After orthodontic treatment concludes, a retainer is essential for maintaining a straightened smile. This custom-made appliance, whether a clear thermoplastic tray or a wire-and-acrylic Hawley device, holds your teeth in their new positions. Forgetting to wear it for an extended period is a common oversight. When you attempt to put a forgotten retainer back in, you may find that your teeth have already begun to move, signaling orthodontic relapse.
The Science of Dental Relapse
Teeth have a natural tendency to return to their original, pre-treatment positions, which is why consistent retainer use is necessary. This phenomenon is rooted in the “memory” of the periodontal ligament, a fibrous tissue that anchors the tooth root to the jawbone. When teeth are moved during treatment, these fibers are stretched and reorganized, but they retain an elastic quality, constantly exerting a gentle force that attempts to pull the teeth back.
The surrounding bone tissue also plays a role in this movement through a process called bone remodeling. Orthodontic forces stimulate cells called osteoclasts to break down bone on one side of the tooth, while osteoblasts rebuild new bone on the opposite side. This cycle of resorption and formation takes time to stabilize completely after braces are removed. Without the retainer holding the teeth firm, the dynamic balance of these biological forces shifts, allowing the teeth to drift.
Immediate Steps: Assessing the Fit
Before attempting reinsertion, thoroughly clean your retainer using a soft brush and mild soap or a specialized retainer cleaner. Avoid using abrasive toothpaste or boiling water, as these can damage or warp the material. Once clean, hold the retainer with your fingers and gently try to seat it over your teeth.
Use your fingers, not your teeth, to press the appliance into place, applying light, even pressure until it is fully seated. Never attempt to bite the retainer into position, as the force can crack the device or cause undue pressure on your teeth and gums. If you feel a slight, temporary tightness, this is a common sign of minor tooth movement. In this case, you may try wearing the retainer full-time for several days to see if the teeth can be guided back into alignment.
If the retainer only goes halfway on, causes sharp pain, or you notice a visible gap between the appliance and your teeth, stop immediately. Forcing an ill-fitting retainer can cause damage, potentially loosening teeth or harming the delicate root structure. If the retainer does not seat fully or comfortably, your teeth have shifted too much, and professional intervention is necessary.
When the Retainer No Longer Fits
If your attempts at gentle reinsertion fail, schedule a consultation with your orthodontist to assess the extent of the relapse. For minor shifting, particularly with a wire-and-acrylic Hawley retainer, the orthodontist may be able to make a simple adjustment to the wire. Clear retainers, such as Essix or Vivera trays, cannot be adjusted if they are warped or no longer fit the current tooth position.
If the teeth have moved only slightly, the solution is to create a new retainer based on a current impression or digital scan of your mouth. This replacement retainer will capture the teeth in their slightly shifted position, stabilizing them and preventing further movement. You will then need to commit to a strict, long-term wear schedule for the new appliance.
For more significant relapse, the orthodontist may recommend limited orthodontic treatment. This focused, shorter course often involves using a series of clear aligners over a period of about three to nine months to reposition the teeth. After the limited treatment is complete, a new, perfectly fitting retainer will be fabricated to ensure the final result is maintained permanently.