Top 5 Orthodontic Retention Factors To Consider When Completing a Case

Orthodontics is a major investment for your patients, both financially and time-wise. While patients are all smiles at the end of their treatment, in order to maintain that perfect smile, both literally and figuratively, you need to understand how orthodontic retention affects results. An orthodontic retainer is a major component of treatment, although most patients feel their case is complete once braces are debonded.

When you take orthodontic courses, you’ll learn the importance of retainers and how it can maintain those beautiful results. You can then convey to your patients how important orthodontic retention is to preventing orthodontic relapse. Here are some factors to consider when completing an orthodontic case and going into the retention phase. 

1. Patient Compliance Varies

Not all patients are consistent with wearing retainers. Fortunately, there are numerous options depending on the patient and retention necessary, including fixed and removable retainer choices, depending on the patient’s willingness to comply and the severity of the initial malocclusion. 

Fixed retainers are a good option for patients who are not willing to wear removable retainers or who have a strong gag reflex. They remain fixed to the linguals of the maxilla and/or mandible to prevent teeth from relapsing into their original positions. One of the only drawbacks is being unable to floss as easily and maintain good oral hygiene. An oral irrigator or floss picks can usually solve this problem though.

Removable retainers come in both a metal Hawley type and clear plastic form. The Hawley is great for patients who are dedicated to wearing retainers because they are adjustable and help stabilize your patient’s new smile. A clear plastic retainer is usually preferred because it is nearly invisible and mimics Invisalign treatment. 

Before deciding on the retainer type for your patient, sit down and speak with them about their options and what will best fit their needs. 

2. Proper Case Preparation for Orthodontic Retention Success

When you plan a case, orthodontic retention is a phase that should be planned out from the beginning. Although treatment factors like tooth movement or compliance can impact retention, it is wise to discuss how orthodontic retention is a lifetime responsibility to maintain good results.

It is a frequent occurrence that patients complete their braces treatment and return unhappily to their dentist because of a relapse. To avoid this headache for both the patient and provider, prepare your patients throughout their orthodontic journey with the understanding that retainers are vital to the success of their treatment. 

At the completion of every orthodontic case, all crowns are lined up, the bite is ideal, and the patients think they are done. Unfortunately, a tooth crown can lie, but their root position does not. If you take a final panoramic radiograph of the patient’s jaw, the roots should ideally line up, which determines the stability of the tooth and bone. When relapse occurs, it is often because root position is not stable and orthodontic retention was not achieved. 

3. Overcompensate Treatment When Necessary

As soon as braces are removed, teeth will try to move back into their original malocclusion. The periodontal ligaments that surround teeth pressure them  to pull back into the pre-treatment position, resulting in relapse. Bone is constantly remodeled during orthodontic treatment, and when it is complete, retainers help maintain the stability of both the crown and root positions. 

It is essential that pediatric dentists and dentists practicing orthodontics overcompensate by slightly over-correcting the teeth. It will be unnoticeable to the patient, but it will give you some peace of mind that when their teeth try to shift back it won’t affect the stability of the orthodontic outcome. 

4. Address Patients Habits Now 

Toxic oral habits like thumb sucking, finger sucking, or a tongue thrust should be addressed prior to treatment, but certainly at the end of a case. Habits can affect the orthodontic outcome and cause unwanted effects on the teeth position and oral health of a patient. 

Retainers can help prevent teeth from shifting even if the patient only has a slight habit, but it is still wise to stop these habits that can eventually interfere with their new, straight smile. 

5. Follow-ups Still Necessary During Orthodontic Retention Phase

Although you may not need to see your patients as often now that their braces are removed, make it a priority for your patients to keep up with follow-up appointments. Convey the important message that orthodontic treatment doesn’t end with the removal of braces, and keeping a yearly maintenance check is equally or even more important. When you review the cost and time they put into orthodontics, it will hopefully give them the motivation to wear their retainers and come by to get their smile checked out. 

Any pediatric or general dentist can take an orthocourse, but it takes much more to help your patients maintain the smile they invested in. Straight wire orthodontics can easily correct a malocclusion, but when you see a patient’s perfect smile decades from now, it is their orthodontic retention that is responsible for that success. If you’re looking to add orthodontics to your service offering, the American Orthodontic Society has a course to suit you.