Contents
Maintaining the effects of orthodontic treatment is a very important element in correcting malocclusion. Retention is the final stage of treatment and applies only to fixed appliances. Why is retention so important and how is the effect of wearing a fixed braces maintained? What types of retention devices can an orthodontist offer us? How long can retention take?
Orthodontic treatment – stages
Orthodontic treatment is a long-term process that can be divided into several stages. Each of them is equally important and is an integral part of treatment. The most basic classification includes six stages of orthodontic treatment:
- consultation, diagnosis and diagnosis – the first stage of orthodontic treatment is a consultation visit to an orthodontist. During the consultation, the orthodontist carries out and orders tests that allow you to make a diagnosis. The examination begins with an interview, which directs the doctor to the cause of the malocclusion. Then the orthodontist performs an extraoral examination, during which he assesses the symmetry of the face, the type of profile and the work of the temporomandibular joints. During the examination, the orthodontist also pays attention to the mucosa of the oral cavity, gums, tongue and salivary glands. In the next part of the examination, the orthodontist assesses the malocclusion. It checks the maxilla-to-mandibular relationship in the anterior and posterior dimensions. It is not uncommon that a decision is made to perform additional tests, such as a pantomogram, cephalogram or X-ray image;
- oral hygiene and healing caries and cavities – before starting orthodontic treatment, each patient must take care of proper oral hygiene and the health of their teeth. Before applying the braces, any carious lesions and cavities in the teeth should be healed. Patients should also remove tartar and plaque. In many cases, a diagnostic laser examination is performed, which allows to detect caries invisible to the naked eye. Only after the teeth have completely healed, the orthodontist may start treating the malocclusion;
- consultation, treatment program and orthodontic appliance selection – during this consultation visit, the orthodontist presents the patient with a treatment plan for the malocclusion. The treatment plan usually takes the form of a document signed by the orthodontist and the patient. During this visit, the patient, guided by the advice of an orthodontist, selects the appropriate orthodontic appliance for him. After making the selection, the schedule of the next stages of treatment, cost estimate and treatment time are established;
- putting on the braces – before putting the braces on, the orthodontist thoroughly cleans the patient’s teeth. Then, metal or porcelain brackets are glued to the surface of the teeth with a special glue and a polymerization lamp. Orthodontic brackets have grooves into which a nickel-titanium arch is inserted. During subsequent visits, the arches are replaced with increasingly stronger ones, which determines the strength of the device on the patient’s bite. The locks are also fitted with ligatures, i.e. popular rubber bands available in various colors.
- control visits – the installation of the apparatus is associated with the need for control visits. They are held every 4, 6 or 8 weeks depending on the stage of treatment. During follow-up visits, the orthodontist assesses the results of treatment and, if necessary, fixes new brackets or changes ligatures.
- completion of the treatment and consolidation of the effects – the last element of orthodontic treatment is removing the braces and ensuring that the obtained effect is maintained. Instead of a fixed appliance, the patient receives a retention apparatus. The retention time depends on the treated malocclusion and is always decided by the orthodontist.
Do you want to know more about the stages of malocclusion treatment? Be sure to read: How is orthodontic treatment performed? Step by step teeth straightening
Effects and complications after orthodontic treatment
The long-awaited effect of orthodontic treatment is a beautiful, healthy smile and a reduced malocclusion. It is worth remembering, however, that orthodontic treatment can cause various complications, especially when the patient did not care for the proper oral hygiene or neglected the timeliness of follow-up visits. The complications that may occur during and after orthodontic treatment include:
- enamel discoloration, caries, stains on the teeth – these complications are the result of failure to follow the advice of an orthodontist regarding oral hygiene. Wearing an orthodontic appliance makes it much more difficult to clean plaque, especially from food debris. Discoloration most often appears in the gingival area;
- gums and periodontitis – are also caused by improper oral hygiene while wearing braces. The bacteria in the plaque cause gums to become inflamed and cause swelling and redness. Additionally, recessions may appear, i.e. the surface of the root is exposed as a result of the atrophy of the gum;
- erosions and wounds on the mucosa – these complications are the result of wearing an orthodontic appliance. These injuries usually appear at the earliest stage of orthodontic treatment.
- allergic reactions to ingredients and compounds used in the production of orthodontic appliances. Almost all cameras are made of various metal alloys. The most common are cobalt, nickel or chrome. Nickel is an allergen, many people struggle with an allergy to this element. In addition, some patients may be allergic to acrylic or latex, which are used in the manufacture of rubber orthodontic gloves;
- tooth root resorption – that is, shortening the length of the tooth root. If the resorption is very intense, your doctor may decide to stop further treatment;
- Dental pulpitis is a rare complication that may be caused by too much pressure on the tooth pulp. This pressure can disrupt the blood flow through the tooth;
- recurrence of malocclusion – here comes the issue of caring for the effects of orthodontic treatment. If the patient neglects the retention period, there is a high probability that the malocclusion will recur. In this case, all treatment effects are lost.
How to take care of teeth while wearing braces? Check: Braces and oral hygiene
What is retention?
Retention is the process of stabilizing a bite that has already been corrected with an orthodontic appliance. The human body is constructed in such a way that the teeth, even after straightening, try to return to their previous place. This phenomenon is common especially in adults who have been functioning with a malocclusion for many years. Retention is therefore a consolidation of the effects that were achieved during orthodontic treatment.
During retention, you should strictly follow the orthodontist’s recommendations and show up at designated follow-up visits. Retention as a process is spread over time and its intensity also decreases with the following months. Initially, the retainer is worn all day, then for several hours, up to several days a week. Adherence to the orthodontist’s recommendations is the most important part of the retention period.
What should you know about malocclusion? Read: Malocclusion and orthodontic prophylaxis
Why is retention so important?
Retention is so important primarily because it prevents the malocclusion from recurring. Without retention, all treatment effects will likely be lost. Orthodontists also point to other important factors that indicate a retention period requirement after orthodontic treatment:
- after removal of the orthodontic appliance, the periodontal tissues and gums are rebuilt. The retention apparatus supports these changes in the oral cavity;
- after disassembling the braces, the soft tissues, i.e. lips, cheeks and tongue, are constantly pressed against the teeth, which are placed in a rather unstable position after treatment. The retention apparatus allows for grading this pressure;
- after removing the camera, we are also dealing with growth changes.
Retention devices – types
Retention appliances, like orthodontic appliances, are divided into fixed and removable appliances. The basic division of retention devices is as follows:
- permanent retention apparatus – it is a retention wire that the orthodontist sticks on the inside of the dental arch. The advantage of this device is that the patient does not have to remember to insert and remove the retainer, and moreover, it is invisible at first glance. A fixed retention apparatus has the disadvantage that it is permanently attached to the teeth, making oral hygiene considerably more difficult. In the case of this type of braces, calculus and plaque settle on the teeth much faster;
- transparent thermoformable plates – a type of removable apparatus, i.e. removable transparent splints covering the entire surface of the teeth. The plates are virtually invisible and comfortable and convenient for patients to use. Their disadvantage is that they deteriorate very quickly – they crack and turn yellowish;
- Hawley acrylic plates – these are movable cameras that look deceptively similar to movable cameras worn by children. The apparatus does not cover the chewing and incisal surfaces, which creates comfortable conditions for eating food and is convenient for the patient.
More information about retention braces can be found here: Retention braces and their role in orthodontic dental treatment
How long does it take to consolidate the effects of orthodontic treatment?
How long the retention period lasts cannot be clearly stated. Fixing the effects of orthodontic treatment depends on the patient’s predisposition and the treated defect. In children and young people, retention usually lasts shorter than in the elderly or those who have functioned for a long time with a malocclusion. Adults often hear that their retention should last for the rest of their lives. First of all, it should be remembered that the periodontium is ready to maintain the proper positioning of the teeth only after about 12 months. The retention devices protect the teeth against re-curvature during this time.
Do you want to know how much orthodontic treatment costs? Check: The cost of installing an orthodontic appliance – how much does a beautiful smile cost?
The content of the medTvoiLokony website is intended to improve, not replace, the contact between the Website User and their doctor. The website is intended for informational and educational purposes only. Before following the specialist knowledge, in particular medical advice, contained on our Website, you must consult a doctor. The Administrator does not bear any consequences resulting from the use of information contained on the Website.