Yes, you can absolutely get braces or other orthodontic treatment again if your teeth have shifted after initial therapy. This movement back toward original positions is known as orthodontic relapse, and it is a common experience for many people who have completed treatment. Surveys suggest a significant percentage of patients experience some degree of relapse within a decade of having their braces removed. The need for a second round of alignment is a common consequence of the natural, lifelong dynamics of the mouth.
Why Teeth Shift After Orthodontic Treatment
Teeth are not rigidly fixed in the jawbone but are held by a dynamic system of tissues, making them susceptible to movement throughout life. The primary biological reason for shifting relates to the periodontal ligaments, the elastic fibers anchoring the teeth to the bone. These ligaments possess a “memory” that encourages them to pull the teeth back toward their starting point after orthodontic correction.
The bone surrounding the teeth also needs time to remodel and solidify around the new positions. Without sufficient external stabilization, the teeth are vulnerable to drifting. The most frequent mechanical reason for relapse is the inconsistent or premature cessation of wearing a retainer as prescribed by the orthodontist.
Daily forces and natural aging also contribute to movement. Habits like clenching, grinding (bruxism), or tongue thrusting exert pressure that causes gradual misalignment. Furthermore, the natural aging process leads to changes in facial and jaw structure, often resulting in slight forward movement and increased crowding of the lower front teeth over time.
Orthodontic Options for Re-treatment
When relapse is significant, a second phase of active orthodontic treatment is generally recommended. The specific method chosen depends on the extent of the shifting and the patient’s aesthetic preferences. For minor issues affecting only the front teeth, limited orthodontic treatment focuses solely on the visible teeth to minimize time and cost.
Clear aligners, such as the Invisalign system, are a popular choice for re-treatment, particularly among adults seeking a discreet option. Aligners are effective for addressing mild to moderate relapse cases, such as minor crowding or spacing issues. For more complex movements, including significant bite corrections or rotations, traditional metal or ceramic braces may still be the most effective appliance.
For very minimal relapse, the existing retainer may be adjusted or a new retainer fabricated to guide the teeth back into position without full appliance therapy. The decision for re-treatment is highly personalized, requiring the orthodontist to assess the severity of the shift, the health of the gums and bone, and the patient’s overall goals.
The Re-treatment Process What to Expect
The re-treatment process begins with a comprehensive consultation, including new X-rays, digital scans, or molds to accurately assess the alignment and degree of relapse. Since the teeth have already been moved once, the new treatment plan often requires less extensive movement than the initial therapy. Consequently, the duration of re-treatment is frequently shorter than the original course of braces, with many mild cases resolved in six to twelve months.
The cost of a second round of orthodontics is highly variable, ranging from a few hundred dollars for minor retainer adjustments to several thousand for full appliance therapy. Factors influencing the final cost include the complexity of movement, the type of appliance chosen, and the geographic location of the practice. Adult bone density is a factor, as mature bone is generally denser than that of adolescents, which can sometimes make tooth movement slightly slower.
Treatment planning for adults must account for any prior dental work, such as crowns or bridges, which do not move like natural teeth. The orthodontist designs a plan that integrates these fixed structures while moving the surrounding teeth. Consistent appointments are necessary throughout the re-treatment phase to monitor progress and adjust the appliances.
Preventing Future Relapse
The cornerstone of preventing future relapse is a commitment to lifetime retention. Once the teeth are realigned, a retainer must be used indefinitely to stabilize the results and counteract the natural tendency for movement. Your orthodontist will prescribe a specific wear schedule, typically involving full-time wear initially, followed by a transition to nighttime-only wear for the rest of your life.
Types of Retainers
There are two main categories of retainers: removable and fixed. Removable retainers, such as clear vacuum-formed or Hawley retainers, offer flexibility but require diligent patient compliance. Fixed or permanent retainers consist of a thin wire bonded to the back surfaces of the teeth, usually the lower front teeth, offering constant stabilization without daily effort.
Regular check-ups are important to monitor the condition of the retainers and the stability of the teeth. Retainers wear out over time, and a warped, cracked, or ill-fitting retainer will no longer hold the teeth effectively. Replacing a damaged or loose retainer promptly is necessary to prevent the need for costly re-treatment.