Moving teeth into a new alignment requires a period of stabilization to maintain the results. Braces accomplish the active movement of teeth, but the surrounding tissue must be given time to solidify around the new root positions. The retention phase involves wearing a custom-made appliance, known as a retainer, designed to hold the teeth firmly in place. This allows the gums, ligaments, and bone structure to fully adapt and remodel after active orthodontic treatment. Failing to wear the retainer neglects this stabilization period, making the teeth immediately vulnerable to shifting.
Initial Tooth Shifting After Cessation
Discontinuing retainer wear immediately results in a rapid, short-term movement known as orthodontic relapse. This movement is driven by the “elastic memory” of the periodontal ligaments, the fibers that anchor the tooth root to the jawbone. Having been stretched and compressed during alignment, these fibers pull the teeth back toward their original, pre-treatment locations.
This initial shifting can begin within the first few days or weeks after stopping retainer use. Common signs include minor rotations of the front teeth and the reappearance of small spaces or gaps. The lower front teeth (mandibular incisors) are particularly prone to crowding and slight misalignment during this early stage. This movement, even if minor, establishes a pattern that will worsen over time without intervention.
Severe Functional and Aesthetic Relapse
Neglecting retainer wear for several months or years allows shifting to progress beyond minor aesthetic issues, causing severe structural problems. Long-term relapse involves significant changes to the alignment of the dental arches and the relationship between the upper and lower jaws. This movement can lead to the return of deep overbites, open bites, or crossbites (occlusal interference).
A misaligned bite results in uneven pressure distribution across the teeth during chewing, leading to abnormal or premature wear patterns. Substantial misalignment can also contribute to discomfort in the temporomandibular joint (TMJ), which connects the jawbone to the skull. This level of severe relapse often requires comprehensive orthodontic treatment, as the structural changes affect both function and appearance.
Fixing Relapse: Re-Treatment Options
Correction for relapse requires an assessment to determine the extent of the movement, which dictates the type and duration of re-treatment. For minor relapse, where movement is limited to a few front teeth, limited treatments are effective. These options include being fitted for a new retainer, which may exert mild pressure to guide the teeth back, or utilizing a short course of clear aligners.
If the relapse is significant, involving major bite changes or extensive crowding, full re-treatment is necessary. This comprehensive approach may require traditional braces or an extended series of clear aligner trays. The re-treatment timeline can sometimes be nearly as long as the original treatment, depending on the severity of the relapse.
The financial burden of correcting relapse can be considerable, often mirroring the cost of the initial orthodontic work. Minor relapse correction typically costs between $1,700 and $4,500. More severe cases can range from $3,000 to $6,500 or more, depending on the appliance used. Dental insurance rarely covers the cost of re-treatment if the relapse is due to non-compliance with retainer wear instructions.