Seeking orthodontic treatment for a second time is common; you can definitively get braces or aligners again. This occurs because teeth naturally shift back toward their original positions after the initial active phase of treatment is complete. This phenomenon, known as orthodontic relapse, is a well-recognized challenge. When relapse occurs, modern orthodontic techniques offer effective retreatment options to restore a straight, functional smile.
Understanding Orthodontic Relapse
The primary reason teeth move after successful alignment is the biological memory of the surrounding tissues. Teeth are held in the jawbone by the periodontal ligament, which consists of fibers that stretch and reorganize during tooth movement. After the braces are removed, these fibers and the surrounding bone tissue have a strong tendency to pull the teeth back to their initial, pre-treatment positions.
The tendency for teeth to shift is influenced by two main factors: failure of retention and natural physiological changes. Inadequate use of the prescribed retainer is the most frequent cause of relapse. The retention phase is required to give the bone and periodontal structures time to stabilize around the newly positioned teeth. The risk of relapse is highest within the first year following the removal of braces if retainers are not worn as directed.
Relapse can occur due to factors outside of compliance, as teeth shift throughout life because of natural aging and growth. Subtle, lifelong changes in the jawbone and dental arches can lead to late-stage crowding, particularly in the lower front teeth. Physiological factors like chronic mouth breathing or a persistent tongue thrusting habit also exert forces that gradually push teeth out of alignment.
Treatment Options for Second-Time Patients
The specific treatment recommended for a second round of orthodontics depends heavily on the extent of the relapse. A comprehensive orthodontic evaluation, including new X-rays and digital scans, will determine if the movement is minor or if a more significant correction is required. This assessment helps the orthodontist tailor a plan specific to the current alignment issues.
For minor relapse, often involving just the front six teeth, a limited tooth movement approach may be sufficient. This focused treatment is significantly faster than a full course of orthodontics. It may involve using a series of new clear aligners or braces placed only on the visible teeth. Clear aligner systems, such as Invisalign, are well-suited for these mild to moderate cases, offering a discreet way to correct slight rotations or spacing issues.
If the relapse is more substantial, affecting the entire bite or requiring significant repositioning, a comprehensive retreatment may be necessary. This second full course of treatment may utilize traditional metal braces, ceramic braces, or a full series of clear aligners. The choice of appliance is often a patient preference, though the orthodontist will recommend the most biomechanically efficient option. Modern techniques often make the process more comfortable and efficient than the patient’s first experience.
The Timeline and Cost of Retreatment
One of the most encouraging aspects of retreatment is that the timeline is frequently shorter than the initial orthodontic process. Since the foundational corrections were established during the first round, the second treatment focuses primarily on correcting the relapse, which can often be accomplished in a matter of months for minor shifts. While a full, comprehensive retreatment might still take a year or more, it is generally less lengthy than the typical 18-to-30-month duration of a first treatment.
The cost of retreatment varies widely and is directly proportional to the severity and complexity of the treatment plan. For minor relapse cases requiring limited aligners or focused bracing, the cost can be a fraction of a full treatment. While comprehensive orthodontic care generally costs between $5,000 and $6,000, retreatment can range from a few hundred dollars for a new retainer up to the cost of initial treatment if the relapse is severe.
Factors influencing the final price include the type of appliance chosen, the required duration of treatment, and the geographic location of the practice. For instance, clear aligners or ceramic braces often cost more than traditional metal braces.
Long-Term Retention and Stability
To prevent the need for a third round of treatment, the long-term retention plan following retreatment is the most important phase. Retention is a biological necessity, not an optional step, because the tissues supporting the teeth require extended periods to adapt to the new positions.
Orthodontists generally prescribe two main types of retention devices: fixed and removable. Fixed retainers consist of a thin wire bonded to the tongue-side surface of the teeth, most commonly spanning the lower front six teeth. These offer continuous, passive retention and do not rely on patient compliance, providing a high degree of long-term stability.
Removable retainers, such as the clear Essix style or the traditional Hawley appliance, are also provided. Essix retainers are custom-made, transparent trays, while the Hawley uses acrylic and metal wires. Following retreatment, a protocol of lifetime retainer wear is typically recommended, often transitioning from full-time wear to nightly wear after the first year. This lifelong commitment is the most reliable way to counteract the natural tendency of teeth to drift with age and ensure stability.