What is Orthodontic Relapse? Cause & Treatment


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Dr Sukanya Goswami
Sukanya has done BDS. She is a dentist, a blogger, an extrovert, and a travel enthusiast. She is also a spiritual believer. When she is not working, you can find her reading books.

One of the best moments for an orthodontic patient is the time when the braces come off or when they use the last set of aligners. All the hard work and patience pays off when the patient looks at the beautiful smile. Retainers play a crucial role in maintaining the teeth in the new position and improving the longevity of the orthodontic treatment. Most people do not understand the importance of retainers and do not prefer to wear them frequently.

Over time, the teeth start to shift back into their original positions, causing a relapse of the orthodontic treatment. Often in such situations, people may require to undergo further procedures to correct the relapse. In severe cases, the dentist may have to go for a second braces treatment to correct the relapse.

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Today’s article will highlight the causes and features of orthodontic relapse. Furthermore, we will discuss the different treatments that can help to correct the relapse and restore the smile of the patient.

What is orthodontic relapse?

Orthodontic relapse is a clinical condition that is characterized by shifting of the teeth into unfavorable positions after completing orthodontic treatment. Typically, after orthodontic treatment, the teeth and surrounding bone require time to solidify in the new location.

Usually, a retainer helps to maintain the position of the teeth in the new location. However, failure to use retainers regularly instabilities the teeth and leads to relapse.  (1)

Some relapses that are identified at an early stage and be corrected by minor dental alterations. However, in severe cases of relapse, the teeth may revert to the original position they were in before orthodontic treatment had started. Often such situations are disappointing and lead to repetition of the entire orthodontic procedure costing more time and money. (2)

What causes orthodontic relapse?

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One of the most common causes of orthodontic relapse is the infrequent use of retainers. However, several other factors can contribute to the shift of teeth in the jaw. Some of them are listed below –

  • Grinding of the teeth – chronic tooth grinding can often alter the bite of the patient. Moreover, it is one of the prime causes of misalignment of teeth.
  • Aging process – often, it is seen that the teeth naturally shift as the person grows older. This happens even after the smile has been corrected with orthodontic treatment. The front teeth are more prone to shift under pressure. (3)
  • Tooth loss – loss of single or multiple teeth can occur due to several reasons such as tooth decay or periodontal disease. Often in such cases, the adjacent healthy teeth tend to shift back into empty spaces creating misaligned bite.

What is the treatment for orthodontic relapse?

Treatment of orthodontic relapse often depends on the severity of the relapse. Usually, minor tooth movements can be instantly corrected with fixed retainers or regular use of removable retainers. However, severe cases of orthodontic relapse may be treated as follows –

Traditional braces treatment

Traditional metal braces are most commonly used to re-align the teeth in the jaw. It consists of a stainless-steel wire which is fixed on the surface of the teeth with the help of metal bands and brackets. This appliance helps to treat both simple and complex cases such as –

  • Closure of gaps between teeth (4)
  • Straightening teeth
  • Relieve crowding of the teeth

Clear aligners or Invisalign

Clear aligners or Invisalign are custom-made retainers that help to straighten the teeth gradually. They are typically made from a transparent thermoplastic sheet which can be easily placed and removed from the tooth surface.

Invisalign is more flexible and prevents irritation of the gums and mucosa, which is often seen as a problem with metal braces. The patient can conveniently remove the aligners while eating and brushing.

Importance of retainer

Now that you are aware of the various factors that can cause a relapse of orthodontic treatment. It is essential to understand the importance of retainers. Ideally, the teeth are supported by the elastic ligaments of the bone and gums that hold the tooth root into the bony socket. Small intermittent forces from orthodontic braces affect the movement of these fibers and eventually move the teeth. (5)

Such a phase of the treatment is called as the remodeling phase. Once the procedure is completed, the tissues and bone require time to settle in the new position and stabilize the bite. Retainers play a crucial role in performing this activity.

Retainers are a type of orthodontic appliance that helps to hold the teeth into their newly moved position. Retainers work on the principle of stabilizing the bite and re-aligning the gums and bones to support the teeth firmly and maintain the aesthetics of the smile. (6)

Take away message

Out teeth are supported by elastic ligaments of the bone and gums. During orthodontic treatment, the tension created in the ligaments by intermittent force from the braces helps to move the teeth into the new position. This phase is known as the remodeling phase of orthodontic treatment. Retainers are usually used in the maintenance phase of the treatment. They help to hold the teeth firmly in the new position and stabilizes the bite of the patient.

Orthodontic relapse is a common dental problem that usually occurs due to the infrequent use of retainers after the completion of the orthodontic treatment. However, tooth grinding, loss of teeth, and the aging process may also contribute to a relapse of the procedure. Some of the corrective procedures of relapse include traditional orthodontic braces treatment or the use of clear aligners. Both treatments are carried out to treat severe cases of relapse.

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