Why Do Teeth Become Crooked After Orthodontic Treatment? How Can It Be Prevented?

Getting orthodontic treatment for yourself or your child can be a long, often expensive procedure. No one wants all that hard work to go waste if the teeth would return to where they started! Unfortunately, this happens in quite a few cases where some basic post procedural instructions were not followed or adequate time for the treatment to settle down was not provided.

This is where most of the trouble arises and a relapse of the orthodontic treatment can take place.

Why Do The Teeth Shift From Their Place?

The process by which teeth are moved from their original position to the desirable one with orthodontic movement involves the application of force, modification of bone and associated ligaments, and then allowing enough time for the movement to stabilize.

The new bone which has formed around the tooth may not be strong enough to support the tooth and thus movement away from the ideal position can occur quite easily. Similarly, the periodontal ligament, which attaches the teeth to the bone, needs time to remodel itself to the new position of the teeth.

If this adaptation does not occur, the periodontal ligament will just end up pulling the tooth back to its original position like a stretched out rubber band.

The third possible cause is one where the teeth apply deleterious forces to a portion of the jaw and cause some of the teeth to move out of position.

It is important to remember that there is an inherent genetic signal for the teeth to return to their original position which must be countered by moving the teeth in a position where they are functionally stable.   

How Can Relapse After Orthodontic Treatment Be Prevented?

After the phase of active movement which is carried out with the help of the braces, there is a phase of passive retention where Removable or fixed retainers are put in place to allow for the bone and periodontal ligament around the teeth to settle down.

The most common method used by doctors is through a simple Removable retainer that has a single wire running across the front of your teeth Depending upon the kind of position the teeth were in prior to treatment, retainers may be used for the upper arch or the lower arch or for both.

READ Orthodontic Braces: Common (And Less Common) Questions Answered

The duration for which these retainers have to be worn is variable, however around 6 months of usage is commonly advised. Patients are directed to wear these retainers at all times except during eating since it can be quite uncomfortable to eat with them on.

In some cases, the doctor may choose to put in place fixed retainers. This kind of retention, also called as permanent retention, involves a small wire running behind the back of your front teeth which has been bonded in position with a composite filling material.

The advantage of this method is that patient compliance is no longer an issue. Also, some situations like gaps in between the front teeth are much more prone to relapse than others. Having permanent retention in place will ensure that the possibility of relapse is eliminated.

Prevention And Correction Of Orthodontic Relapse    

Teeth Crooked After Orthodontic Treatment?

Since tooth movement occurs so slowly and gradually, it can be difficult to immediately notice the changes in position that are taking place. In some cases, the patient did notice but did not do anything about it and hoped that it would stop on its own.

Whatever the reason may be, treatment options to bring the teeth back into position start to become narrower as time progresses.

The biggest potential for movement occurs within the first one year of completion of orthodontic treatment, thus patients should be vigilant for any signs of relapse. Detected at an early stage, the slight amount of movement can be corrected through the use of Removable retainers alone and ensuring that a longer period of stabilization is allowed for.

In the later stages, though, it will require fixed orthodontic treatment to once again get the teeth back to their original position. The good thing about this treatment option though is that it rarely takes as long as the initial treatment time for the teeth to return back to their original position.

Patients can expect to wear the braces for close to two or three months to bring about a moderate amount of change in the position of their teeth.

If patients do not want to wear braces again then other options like invisible retainers are also available. These are quite expensive, and in fact, may cost more than the initial treatment did but are quite effective and  an unobtrusive way to get the teeth back into their desired position.

A functional assessment of the occlusion can also be done to see if there are any forces that need to be corrected. This is an often overlooked part of the treatment which can have some serious repercussions later on once the braces have come off.

The last resort can be to use minimally invasive techniques like veneers and laminates to bring about some cosmetic changes in the smile. These techniques can however only be used in the region of the front teeth.

READ When Orthodontic Is Treatment More Than Just Cosmetic: Braces For Medical Reasons

Conclusion

Teeth that have been subjected to orthodontic movement need adequate time to get stabilized in the new position or the possibility of a relapse happening is quite high. The problem that has been noted is that by the time the long orthodontic treatment is over, patients are often not bothered by the need to wear retainers.

The teeth most commonly affected are the lower front teeth which start to become crowded after a period of a few years. Problems from the relapse of orthodontic treatment extend beyond just the cosmetic ones and can lead to functional difficulties, make oral hygiene maintenance difficult and predispose the patients for the development of future chronic gum problems.

The simplest and most effective way to avoid all of this is to just listen to the post-procedural instructions your dentist gives you and to follow up regularly for a checkup.