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.

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- 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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How Does The Invisalign Process Work?

Invisalign Aligner

Invisalign Aligner

How Does the Invisalign process work?

The first step to starting Invisalign treatment is to get an exam at our office.  The exam is free.  At the exam we will determine whether or not you are a good candidate for Invisalign treatment.  Invisalign is really good at what it does, but there are certain situations where Invisalign will not work very effectively.  A key to remember is that Invisalign works for teens and adults.  Kids that still have baby teeth, or adult teeth that still have to grow in a lot do not qualify.

Once we determine you are a good candidate for Invisalign, we take records.  The records include photographs of your teeth and face, dental impressions of your teeth, and two x-rays.  We send those records off to Invisalign with detailed instructions on how I want the teeth to be moved.  Invisalign then scans your impressions, so that they have a 3D model of your teeth in their computer.  Their technicians will move the teeth step by step in the computer model to their final positions.  I then log on and review the movements of the teeth.  Typically, they get it pretty close, but I have to instruct them on some fine point details of how I want the teeth to be moved.  They make the changes, and then I review them again.  I usually need to do this a couple of times to get the teeth exactly where I want them.  Once I am satisfied, I ask Invisalign to go ahead and make the trays and mail them to our office.  It usually takes about 4 weeks from the time of the impressions until we get the trays back to our office.  Then you are ready to start straightening your teeth!

The way the system works is you wear a set of Invisalign trays (called aligners) for two weeks at a time.  Each tray is manufactured so that the teeth are slightly straighter than the previous tray.  The teeth will typically move 1/10mm per tray.  So when you put a new tray in, the teeth in the tray are slightly straighter than your teeth are.  This puts pressure on your teeth, and over the course of two weeks your teeth will move so that they match the tray.

Most people that get Invisalign treatment have crowded front teeth.  So if you think about crowding, there is not enough room for the teeth to fit.  We need to make more room somehow and we do this in several ways.  On most people, I will have the trays do some expansion of the back teeth.  This does several beneficial things.  One, it makes more room to correct the crowding in the front.  Two, it makes for a broader smile, which also looks better.  For a lot of people, we will also bring the front teeth forward slightly.  A third way we make more room to correct the crowding is to make some of the teeth slightly skinnier.  This process is called interproximal reduction (a fancy way of saying we do a little bit of sanding or filing in between some of the teeth to make a little bit more room).  This is not something that you can readily see and it stays well within the enamel of the tooth so that you don’t get sensitivity later.

On a lot of people we also need to use something called ‘attachments’ on the teeth.  Attachments are small, tooth colored, bumps of plastic material (composite) that we need to put on some of the teeth.  Basically, what they do is to give a handle or gripping point for the aligner to click into place around.  They help the aligner stay on better and they also can put pressure on the teeth in the direction we need to straighten them out.  Not everyone needs these, but a lot of people do.

Sometimes we will also ask people to wear rubberbands with their aligners.  This is very similar to what we would ask a patient to do with traditional braces.  We will use these to rotate a particular tooth, or if they are worn from the upper aligner to the lower aligner, they are used to help correct the bite.

I will ask most people to wear their aligners close to full time.  A major advantage of the Invisalign system is that you can take them out to eat.   We also ask you to take them out to brush and floss and you clean the aligners with a toothbrush at the time you are brushing.  Typically, this means you will have your aligners in for about 20 hours a day.  If you do not wear your aligners this much, the teeth will not have moved to their final position for that particular tray.  When you go on to the next set of trays, they will not fit quite as well.  This has a cumulative effect and by the time you get 3 or 4 trays down the line, they will not be fitting well at all.

Most of the time (I would estimate about 70%) we will get finished with your last tray and there will be a few teeth that are still slightly out of position.  I tell people this ahead of time, because it is pretty normal.  If that is the case, we take a new set of impressions and I have Invisalign make us some more trays to detail things.  The process for this is identical to what I described earlier.  The new trays will come back in 3-4 weeks and we will continue with straightening your teeth.  Invisalign refers to these as refinement trays.  There is not an additional fee for this, it is part of the process.  Most people need to get 1 set of refinement trays.  Invisalign allows us to do this up to 3 times, but in my experience that is very rare.

Once we are done with your final trays, it is time for retainers.  Most Invisalign patients chose clear plastic retainers that look like Invisalign trays.  Some people choose to get a fixed (permanent) retainer on the inside of their lower front teeth.  This is a wire that goes across the inside of your lower front 6 teeth.  The choice will be yours as to what kind of retainer we use.  I ask most people to wear their retainers full time for 2 months and then we cut back to just while sleeping.  Eventually, we get to the point where you are just wearing it a night or two a week.  People often ask why we need to use retainers.  The simple fact is that nothing about your body remains constant.  It all changes as we age and that includes your teeth.  Biting and chewing can put a lot of pressure on your teeth, and over time, these forces can move your teeth around.

Well, that just about does it.  If you have any questions please feel free to call our office (579-0903) and we can set you up for an exam and get you that winning smile you have always wanted!

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You can also check out an Invisalign informational video on our youtube channel.

Kyger Orthodontics in the News, Check Out Our Write Up in the Explorer Newspaper

Kyger Orthodontics in the news: Explorer Newspaper

http://explorernews.com/business/article_505dc770-5374-11e2-9d79-001a4bcf887a.html

We recently had a nice write up in the Explorer Newspaper.  It tells about Dr Kyger and has a quote from one of his patients about how her orthodontic treatment changed her life.  Check it out!

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