Orthodontic Retention

I am not anywhere close to needing orthodontic retention, but I want to talk about it now since it is very important. First, my update. I am completely used to wearing my aligners. I continually check with my tongue to make sure they are in place. On the bottom I have the space where my baby tooth came out, so I would be very self-conscious if my aligner were not in my mouth. My space is getting a little smaller, but still very noticeable. With the aligner in, it cannot be seen.

What does orthodontic retention mean, and why is it needed?

I will try to very simply answer both parts of this question. When active tooth movement stops, the teeth need to be held where they are. There are changes in the bone that happen when teeth are moved. These changes take time to happen and are very unstable for a long period of time. The changes in the bone need to stabilize after tooth movement has stopped. If the forces on the teeth have not been controlled properly, they will have a great tendency to move back where they were. The retainer phase is not optional or haphazard, but it is a vital part of the treatment. So often, when the braces come off or people get through the last set of aligners, they think they are done. They are only done with the active tooth movement phase and are starting the next phase of treatment. If the retention is not done properly, the entire outcome can be jeopardized.

Young people who have had fixed braces are especially vulnerable to relapse. Now they are in control of the wear time and are not used to having this freedom. It is difficult to stress to them how important wearing the retainers (appliances) are to the final outcome. The appliances are often lost, sometimes on the first day. This is an oft repeated phrase I hear from my patients when asked if they had braces as a child: "I did, but I didn't wear my retainers and my teeth shifted."

Again, I stress, retention is part of the treatment. Without orthodontic retention, it is like trying to hold two things together with glue and then pulling on them before the glue dries. I'm just saying...

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