated and constant force on your teeth.  This means they are not only more comfortable, but they also move your teeth faster and you don’t need to get them adjusted as often.  As the teeth straighten out, the orthodontist is able to put in progressively thicker and stiffer wires until you get to those stainless steel wires mentioned earlier.

Most people that have braces will need to wear elastics or rubber bands.  These typically go from one or more of the upper braces to one or more of the lower braces.  These elastics pull on your teeth and move them in the direction that the need to move.

I’ve mentioned several times in this post about how the braces/wires/elastic put pressure on your teeth.  This pressure is transmitted from the teeth to the bone that surrounds them.  The bone responds to this pressure and ‘remodels’ around the tooth.  Some bone is taken away in some areas and added in other areas around the tooth, depending on the direction it is being pushed.

That is pretty much how braces move teeth.  If you are interested, you can check out our website for more information.

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