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.

Kyger Orthodontics Homepage

Orthodontic Correction of Lower Crowding Time Lapse Video

Orthodontic Correction of Lower Crowding Time Lapse Video

 

Anterior Crossbite Correction Time Lapse Video

Anterior crossbite correction time lapse video.  This video show the correction of a crossbite of the lower left canine tooth and a correction of a deepbite.  The results were achieved without the extraction of any teeth with the use of traditional orthodontic braces.  The treatment mechanics included expansion of the dental arches, and interproximal reduction (IPR) of some of the lower teeth.  Interproximal reduction is the technique of using a sanding disk in between some of the teeth to make the teeth slightly narrower.  Typically, this reduced the width of the teeth by a few tenths of a millimeter per contact.  This reduction stays well within the enamel of the teeth and patients do not have any sensitivity afterwards.  Retention was with a fixed (bonded) retainer glued to the inside of the lower canine teeth and a removable retainer for the upper teeth.  Check out our other patient education videos on our YouTube Channel.

Kyger Orthodontics Homepage

 

Anterior Crossbite Correction Time Lapse Video by Kyger Orthodontics

Anterior Crossbite Correction Time Lapse Video by Kyger Orthodontics

Underbite Correction Time Lapse Video

Underbite Correction Time Lapse Video

 

This video is an example of a patient that had a severe underbite. It shows a frontal view of the teeth and how their positions changed with treatment. An underbite results from either a small upper jaw, a large lower jaw, or a combination of the two.  In an underbite, the lower front teeth are in front of the upper front teeth.  The correction of the underbite was achieved without a jaw surgery by using a facemask (reverse pull headgear) and having two lower bicuspids removed.  The upper dental arch was narrow, so a palate expander was also used.

It should be noted that this kind of treatment can only be performed on a growing child.  The facemask (reverse pull headgear) actually makes the upper jaw grow forward more.  Once a girl reaches the age of 13-14 years of age or a boy reaches the age of 15 years old this type of treatment is not effective.  Often, it is easier to do this type of treatment on kids when they are 8-9 years old.  They are much more compliant with wearing the facemask at  that age than teenagers are.

Check out our other patient education videos on our YouTube channel.

Underbite Correction, Orthodontics, Facemask

Underbite Correction

Kyger Orthodontics Homepage

 

 

 

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

kygerorthodontics.com

 

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

Kyger Orthodontics Homepage

 

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

kygerorthodontics.com

 

 

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

kygerorthodontics.com

 

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:

Kyger Orthodontics Homepage

Orthodontic Problems to Watch for in Adults

Orthodontic Problems to Watch for in Adults