I tell patients that the teeth will continue to move after orthodontic treatment, so it is their call " Whether they want no movement or they accept minimal movement'. Accordingly they can opt for life-long retention or retention for few years.
We don' t tell patients to wear retainers for Life. It depends.
if we could understand the post treatment factors affecting stability of occlusion, and if we are satisfied that forces on each individual tooth are very well balanced after treatment, we may not require retainers at all.
Nature doesn't give retainers to best occluded teeth with perfect smiles.
if at all we have to give life time retainers, patient as well as the treating doctor should be aware of their advantages and ill effects on surrounding tissues. after weighing all pros and cons, the decision of course, lies with patient.
I do agree with you Doctors. Could you please tell us you retention regimen?
It depends on. Each time needs a personal approach to the patient and his relatives.
No, continued growth of the skeletal system through life precludes this practice. Over use of retainers seems to lead to periodontal issues.
Dear Dr. Dirkes
Do you know any RCT / systematic review or metanalysis. In books retention is clsssified under cases which require no retention (anterior crossbite), cases require short term retention, long term retention and last permanent retention as in midline diastema.
No. Not much in regards to EBD in ortho. The disasters in over retention are thankfully few and far between.
1 or 2 years and sometimes a lingual bonded retainer to hold teeth 7 and 10 if they were mesially rotated.
Dear Dr. Dirkes;
I use fixed retainers + VFR, some times wraparound in extraction cases. An allinger is alway constructed.
Single anterior tooth in cross bite and serial extraction cases do not require retention. Could you please share your retention regimen. Thanks
Dear all! Please, attention. Hippocratic commandment: "Do not harm the patient." Consequently, the patient is necessary to say what will ease his suffering, and not hurt. Thus it is necessary to speak compassionately and not hypocritical.
Dear Dr Kulchitsky;
This is great statement, i like it. Also to show empathy.
If they are smart and most are not. Please go back to the 1960's and Begg's research on facial growth. Teeth become crowded because the "arches" grow at different rates in most patients. Grow faster in the anterior-posterior direction and crowding occurs, grow faster in the lateral direction and spacing occurs. If you properly move the teeth by stimulating bone growth (replicating the eruption process) then the teeth will stay more stable than in the tipping/torquing process normally used in the "science" of ortho. So wear the retainers about 30 minutes a day, changing them every 3-4 years and the teeth will remain stable. And be kind to your patients and never do serial extractions as the research says that in a great percentage of patients this leads to Obstructive Sleep Apnea. This is a life threatening under diagnosed disease in the world population. As a General Practitioner I have done ortho with a procedure called FastBraces and never had to remove teeth, had NO root resorption, less pain during movement and in only 1 case extended the ortho treatment past 1 year. I treated about 90% of the patients wanting ortho treatment in my practice using this methodology.
Dear Adil Mageet
pls check the link,
AFTER BRACES ALWAYS RETAINERS
Why retainers?
After your orthondontic treatment is finished, and your braces are removed, you will need retainers to hold your teeth in their new positions.
For how long do I need to wear retainers?
It takes time for the bone and all the tissues around your teeth to reorganise and therefore it is necessary to use retainers until your bite stabilises. In the first month after the braces are removed, the risk of relapse is very high.
Relapse means that the teeth can take up to one year or more to stabilize after treatment. If you had gaps between your teeth before treatment, the retention period will be longer.
Usually, retainers are worn for as long a time as you have had your braces. If your teeth move back to their original positions, you may need fixed braces again to correct them.
What Will My Retainers Look Like?
The retainers are individually designed to prevent teeth from reverting to their original positions. Retainers can take the form of a removable appliance or a fixed wire bonded at the back of your front teeth.
Do I have to Wear Them All the Time?
Your orthodontist will prescribe the retention plan that is best for you. Some retainers are used full-time for the first 6 months; after that, the retainers are worn only at night, for a few years. Other retainers are worn full-time for about a week, and solely at night thereafter. Fixed retainers are normally kept in place for 5 years.
Is it Important to Use Your Retainers as Instructed?
Removable retainers should be taken out during eating, contact sports and when you brush your teeth. To clean the retainers, remove them first and brush them in tap water using a toothbrush and some toothpaste. Brush your teeth after this.
The safest place for your retainers is in your mouth. If you are not using the retainers they should always be kept in a box. There is a great risk of losing retainers if they are wrapped in tissue paper after you remove them from your mouth.
How Will Retainers Affect My Daily Life?
A removable retainer has a wire holding the front teeth. It will be visible but much less than the fixed braces.
If you have a removable retainer in your upper jaw, it will take you one to two days to get accustomed to them and speak properly. It is normal to experience a lot of saliva in your mouth with a new retainer.
Always bring the box to store your retainers to be kept should you need to remove them. If you have a fixed retainer, you should spend more time to brush the back of your teeth. You have to brush all around the wire so that calculus will not form. You will be instructed on how to use dental floss with a floss-threader. Do remember not to use your front teeth to for biting hard foods or objects. Fixed retainers do not affect speech.
Will my teeth never change when the period of retention is over?
Bone has the capacity to change and remodel for as long as we live; that is why a broken bone can heal.
From 20 to 50 years of age, faces mature and teeth continue to push forward, causing crowding of the lower front teeth. This happens regardless of whether you have had wisdom teeth removed, extractions of teeth or previous orthodontic treatment for crowded teeth.
To avoid the risk of late crowding, removable retainers can be worn at night for a longer period and fixed retainers kept in for more than 5 years.
Adult patients usually sleep with their retainers on for the rest of their lives, if they want their teeth in perfect alignment.
https://www.youtube.com/watch?v=q5d9SAzU8hU
Dear Dr. Nirmala;
Could you please share your retention regimen. Best regards
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