After orthodontic treatment, it’s not uncommon to feel like your teeth are shifting as there is a process called settling which needs to occur. Teeth are housed in the bone and are connected to the bone by something called the periodontal ligament. During treatment, the ligaments are stretched and remodelled so it takes several months after being finished for the ligaments to fully adjust and for the teeth to finish shifting and find their new position. As an aside, this is why teeth are often more mobile and loose during orthodontic treatment. This is temporary and teeth should return to their previous mobility, assuming there is no bone loss or root resorption, once treatment is done.
There are a number of retainer options available and this is covered on our website. Lingual bonded (or fixed) retainers tend to keep teeth in a more rigid position but can break quite easily (especially on the top) and require a significant oral hygiene commitment. Removable retainers tend to allow for more settling of the teeth – Essix retainers generally tend to keep teeth more in position than Hawley retainers. Regardless, it is normal to expect teeth to shift less than 1mm. Again, this is a reflection of the natural settling process and should be expected.
That being said, if you feel your teeth are shifting, we have developed this blog post to help guide you through some questions to ask.
What Options Are There To Help With Teeth Shifting?
Firstly – you should never have just lingual bonded retainers. A lot of people think that by having glued wires behind their teeth that they will stay straight forever. This is not true. Lingual bonded retainers can easily break and oftentimes, this is not easily perceived or felt. If the glue becomes detached from a tooth, you may not know. In this case, a tooth can start to shift. Sometimes, when inserted, the lingual bonded retainer can be active and can slowly deliver force to a tooth over time, causing it to shift. For this reason, we ALWAYS recommend having a removable retainer that fits on top of lingual bonded retainers. Even if the removable retainers are not worn every single night, just wearing them a few nights a week should keep the teeth in position. If the lingual bonded retainer is broken, the removable retainer will keep the teeth straight. Therefore, our first suggestion is to put on your removable retainer and see how it fits.
After putting on the removable retainer, it may be tight (which means your teeth have shifted) and that is OK. If it does not fit at all, your teeth have likely shifted a lot and you will require an appointment with your orthodontist. That being said, if it fits and is tight, consider wearing the removable retainer full time for a few weeks. It will act like an aligner and push your teeth back to the position in the retainer. After the teeth are back in position, you should probably wear your retainer most nights to keep them in place as your teeth clearly want to shift.
Do I Need a Retainer To Avoid My Teeth Shifting?
A small percentage of people do not require retainers. Their teeth will not shift after orthodontic treatment. Unfortunately, there is no way of knowing who this small group is – so that is why we recommend retainers for everyone. It is possible that over time you can wean down wear and see what happens. Regardless, most people’s teeth will want to shift without retainers so that is why we provide them to everyone and recommend they be worn.
If after full-time wear of your removable retainer, if you feel like your teeth have not returned to normal, you should probably call your orthodontist. They may be able to make an adjustment to the retainer (such as adding a dimple) to help nudge a tooth back. If you have lingual bonded retainers and your teeth have shifted make sure to get your orthodontist to check the glue to make sure it is still intact.
Another consideration is the age of the removable retainer. If it is old, it may have been stretched and worn down over time. If this is the case, getting a brand new retainer may help move the teeth back. If you were initially scanned for your retainer, chances are there is a digital file saved. If this is the case, the replica of your teeth in the straight position can be fabricated through 3D printing and a new retainer fabricated. The new retainer can also act as a fresh aligner and push your teeth back.
How To Prevent Needing Additional Treatment
To prevent your teeth from shifting the simplest solution is to wear your retainers! We always recommend having a backup set in case your retainers break or get lost – hence we developed our Digital Retainer Program.
If you have any questions about retainers, or teeth shifting after treatment, or any other general inquiries for bookings and appointments, please contact our office for more information.
