Yay! Got your braces off? You have a set of aligned teeth ready to flash a smile! You no longer need to be a dainty eater. Give your mouth some movements, devour an extra large pizza or chomp on a burger!
Stay put with the food!
I hate to break it to you, but the last phase of your orthodontic treatment remains! A half-truth is a whole lie- braces do straighten teeth only if you wear retainers after therapy. NO TWO CASES ARE SAME many orthodontists recommend retainers after fixed orthodontic therapy. Some might recommend it worn for a few months, for others it might be years. The treatment plan and duration vary depending on bone density, growth maturity, age, craniofacial patterns, patient compliance, and the type of braces used.
Orthodontic treatments help straighten teeth but have a high potential for relapse.
Teeth are constantly moving throughout your life. They don't wiggle and wobble in your sockets. The movements arise due to masticatory (biting) forces, and pressure from soft tissues, cheek, and tongue. You don't see or feel it happening day by day, the movement is incremental. This is the rationale for orthodontic treatment. Braces are an assembly of wires that go into brackets, cemented on tooth enamel.
Let's go 'BEHIND THE SCENES' of bone remodeling.
If the force is applied on one side of the tooth, the fibers get compressed resulting in bone resorption on the pressure side. While the other side's fibers get stretched and develop tension leading to bone deposition.
On the compressed side, bone is eaten away by osteoclasts clearing the way for the teeth to move. While on the tension side, bone is deposited creating NO WAY HOME for the teeth. Braces take physics and biology ingenuity to fix your teeth which is beyond the scope of this article.
But the orthodontic treatment has high RELAPSE potential.
Old habits die hard!
Sigh! Our teeth tend to shift back into their original positions. After braces have applied forces on teeth to align them in occlusion, retainers keep this alignment intact until the new bone and tissues grow around them. The periodontal fibers (PDL) are connective tissue fibers that anchor teeth in a socket.
WHAT CAUSES THE RELAPSE and WHY YOU NEED RETAINER TOUCH-UP?
The fibers have a memory of their own; the transeptal fibers are often responsible for relapse. These PDL fibers are stretched during the treatment, and after the braces are removed they tend to contract and return to their original positions.
It takes around a year for the periodontium (specialized tissue that surrounds teeth) to adapt to the new teeth positions. Retainers retain the teeth in the new positions until the periodontium adapts itself.
The lower and upper jaw (Mandible and Maxilla respectively) continue to grow during an adolescent growth spurt. No orthodontist can stop biology and hence post-treatment relapse is inevitable.
The list of factors responsible for relapse is very detailed but let us leave it to the experts.
WHAT ARE RETAINERS?
Retainers are part of the BRACES AFTER-CARE oral regimen. These are custom-made mouthpieces, even if you fail to wear them for a few weeks. They won't snugly fit and you will have to schedule another appointment.
TYPES OF RETAINERS
REMOVABLE- This type of retainer can be removed and reinserted by the patient.
FIXED- This type of retainer is fixed on teeth and can be removed only by the dentist.
HOW TO MAINTAIN RETAINERS
- Maintain a clean case for retainers.
- Clean them with non-abrasive paste every day since these can harbor bacteria.
- Check for distortion, breakage, or any plaque accumulation.
- Brush the food debris and plaque with normal tap water.
- Keep them at a safe place out of reach of animals, and toddlers.
- Take them out when you go for a swim.
- Bring your retainers with you whenever you visit your orthodontist for a follow-up.
- Use sticky note reminders.
MedBound Times approached Dr. Neema Bisht to gain her insights on retainers.
Retainers are very important to prevent the relapse of orthodontic treatment, they also prevent teeth from moving back to their original position.Dr. Neema Bisht, BDS
DENTAL PARENTING
Encourage children to wear retainers by waking them up to tooth fairy presents underneath the pillows. Tuck an 'appreciation note' under their pillows if they have outgrown the idea of the 'tooth fairy' tradition.
In DENTISTRY WORLD, positive reinforcement is a management technique to facilitate good dental health practice by rewarding the child. Positive reinforcement refers to the introduction of a pleasant stimulus (present, pat, hug, or word of praise) after the desired behavior.
RETAINERS give you a SMILE for a lifetime!
The onus is on you to follow the retainer regimen religiously as prescribed by your orthodontist.
REFERENCES:
Kartal Y, Kaya B. Fixed Orthodontic Retainers: A Review. Turk J Orthod. 2019 Jun;32(2):110-114. doi: 10.5152/TurkJOrthod.2019.18080. Epub 2019 Jun 1. PMID: 31294414; PMCID: PMC6605884.
Andriekute A, Vasiliauskas A, Sidlauskas A. A survey of protocols and trends in orthodontic retention. Prog Orthod. 2017 Oct 9;18(1):31. doi: 10.1186/s40510-017-0185-x. PMID: 28990138; PMCID: PMC5632597.
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