The short answer to whether you can receive orthodontic treatment again is yes. Many people who had braces years ago find that their teeth have gradually moved out of alignment, a common phenomenon known as relapse. Orthodontic retreatment is a frequent concern for adults and is often simpler and faster than the original treatment. This second course of treatment is a common and successful option for regaining alignment.
Why Teeth Shift After Initial Treatment
The most frequent reason for teeth shifting is the inconsistent use of a retainer following the initial treatment phase. Teeth are held in place by periodontal ligaments and fibers that possess an elastic memory. If retention devices are not worn as prescribed, the forces from these fibers can slowly cause the teeth to drift back toward their original positions.
Natural biological processes also contribute to minor shifting throughout a person’s life, even without orthodontic intervention. As the body ages, a process called mesial drift occurs, where teeth tend to move slowly toward the midline of the face. Changes in jaw structure and bone density over decades further influence the stability of the dental arch.
External pressures and habits can also play a role in destabilizing a corrected smile. Habits like tongue thrusting, where the tongue pushes against the front teeth during swallowing, exert constant, low-level force that gradually moves teeth forward. The eruption or presence of wisdom teeth, while not always the cause, can sometimes add pressure that contributes to crowding and movement in the back of the mouth. Understanding these underlying factors is the first step in planning a long-term solution.
Orthodontic Options for Retreatment
Adults seeking retreatment often prioritize aesthetic considerations, leading to a variety of modern options beyond traditional metal hardware. Clear aligner therapy has become a popular choice for correcting minor to moderate relapse due to its near-invisibility and removability. Patients appreciate the ability to take the aligners out for eating and cleaning, which simplifies oral hygiene compared to fixed appliances.
For those requiring more complex tooth movements, less noticeable fixed appliances are available. Ceramic braces use tooth-colored or clear brackets and wires, making them significantly less conspicuous than standard metal brackets. They function identically to traditional braces but offer a more aesthetic appearance for the duration of the treatment.
An even more discreet option is lingual braces, where the brackets and wires are custom-designed and bonded to the back surface of the teeth. This placement makes them virtually invisible from the front. Traditional metal braces remain a highly effective choice for extensive corrections, offering durability and efficiency, particularly in cases involving significant relapse or bite issues.
The Retreatment Process and Duration
The process for starting retreatment begins with a comprehensive consultation to assess the extent of the relapse and the overall health of the jaw and supporting bone structure. New diagnostic records, including X-rays, digital scans, and photographs, are necessary to precisely plan the required movements. The orthodontist analyzes these records to determine the most appropriate appliance type and the estimated treatment length.
Retreatment is often significantly shorter than the initial orthodontic treatment because the goal is typically to correct minor shifting. Depending on the severity of the relapse, active treatment may last anywhere from six to eighteen months. The total cost varies widely depending on the complexity, the length of time needed, and the specific type of appliance chosen.
Patients must commit to a schedule of regular adjustment appointments, typically every four to eight weeks, to ensure the planned movements are progressing correctly. Maintaining meticulous oral hygiene is important during this time to prevent issues like cavities or gum inflammation. This focus ensures the efficient movement of teeth back into their desired positions before transitioning into the maintenance phase.
Ensuring Long-Term Stability (Retention)
After the teeth have been successfully realigned through retreatment, the focus shifts to the retention phase, which is arguably the most important step in preventing future relapse. The concept that teeth never stop moving necessitates a commitment to lifelong retention to ensure the results are permanently maintained. Ignoring this phase is the primary reason why many patients require retreatment in the first place.
Retention is typically achieved using one of two main types of appliances. Removable retainers, such as clear thermoplastic models or the traditional Hawley design, are initially worn full-time and then transition to a nightly schedule. These devices are easy to clean and allow for unimpeded brushing and flossing, but their effectiveness relies completely on patient compliance.
The alternative is a fixed or bonded retainer, which consists of a thin wire permanently cemented to the back surfaces of the front teeth. This option offers constant, passive retention and eliminates the need to remember to wear a removable device every night. However, fixed retainers require more careful flossing techniques to clean around the wire and must be checked regularly for any signs of breakage or detachment. Retainers are susceptible to wear and tear and must be replaced every few years to ensure they continue to effectively hold the teeth in their perfected positions.