Retainer not really working. Anyone experience this?

[rlweber]

I finished my Invisalign treatment about a 18 months ago, and started wearing the retainers. They are clear like the aligners and comfortable. But after about 6 months or so, I noticed gaps returning in my front teeth, so I ordered a new set of retainers (thinking well, plastic might stretch, right?).

The new retainer was SUPER tight. Almost couldn't get it on. After I wore it about three days, my teeth were back to looking good. So I assume I had stretched my first retainer -- a lot.

Now I've had my SECOND retainer about 6 months, and the gaps are returning again! I just know I've stretched this retainer out, too. I never eat with it in; I drink only water with it in, and I wear it faithfully: all night every night and at least three or four hours a day. Still, I see those old dreaded gaps returning.

Has anyone had this experience or can anyone help? Am I doomed to buy a new set of retainers (about $120) every 6 months?

[ajvasey]

well I'm just starting my invisalign treatment, but I do have a large separation in my front teeth and my ortho suggested that it might be a possibility that if I wanted to keep that gap closed that I might need a permanent attachment on those two teeth. The attachment being on the inside of my mouth. Now, the ortho didn't like that idea and it would be a last resort but it is an option. Personally, if thats the case for me, I would rather just have a small separation or do dental bonding to close the gap. I would never want a permanent attachment on the inside of my mouth.

now again, this is only what the ortho told me, not from experience. yet.

good luck.

[rlweber]

I've thought about a permanent attachment, but I've heard they erode the enamel on the back of your teeth. They also collect plaque.

I think all my teeth are moving, based on how tight that new retainer was. I'm now wondering if I'm going to need "another round" of invisalign.

MY WISH: That I could get one more new retainer, get my teeth back to the ideal position one last time, then find a way to KEEP THEM THERE FOR GOOD.


Pipe dream?

Certainly someone else has felt their retainer might be "stretching," or had to replace theirs (maybe because they lost it) only to realize how tight the new one was?

[Sunny]

Ask your ortho for advice on this one.

Permanent retainers should not affect the health of your teeth, as long as you have a good oral hygiene routine.

Hope your ortho can help!

[rlweber]

Thanks for input all. But still looking for someone with retainer experience. Has anyone finished the program and is now in the retainer stage? I'd like to hear from you ...

[Tammy]

Thanks for input all. But still looking for someone with retainer experience. Has anyone finished the program and is now in the retainer stage? I'd like to hear from you ...

I have finished my invisalign and now am wearing a retainer at night. I have not noticed any movement but have only been done for about 1 month now...My dentist made a retainer for me out of a thicker plastic rather than getting it directly from invisalign. I found it harder to get used to but it does not bother me anymore. If I notice any movement I will get the wires behind my teeth because I don't want to go back to my old teeth. I had very minor crowding and was done the program in 6 months. So far so good and I would highly recommend Invisalign to anyone......

[rlweber]

Hi Tammy:

Do you have any more information, or could you get information, about where your dentist got your retainer? Did it come in a package with another brand name on it? It sounds like exactly what I need! Any information you could provide would be very much appreciated. Or, if you could get me contact info for your dentist (web address, e-mail, anything). Thanks for responding!

[Tammy]

Hi Tammy:

Do you have any more information, or could you get information, about where your dentist got your retainer? Did it come in a package with another brand name on it? It sounds like exactly what I need! Any information you could provide would be very much appreciated. Or, if you could get me contact info for your dentist (web address, e-mail, anything). Thanks for responding!

I have just been back to my dentist and found out that my teeth have moved back 2 aligners within the past 6 weeks.....I am not very impressed. I have to wear my 2nd last aligners for 2 weeks and then probably my last ones for the next 2 weeks. After I am done this time I am insisting that he put the permanent retainer (wire behind my teeth) on both top and bottom. The retainer my dentist made for me was done by him, I believe in his office. I will ask him when I go back mid-February, Although I think it probably is better than the Invisalign (not convinced...) I really believe if you are not going to wear them all day everyday for at least the 1st year after, your teeth will shift regardless. My dentist does not like the permanent retainers but has agreed to do it if I insist.....I INSIST!

Hope this helps!

[Sunny]

Great that you're insisting Tammy, as I agree there's no way I'd want to do this twice!

I've read some ortho's don't like the permanent retainers due to oral hygiene issues, but as long as you floss and brush carefully, there shouldn't be a problem. Also make sure you (and your dentist) check the permanent retainers regularly, as they can become loose from the bonding and it's essential you get them fixed asap when this happens.

Our teeth move for as long as we're alive ... so we know what we've got to do, if we want our teeth to stay in their new postions.

Good luck!

[rlweber]

I have just been back to my dentist and found out that my teeth have moved back 2 aligners within the past 6 weeks.....I am not very impressed. I have to wear my 2nd last aligners for 2 weeks and then probably my last ones for the next 2 weeks.

Very interesting! So I guess wearing the retainer only at night may not be enough for you. Is it possible that you also could be "stretching" your retainer at night? I had a dentist tell me I might be grinding my teeth or clenching my jaw at night (I'm pretty sure I do this, in fact), which could be causing premature stretching of my retainer. It is plastic, after all.

What do you think Tammy? And please get back to me when you find out about the origin of your retainer. I'd love to know how it's different than Invisalign, and if your dentist might think it's more durable or "stretch-proof."

Also to Sunny: Thanks for you input! I'm definitely going to inquire about a permanent retainer. Like Tammy's dentist, my dentist seems a bit reluctant. But if I can't get these plastic Invisalign retainers to do the job, it might be my only option (unless Tammy's is made of some super-hero plastic. We'll see!).

Thanks ladies!

[angelbabiez9700]

My dentists told me to wear them for 22 hours out of 24 hour day, you posted that you wore them all night and only 4 to 5 hours a day, I'd bet that isnt enough to keep them from shifting. I would also be concerned for those who got done using their invisaligns too early...teeth should be gradually moved, very very slowly it is better for your gums and your end result of keeping your teeth from shifting again. I think you get to keep your last retainer permenantly, my personal opinion is that if you wear them long enough your teeth should pretty much stay in the same place, that is if you dont have any gum problems. Gums can get softer over a period of time and if you are older or have any kind of issues with your gums, I would talk to my dentist to see if that plays a part in your teeth shifting. I havent had any experience with my trays stretching, they should be tight, but I dont know anything about them stretching....I also grind my teeth at night and during the day.

[Sunny]

My dentists told me to wear them for 22 hours out of 24 hour day

Angel this is during treatment with invisalign. The poster is referring to retainers, and you need to wear them much less, until you need only nightly wear for two or three nights a week.

I would also be concerned for those who got done using their invisaligns too early...teeth should be gradually moved, very very slowly it is better for your gums and your end result of keeping your teeth from shifting again.

Some people have teeth that move more quickly or slowly than others. This does not mean that teeth that move more quickly will not remain retained with correct retainer wear or that your gums will be affected. This is a personal body issue and your gums will not be affected. It's the bone that is affected by tooth movement, and as long as it's done by a professional, who checks the roots of your teeth and bone surrounding them, by x-ray, you should not have any issues.

The best way to keep teeth from shifting again, is by wearing retainers for some part of the day (usually while you sleep) after treatment is finished.

my personal opinion is that if you wear them long enough your teeth should pretty much stay in the same place, that is if you dont have any gum problems. Gums can get softer over a period of time and if you are older or have any kind of issues with your gums,

Teeth will move, this is not an age related issue. They move from the time you are born till you die. If teeth have been moved using orthodontic treatment, there is considerable research to show they move more easily back to where they originally were. Tooth movement is about bone, not about your gums. You can have teeth fall out if you don't take good care of your gums, but this does not encourage the sliding in the bone.

Good luck with your treatment!

[angelbabiez9700]

Thanks for clearing that up, I realized I was wrong after I read the posts, I meant that gums are softer when your younger and harden as you grow older..teeth do move all your life, I guess I should I pointed out that I meant if someone were to have severe gum issues, or receding gum line. However, I am wrong about that. My friend(she's in my nursing class) wore the metal braces for 4 years and did not wear her retainer...and she has gaps in her teeth again, a pretty good size one in the middle..so I would agree with you, wear the retainer. My cousin in law, has her retainer permenantly put in behind her teeth, which is what alot of dentist are doing, I dont know if its always been that way or not, but she said it was because teeth do continually move all your life.

[Sunny]

I like the idea of permanent retainers, but many orthodontists won't use these due to oral hygiene issues, especially with younger patients. They require a higher level of brushing and flossing needs more care. My oral hygiene has been excellent, so I'm hoping this may still be an option for me.

The thing to remember with permanent retainers, is that you most likely will still need removable retainers, as if an ortho does use these, it will only be behind 4, 6 or 8 teeth ... which leaves the reset to push forward. Research shows that this is more difficult, but permanent retainers aren't truly permanent. They often will buckle and come off the bonding behind the teeth, so a high level of diligence is required by the wearing and their dentist to make sure if this happens, it's replaced asap.

Shame your friend didn't continue with her retainer wear. My daughter didn't either, and her teeth are worse than they were before she had braces for two years ... a shame!

[rlweber]

Teeth will move, this is not an age related issue. They move from the time you are born till you die.

True (unfortunately), Sunny. A dentist recently debunked for me the myth that once you move teeth, the "bone sets" and the teeth will not move anymore. I guess what they know now is (to paraphrase him), that every tooth has a series of tiny little rubber-band-like materials surrounding the root. No matter how much you move a tooth, those little rubber bands are programmed to move that tooth back to its "proper" spot.

I guess the cruel reality for we braces folks is that the "proper spot" is precisely where we do NOT want that tooth.

Gotta love technology.

[Sunny]

Love your way of explaining it rlweber!

Sounds like you had the same explanation that I had ... an important lesson to remember!

[Zoso]

Definitely an interesting analogy, and useful to a certain point. I believe that what he is referring to as being like rubber bands will be the periodontal ligament, which attaches the tooth to the bony part of the gums. Because of this anatomical feature, even perfectly healthy, unbraced teeth can wiggle just a tiny bit.

Anyway, as the bracket transfers the forces from the archwire (and elastics, and whatever other appliances) to the tooth, the PDL will be compressed in the direction of movement, and stretched "behind" the tooth. (This is why the teeth sometimes feel "spongy" during orthodontic treatment.) These changes in turn bring about remodelling of the supporting alveolar bone - special cells called osteoclasts respond to the increased force ahead of the moving tooth by breaking down bone tissue. And in the wake of the moving tooth, osteoblasts create new bone cells. It does take some time for this new bone to consolidate and become as dense as that which was broken down ahead of the tooth, and this is why retainers are often prescribed for 24/7 wear initially after the braces are removed.

With this explanation of tooth movement in mind, I think we can see that relapse is probably not generally due to the elasticity of the PDL. Now, there is one exception that I'd like to mention, and that is the situation of a tooth that has been derotated. And that is one reason that rotated teeth are a case where more ODs might tend to recommend fiberotomy after orthodontia is complete - this is a fairly minor surgical procedure in which the gingival and/or transseptal periodontal fibers around a tooth are severed to reduce the tendency for relapse. Indeed, some orthos even recommend fiberotomy when there were no rotated teeth to correct, but whether in such cases this is held by an OD to be necessary/helpful will often be more a factor of where they trained.

So what does cause relapse otherwise? Well, braces aren't the only thing that exerts forces on the teeth. The teeth are just one component in a larger system that includes the jaw bones, jaw muscles, tongue, and so forth. And the whole system will tend to exert forces on the teeth. Now, assuming that nothing else has been changed (no extractions, no jaw surgery, etc.) then this system of forces will be largely the same as it was pre-treatment, so guess what they tend to do Of course, if treatment has involved extractions or surgery, then a whole new force system is established, but even that is not necessarily going to be such that it is perfectly balanced to keep the teeth in their best possible post-braces positions. So I suppose (getting back to the original analogy) you might think of the jaw muscles as great big rubber bands that are putting forces on the teeth.

One other thing to mention is of course habits. For example, if the patient has an uncorrected tongue-thrust habit, that will tend to undo certain aspects of orthodontic treatment as well.