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Retention

Retention is an ugly word in orthodontics. It’s our little secret that teeth can crowd up again after the braces are removed! Why does this occur? There are actually two types of relapse:

1. Short-term (<1year)
2. Long-Term (>1 year)


Short-term relapse is primarily caused by elastic fibers that are part of your gum tissue. These elastic fibers become stretched during tooth movement and can pull your teeth back towards their original positions after the braces are removed. This is the major cause of short-term relapse. That is why retainer wear is most critical during the first year after your braces are removed. It takes about one year for your original elastic fibers to be replaced by newer elastic fibers that will actually help the teeth stay in their current (straight) position.

Longer-Term Relapse can occur because our bodies are always changing throughout life. Aging-related changes and/or significant weight gain or loss can affect muscle tone in the head and neck. The muscles of the lips, cheeks, and tongue can apply pressure to the teeth and cause movement which is usually a negative event.

Dr. Couto has given a lot of thought to the best way of keeping teeth straight after orthodontic treatment. She wants to protect your investment in time, energy, and money so that your smile or that of your child’s will last for decades!

Bonded Retainers are glued to the back surfaces of the lower six front teeth where they are completely invisible to others. They are placed on the same day the braces are removed to prevent shifting of the front teeth. These retainers are very small, comfortable and do not affect speech. Importantly, these retainers are ‘glued in’ so they cannot be lost or forgotten so the front teeth will stay straight! The only negative to this type of retainer is that flossing becomes harder and requires the use of Super-Floss or Floss-Threaders.

Because the teeth can always move, Dr. Couto recommends that the bonded retainers be left in place indefinitely. A study published in 2007 by Booth, Edelman, and Proffit showed that this type of retainers are both safe and effective. The bonded retainers caused no damage to the teeth or gums in patients that wore them for a period of 20 years as long as the patients had good brushing and flossing habits. In addition, patients who chose to remove their bonded retainers experienced much greater relapse in crowding than those who left their retainers on permanently.

Therefore, the only reason to remove these retainers is if your family dentist feels that you are not cleaning them properly. Please remember that regular checkups to your family dentist are extremely important to maintaining the health of your teeth and gums.

A couple of additional notes about retention:

Dr. Couto warranties both sets of retainers for one year after your braces are removed. However, repair and replacement charges are applied after one year. Retainers should be considered personal use items such as eye glasses that need to be replaced every few years. Please repair or replace your retainers when they are worn out to prevent shifting of the teeth.

The frequency of repair/replacement depends on factors such as the overall health of the gums, flossing technique, diet, strength of the jaw muscles, and whether or not any clenching or grinding patterns exist.

Finally, while retainers maintain most of your orthodontic correction, some minor movement can occur with time.

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