KEEPING YOUR TEETH STRAIGHT WITH RETAINERS

(The following advice is of the utmost importance to keep your teeth straight forever)

The retainers that have been/will be provided to you are the only insurance that your teeth will remain perfectly straight.  I urge you to wear them 6 nights a week for three years and then 2 nights each week for as long as you want your teeth to be as straight as they were the day your braces were removed.

The moment you discard/lose/break your retainers your teeth will be subject to the forces of your tongue and lips which are powerful enough to move teeth.  The longer you hold the results of the orthodontic treatment in place the more likely they will be to remain in that position once retainer wear becomes less frequent.  Please remember the only guarantee for straight teeth for life is continued wear of retainers forever!

Patients who have finished treatment before the age of 17 should be particularly aware of the fact that their wisdom teeth are about to begin erupting (especially lower wisdom teeth).  It may take as long as 4 years to complete the process.  During this period the teeth will move, and sometimes drastically in order to make room for the wisdom teeth.  Just when you think are finished with retainers it becomes essential to start wearing them frequently again.  If you had crowded lower teeth to begin with and you do not wear your retainers you are more likely to see your lower front teeth become somewhat crowded again.

Patients who are adults rarely need to worry about wisdom teeth. However they should worry about periodontal disease which is very common wherein the bone that supports and holds the teeth firmly in place erodes leaving the tooth standing partially out of in its socket.  Such a “periodontally” involved tooth/teeth will inevitably in time be moved out of position by the tongue and lips.

I have seen the beautiful and near-perfect look of straight teeth become crooked in as short a period of time as 3 days because the patient lost/broke their retainers and were too lazy, indifferent or worried about expense, to have them immediately replaced.

If you neglect to wear your retainers from the very first day I give them to you, your teeth will relapse more than 75% back to their original crooked position in about 12 months.  It will take the same time to correct this relapse as it did the first time you wore braces.

         I URGE YOU TO PURCHASE THE RETAINER INSURANCE WE OFFER YOU HERE AT THE OFFICE.  THE TOTAL COST OF THIS INSURANCE IS $235.   THIS INSURANCE PLAN WILL PROVIDE YOU WITH REPLACEMENT RETAINERS FOR THE DURATION OF THE THREE YEAR MANDATORY PERIOD DURING WHICH YOU WILL HAVE TO PAY A  CO-PAY OF ONLY 35/RETAINER ($50 FOR BOTH RETAINERS).  YOU ARE REQUIRED TO WEAR YOUR RETAINERS FOR AT LEAST 6 NIGHTS PER WEEK.  ADDITIONAL YEARS OF COVERAGE CAN BE PURCHASED AT $50 PER YEAR. Protect your investment!

When making the choice as to whether or not you should take this insurance consider how much money, time and effort you invested in obtaining your or your child’s smile. The fee for replacement retainers is $185 per retainer ($370 F0R BOTH) if you decided not to take the in-office retainer insurance.

If you have taken the retainer insurance the co-pay is $35/retainer $50 for both. (Clear, custom fitted, removable retainers that cover the teeth).

Finally, when retreatment due to relapse is required, the fee will vary from $985 to $1485 and usually takes 3-5 months to complete. Without exception all retreatment is done with fixed braces.

Thank you for having chosen me to be your orthodontist.  It has been my pleasure to have taken care of you. I hope you will recommend me to other family members and friends.  Sincerely, with care and concern, Dr. Ted J

 I have read this note and      (I am)        (I am not)    taking the retainer insurance plan.

SIGNED__________________________DATE____________________

www.drted.com         drted35@aol.com         718 852 1551

Why do teeth become crooked again after the braces are removed?

    The problem of "relapse" of recently straightened teeth is more common than we wish.
    In spite of the careful attention given to informing the patients how important retainers are to prevent the teeth from returning to their crooked position, relapse occurs. No one is more disappointed than Dr. Ted to see relapsed/crooked teeth. It is even more sad when it happens in spite of Dr. Ted’s giving ample warning of the likelihood that it will happen. So why do teeth get crooked again?

    This occurs because teeth need time to "permanently set" or grow into their new positions like poured cement setting around a newly placed parking meter. The teeth are held in place by millions of elastic-like threads “ligaments” in the bone socket holding the tooth. When teeth are orthodontically turned/moved toward a new "corrected" position the ligaments twist with them. The body in time rebuilds new tooth-socket bone and "straight" ligaments around the teeth -- that takes time (24-36 months).
    I provide my patients with retainers the day after their braces are removed with the following bit of dogma - "Keep them in your face or in the case" I'm giving you and never wrap them in a napkin".  Of course I am always bothered when a patient returns complaining of relapse and a bit angry since I put my heart and soul into straightening the teeth in the first place. I always ask to see their retainers. The inevitable response is that they lost them. How? I ask. "I wrapped them in a napkin at dinner and it was thrown out with the trash".
    I would be remiss if I did not note that many orthodontists consider the erupting wisdom teeth to be a cause of teeth becoming crooked again. It is wise to know that wisdom teeth in females are starting to erupt around 17-18 (males, 19-20) and they can be a powerful force causing the teeth (especially the lower front teeth) to "relapse" if the patient has completely stopped wearing the retainers. Consequently, after wearing your retainers every night for three years, you should continue wearing them one- two nights/week forever if you want your teeth to remain as straight as they were on the day that the braces were removed,. 
    These days I also offer three year retainer insurance plan, which encourages patients to return immediately for replacements when they lose/break or bite through their retainers. Generally speaking if retainers are not worn at all one can expect the teeth to slowly relapse to about 75% of what they looked like when treatment was first started.  In adults relapse sometimes occurs when gum problems spread beyond the gums into the bone socket and causes the socket to erode in part.
    When I have accomplished the straightening of the teeth I provide my patients with a comfortable, transparent, thin, hard plastic covering that fits precisely over the teeth that are most likely to shift away from their corrected position. This clear, durable retainer is easy to wear and quite invisible, unlike the old-fashion retainers that have a metal bar that passes over the upper front teeth and covers the palate.  Rarely if ever do I provide that kind of retainer for my patients.
    I advise them to wear the retainer nights only for 3 years, and then 1-2 nights each week for as long as they desire their teeth to stay as straight as the day the braces were removed. I give this advice because your teeth throughout life are continuously erupting into your mouth and never stop migrating forward as well. This is particularly evident in the lower front teeth where relapse is usually the first place to be observed when it occurs, especially when one completely stops wearing the retainer. Worst of all, when the lower front teeth relapse they can deliver forces to the upper front teeth that can cause them to become crooked again.
    Here are the solutions for relapsed teeth:  We can make you new transparent fitted retainers to hold the teeth exactly as they are.  Or, you can have Dr. Ted reapply fixed braces for 3-6 months and retreat the teeth, assuming the corrections are relatively minor.  ($985-$1485).

In conclusion, think of wearing your retainers as the final part of the orthodontic treatment that took Dr. Ted two long and tedious years to complete. Most of all, enjoy your wonderful new smile which you can think of as Dr. Ted’s “signature.”

Thank your for choosing me to makeover your smile.    Dr. Ted J

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