Ask an Orthodontist: Should I wear my retainer?

This week’s featured Smile Generation Dentist is an Orthodontist! In case you were wondering, orthodontics is the dental specialty and practice of preventing and correcting irregularities of the teeth. Think braces and retainers.

Dr. Sergio Ferreira is the orthodontist at San Clemente Dental Group, a member of the Smile Generation family. He has been practicing orthodontics since 1997. His jovial personality helps him form relationships with patients. You get a sense of his pleasant disposition in his answers to these two questions posted on our Facebook page.

Q. From Alicia Johnson:
“I had braces for 2 years when I was about 11-12 or 13 (don’t remember exactly). I wore my removable retainer (top teeth) nightly until about freshman year of college and stopped. I have since put in my old retainer a few times and it is tighter- would it hurt to start wearing it at night again to make my teeth as tight together as they used to be? ( I am now 25, so I haven’t worn it for about 6 years) THANKS!!!”

A. Hello Alicia!!!!!
The biggest mistake orthodontic patients can make after treatment is not wearing their retainer. A lot of patients need braces again for not wearing retainers properly… It looks like you did follow the instructions. Regarding your question about whether you should start wearing your retainer again,

Well, it all depends on how your teeth look. If they look good, and if you do not present any crowding or spacing, and if your wisdom teeth are erupted or extracted, you do not need to go back to the retainer.

Wisdom teeth may be responsible for shifting of teeth. It is normal for your retainer to feel tight after 6 years because teeth always shift a bit. If you see spacing or crowding, “Yes”, you should start to wear the retainer every night again. If the retainer feels very tight, it means that your teeth are moving or moved a lot. If it feels a bit tight, this is normal after 6 years. Retainers are like “money in the bank”. More is better. If you start to wear it again, your teeth will feel tight for a few days until you get used to it again.

I always tell my patients: Wearing retainers to sleep does not bring any inconvenience to you. They are the “pajamas for your teeth.” I am much older than you and I still wear mine! I had treatment as an adult and stability is harder.

Q. From Katee Afshar:
“ What is Phase 1 and why do most dentists think it’s so important?”

A. Hello Katee!!!!!

This is a very important question!

Phase I treatment in Orthodontics is an early treatment performed when the child is in mixed dentition (from 6 to 9 years of age). It is very important to understand that the child may need to go to phase II of treatment. It is necessary to make this very clear to the parents.

A lot of doctors do not explain that and when phase II is needed, parents do not have money or the insurance was used already… Parents must ask the doctors what will be accomplished on phase I. I’ve seen many cases where patients just had four brackets and nothing was accomplished. I do perform phase I, but only when it is really necessary. In lots of cases, I’d rather wait for full treatment.

Here are some cases when Phase I is recommended:

- Posterior or anterior crossbites. Basically, a crossbite is when one or all of the upper teeth are inside the lower teeth when you bite. It is much more difficult to treat when one is an adult. Sometimes, only surgery can correct some cases.

- Extreme flaring of upper incisors.

- Severe crowding. Expansion of the arches or serial extraction of deciduous teeth may be performed in an early age to open spaces for erupting teeth.

Depending on the age, I usually combine both phases of treatment and perform full treatment for about 3 years. It is more cost-effective that way. I do not like the idea when phase I is finished and parents are charged again to go to Phase II. A detailed treatment plan must be always reviewed by the parents. Lots of problems presented in mixed dentition can be easily treated in full treatment case.