Whether someone has had them or not, braces are a common orthodontic treatment to resolve abnormal bites or crooked and crowded teeth.
Once the problem is corrected, that’s when patients begin to use a retainer, which helps keep teeth in place following braces.
But, for retainers to work, Dr. Philip Bomeli, an orthodontist at Solon Orthodontics in Solon, and Dr. Shira Z. Tor, a partner at Weiss & Tor Orthodontics in Beachwood, said individuals must be diligent.
“Teeth tend to want to move again,” Bomeli said. “They tend to crowd up more again, like the lower front teeth. Places that originally have spaces, it’s not that they go completely back, but they want to go in that direction. There are changes that occur in teeth and they will always want to move unless we keep them there.”
Tor said, “We suggest using (retainers) for as long as possible. Your teeth, bones and gums age as every other part of the body does. If I had a dermatologist tell me to put on a cream every night to stop wrinkles, I would do it. So, I explain it that way when it comes to retainers.”
The professionals said the main function of a retainer is to hold the teeth in place following braces.
“They maintain that space,” Tor explained. “But there will be slight changes because when you use them, retainers help maintain how straight they are for as long as possible. There are also different types of retainers and no perfect solution.”
Bomeli said braces can range from clear plastic retainers that wrap around teeth to the traditional type of retainer with a molded bridge and bonded wire. Regardless of the type, there are added benefits to braces, as well.
“As a side benefit, for folks who grind their teeth, clear retainers are helpful as they would grind on the plastic,” he noted. “If the plastic wears down over time, they can replace that. It’s better than the actual teeth wearing down.”
Suggested retainer use has little to do with a patient’s age, but more so with how long it’s been since their braces came off, Bomeli said.
“The distance from when they had braces, the farther out, missing a night here or there is not the end of the world,” he stated. “But, if they miss a week after two months from removal, that isn’t good. You’ll see movement.”
Bomeli added after braces, the visible teeth would be in the right spots. But, the underlying substructure of gums and bone, one wouldn’t be able to tell their position right away.
“It takes a couple of years for that foundation to become as solid as it’s going to be,” he said. “And again, things will always want to move. Retainers are always important in that sense. Patients always ask how long they have to wear their retainers and I say for as long as they want straight teeth.”
If a patient skips days of retainer use, a couple of things could occur but that depends on their condition before braces. One thing is some patients could need braces again, Bomeli said.
“We see folks who are parents of other patients we have that say they didn’t use a retainer and now they need them moved again,” he recalled. “Either, it’s back to braces. Or, one thing that is often a good means of helping someone realigning teeth is Invisalign. The folks that tend to be good Invisalign candidates have teeth where the major movements have been taken care of but things have moved a little bit.”
Tor said individuals struggle to regularly use their retainer for one simple reason: it’s a nuisance.
“It’s the same reason why I don’t use my night cream every night,” she stated. “It’s an extra step in the routine and it’s hard to see the long-term goals. People like quick and easy. It’s daunting to think it’ll be part of your routine forever.”
The best way to make retainer use easier is to incorporate it into your routine, Bomeli said.
“Everyone has a cellphone and when it comes to active treatments, think about setting phone reminders,” he suggested. “You’re always on the phone. Also, you can put the retainer in a location where you’ll always see it. Once it becomes ingrained and it’s part of your daily routine, that is when you’re in a good spot.”