At a glance

Straightened teeth can shift years later: without a retainer they tend to move back towards where they started, and their alignment keeps changing over time. After an examination that checks the gums first, a limited shift can often be corrected, with clear aligners for instance, then held with a retainer.

Why do teeth move years after braces?

Several causes often add up:

  • a retainer stopped or broken: without one, teeth tend to move back towards where they started;
  • time: even after retention, alignment keeps changing, especially in the lower front teeth; in patients treated with extractions, this change has been observed over 20 years;
  • the gums: gum disease can make teeth flare out, spread apart or drift;
  • a lost tooth: the neighbouring teeth gradually tip into the gap.

Even well-run treatment needs supervised retention, and the mouth keeps changing over the years.

Nothing in the starting records or in the end-of-treatment result reliably predicts which patients will see their teeth move. One more reason to keep a retainer rather than count on luck.

How can you tell your teeth have moved?

The signs that come up most often:

  • your retainer tray feels tight, or no longer goes in;
  • a gap has opened between two teeth, or food gets stuck there;
  • a lower front tooth has moved in front of its neighbour;
  • your teeth no longer meet the same way when you close your mouth;
  • in photos, your smile no longer looks like it did at the end of treatment.

As a rule, the smaller and more recent the shift, the simpler it is to correct. So it is better to have it looked at early than to wait and see.

Some signs point to the gums rather than to simple relapse: a tooth that moves when you touch it, gums that bleed or recede, bad breath that lingers. Those call for a prompt appointment.

What should you do as soon as you notice a change?

  1. If your retainer tray still goes in without forcing, keep wearing it as prescribed.
  2. If it no longer goes in, do not force it: keep it and bring it to your appointment.
  3. If a bonded wire has come loose, book an appointment without waiting, and do not glue it back yourself.
  4. Take photos of your teeth, from the front and each side: they will serve as a point of comparison.
  5. Have your teeth and gums examined before deciding anything.

What the bonded wire and the retainer tray each do is explained in the guide to retainers.

Should the gums be checked first?

Yes, especially in adults. When teeth spread apart or flare out, the cause may be gum disease rather than simple relapse. In advanced periodontitis, the gums are treated first; orthodontic tooth movement then comes among the possible treatments, with a full diagnosis and frequent re-evaluation.

So the examination includes a gum assessment, then a scale and clean or gum treatment if needed, before any plan to straighten the teeth; an X-ray is also needed, taken outside the practice. The guide to clear aligners after 30 or 40 covers the same questions.

Can clear aligners correct relapse?

Often, yes, when the shift concerns the position of the teeth and the gums are healthy or stable. Trays can redo limited movements, on a few teeth or a whole arch, without going back to brackets glued on every tooth. Treatment still starts only after an in-person examination.

When the shift is large, or the bite has changed, the examination tells you which solution fits; it is not necessarily the same as the first time.

How does a correction with aligners go?

  1. an examination: teeth, gums and photos, with an X-ray taken outside the practice;
  2. a scan of your teeth, then a 3D treatment plan showing the planned movements;
  3. the trays, changed at regular intervals, with check-ups;
  4. a retainer at the end, to keep the result.

The steps, length and price of treatment are set out on the clear aligners page.

How do you stop it happening again?

With a retainer, again, and this time for the long term: every patient needs one, aligner patients included, because teeth can keep moving for years after treatment ends.

Keep up regular check-ups too: a loose wire or a worn tray is spotted earlier in the chair than at home.

If you still have your old retainer tray or photos from the end of your first treatment, bring them to the first appointment: they show where your teeth were, and help set the goal.

Questions

Does this mean my first treatment was done badly?

Not necessarily. Well-straightened teeth can move years later, especially if retention was stopped, and alignment keeps changing with age. The examination looks at where things stand today, not at rewriting the past.

Can just the front teeth be corrected?

Sometimes: when the shift is limited to the front teeth and the bite has not changed, treatment can focus on them. The examination tells you whether that is reasonable in your case.

Does a second treatment take as long as the first?

Not necessarily: it all depends on how far the teeth have moved. A small relapse is often corrected in a few months; a large shift takes longer. The length is estimated when your case is studied.

Can I force my old retainer back in to push my teeth back?

No. A retainer is not made to move teeth, and forcing it can hurt. If it still goes in without forcing, wearing it can help hold things until the examination; if not, bring it to your appointment.

My child has just finished treatment: how do we stop this happening?

By wearing the retainer exactly as prescribed, always keeping it in its case and coming to check-ups. A wire that comes loose or a tray that no longer fits should be reported straight away, without waiting for the next appointment.

How much does aligner treatment cost to correct relapse?

At Beausourire, aligner treatment costs from 100,000 DA for one arch and from 150,000 DA for both. The price includes the scan, the 3D simulation, every tray, attachments and enamel reduction, finishing trays if needed, every check-up and the retainer. The exact price depends on the shift to correct and is set out in a written quote before you start.