It is a common scenario for teeth to shift after initial orthodontic treatment, and the answer to whether you can receive braces a second time is definitively yes. This phenomenon is so frequent that it has its own term: orthodontic relapse. Modern orthodontics is well-equipped to handle retreatment, offering a range of solutions that are often tailored to the specific nature of the relapse and your previous treatment history.
Why Teeth Move Back
Teeth shifting back toward their original positions is primarily a natural biological and mechanical response known as orthodontic relapse. The most common factor is the lack of consistent retainer wear, which is the primary device designed to hold the teeth in their new alignment. Skipping retainer usage allows the teeth to drift and undo the work of the active treatment phase.
Relapse is not solely a compliance issue; biological factors also play a significant role. The supporting tissues of the teeth, including the periodontal ligaments and gingival fibers, possess a kind of “memory” and naturally attempt to pull the teeth back. These fibrous structures require a long period of stabilization after active tooth movement to fully reorganize around the new positions.
Natural physiological changes that occur with age also contribute to shifting. Continuous growth of the jaws and changes within the dental arch can cause subtle movement throughout life. Furthermore, oral habits like grinding (bruxism), or even the eruption of wisdom teeth, can exert forces that push teeth out of alignment, necessitating a second round of correction.
Options for Secondary Orthodontic Treatment
The approach to secondary treatment is highly dependent on the extent and severity of the relapse, and it is often more targeted than the first time. For minor shifting, particularly limited to the front teeth, an orthodontist may recommend “limited treatment.” This uses fewer brackets or aligners to correct only the visible teeth, resulting in a quicker process.
Clear aligners, such as those used in systems like Invisalign, are a highly popular option for retreatment due to their aesthetic appeal. They are often sufficient for correcting mild to moderate relapse cases, offering a discreet way to realign teeth without traditional metal hardware. However, patients must be highly compliant, wearing the aligners for 20 to 22 hours per day to ensure effective movement.
For more severe relapses or complex bite issues that have returned, traditional braces, including metal or ceramic varieties, may be necessary. These appliances provide the robust control needed for significant tooth movement and full bite correction. A less common but highly aesthetic alternative is lingual braces, which are fixed to the back surfaces of the teeth, making them virtually invisible.
The Secondary Treatment Timeline and Experience
A second round of orthodontic treatment is frequently a shorter process than the first, particularly if the relapse is minor. While a full initial treatment might span 18 to 36 months, retreatment for slight misalignment can sometimes be completed in as little as 6 to 12 months. The duration is directly linked to the complexity of the case, with simpler front-tooth corrections progressing much faster.
The process begins with a thorough re-evaluation, including digital scans and X-rays, to determine the exact extent of movement and the new treatment plan. The cost is determined by the case’s complexity; a limited treatment is typically less expensive than a full correction. General cost ranges for a full second treatment often fall between $3,500 and $8,500, with clear aligners sometimes costing slightly more than traditional braces.
In terms of patient experience, the physical sensation during re-treatment is similar to the first time, involving temporary soreness after adjustments. However, many adult patients find the experience more manageable, as they are often more motivated and aware of the importance of compliance. The initial discomfort associated with the application of the appliance and the first few adjustments remains a part of the process.
Long-Term Strategies for Maintaining Alignment
Preventing the need for a third round of treatment centers entirely on adhering to a strict retention protocol. Retention is considered a separate, permanent phase of orthodontic care, and it is non-negotiable for maintaining results. The most common types of retainers are removable and fixed.
Removable retainers include the clear, vacuum-formed retainer (VFR) and the traditional Hawley retainer. The VFR is aesthetically popular and fits snugly over the teeth, while the Hawley retainer uses an acrylic plate and metal wire and often allows the teeth to settle into a better bite. Compliance is the single most important factor for success with removable retainers, as they must be worn as directed, often indefinitely at night.
Fixed retainers consist of a thin wire bonded to the tongue-side of the front teeth, typically on the lower arch. This option is permanent and requires no patient compliance, making it highly effective for preventing relapse in the high-risk front teeth area. Regardless of the type chosen, the consensus in orthodontics is that retention is a lifetime commitment to safeguard the investment made in the corrected smile.