Orthodontic elastics, commonly known as rubber bands, are a precise component of treatment used to correct the relationship between the upper and lower jaws. While braces and aligners primarily focus on straightening individual teeth, elastics apply inter-arch force to fine-tune the bite, or occlusion, which is how the teeth meet when the mouth is closed. These small, medical-grade bands are typically attached to hooks on the upper and lower appliances in specific patterns to achieve the planned alignment and jaw correction. The consistent, light force they provide is necessary for the biological process of moving teeth into their final, corrected positions.
The Biological Mechanism of Treatment Reversal
A one-week lapse in wearing orthodontic elastics allows the teeth to begin rapidly reverting toward their original, misaligned positions, a process known as relapse. This immediate reversal is driven by the periodontal ligament (PDL), the specialized tissue that anchors the tooth root to the jawbone. The PDL possesses an elastic “memory” because its collagen fibers have been stretched and compressed during the active movement phase of treatment. When the consistent tension from the elastics is removed, the stretched fibers recoil, actively pulling the teeth back along the path they just traveled.
This biological recoil is surprisingly fast, meaning the seven-day period is long enough to result in a substantial amount of lost progress. Orthodontic movement relies on the continuous breakdown and rebuilding of bone around the tooth, but this bone remodeling process lags behind the immediate elastic memory of the PDL. In the absence of sustained pressure, the PDL fibers quickly initiate the reversal of movement. When the elastics are finally reintroduced after a week, the teeth will have settled into an intermediate, unstable position, which is the source of the noticeable stiffness and resistance upon restarting.
Immediate Steps for Reintroducing Elastics
If a week has passed without wearing the elastics, the most important action is to contact the orthodontist immediately for guidance before attempting to restart. The teeth have shifted, and the original elastic configuration may now be applying force to the wrong position or direction. Attempting to restart without consultation can cause significant pain because the teeth must be forced back across the distance they traveled during the relapse.
Patients should absolutely avoid the impulse to “double up” or wear stronger elastics to try and catch up on the lost time. Applying excessive, heavy force is a risk factor for damaging the tooth root, specifically causing a condition called root resorption. Orthodontic movement must be gentle and continuous to allow the bone and PDL to safely adapt. Upon reintroducing the correct elastics, patients should expect increased initial soreness that may last for several days, similar to when the elastics were first introduced. This soreness is a direct result of the pressure needed to move the teeth back from their relapsed position.
The Effect on Total Treatment Duration
A seven-day lapse in consistent elastic wear will inevitably prolong the total duration of the orthodontic treatment. Because the teeth have reverted, the orthodontist must now factor in time to regain the lost movement and then continue with the original treatment plan. This typically translates to adding a minimum of two to four weeks, or often more, to the overall timeline to compensate for the setback.
The unwanted tooth movement that occurred during the lapse can also disrupt the entire mechanical system. The orthodontist’s next appointment may require unexpected adjustments to the archwires or even a change in the elastic configuration to correct the relapse before resuming the forward progress. Time must be spent moving the teeth back to the position they were in a week prior.