There is nothing more troubling than to get your braces off and notice almost immediately that your recently perfect teeth are already moving! Is it normal for teeth to shift that quickly? Did the orthodontist do something wrong? Can it be prevented? How can these slight movements be fixed when they occur?
There is nothing in your body that does not wrinkle, sag, or weaken with time. Our hair gets thin, our tummies sag, and our faces wrinkle. Is it any surprise that the alignment of our teeth changes after our braces come off? The law of entropy states that everything in the universe naturally changes from a state of organization towards a state of chaos. In other words, things fall apart. The goal of orthodontic retention is not to prevent all movement. That is unrealistic. The goal is to minimize changes after the braces come off.
It is normal for the teeth to “settle” after the braces come off. This settling can result in a bite that is actually better than when the braces were in place. Movement of the front teeth however is undesirable and patients, along with their orthodontists, want to prevent it as much as possible. When the braces are on, the teeth are held tightly in place while the doctor carefully positions each one. After the braces come off however, there is no such control. The forces of occlusion, wear, and the tongue come back into play. Even if the teeth are held in place with a bonded retainer after appliance removal, the position of the teeth will still change with time.
Retainers are the key to preventing tooth movement. The most important time to be faithful with your retainer is immediately after your braces come off. Everyone is different and the length of time that retainers must be worn fulltime varies. Each patient must monitor their own teeth during the first month or two after their braces come off and make sure they wear their retainers at least as much as prescribed by their orthodontist, even more if necessary. If you don’t wear your retainers and your teeth move because you didn’t, you may have to have braces again to move things back where they were.
If you are wearing your retainers faithfully and your teeth still move, you may need to have a bonded retainer glued behind them for a while until they are more stable. If you have a tight bite, you may not have room to fit a retainer behind your front teeth. In these cases you will need to let the teeth settle and have the teeth bonded or veneered by your primary care dentist to close the space. The spaces in these cases are due to the narrow size or shape of the teeth and not their position. Consequently, the “fix” is to change the size of the teeth and not to try and move them again.
If you notice small but progressive changes in the days or weeks after your braces come off, your retainer may need to be adjusted or replaced. The sooner you notice the problem and report it to your orthodontist, the more likely it will be that merely changing or adjusting your retainer will be enough. Clear aligners can also be created to correct minor movements that have occurred. These aligners may then be worn as permanent retainers after the realignment is complete. Bigger movements may require that brackets go back on the teeth for a visit or two. The longer changes are left unaddressed, the more extensive the additional treatment will be.
Some slight change after your braces come off is normal and cannot be prevented. You need to have realistic expectations about how straight your teeth can remain after the removal of your braces. If you are wearing your retainers as instructed by your orthodontist and unacceptable changes still occur, you must return to your orthodontist as soon as possible. The longer you wait, the longer the road back will be.