Orthodontic relapse is when your teeth return to its original position before your braces or clear aligner treatment. This happens when teeth get shifted out of their original position due to poor oral and dental habits, age, jaw growth or inconsistent retainer wear, amongst other reasons. 

 

 

What Is Orthodontic Relapse?

Orthodontic relapse refers to the tendency of teeth to move back towards their original positions after orthodontic treatment has been completed. 

To prevent relapse, dental professionals typically recommend using prescribed retainers consistently, having regular follow-up appointments with your dentist or orthodontist and addressing any underlying issues that may contribute to tooth movement.

 

 

What percentage of patients have an orthodontic relapse?

Studies suggest that around an average of 30-50% of patients may experience some degree of orthodontic relapse within 10 years after treatment. 

This percentage can vary significantly depending on several factors such as: 

Type of malocclusion: Some types of orthodontic issues are more prone to relapse than others.

Patient compliance: Those who consistently wear their retainers as instructed typically have lower relapse rates.

Age at treatment: Younger patients may have a higher risk of relapse due to continued facial growth.

Treatment approach: Different orthodontic techniques may have varying long-term stability.

Length of retention period: Longer retention periods are generally associated with lower relapse rates.

Individual biological factors: Each person’s unique oral anatomy and growth patterns can influence relapse potential.

Orthodontic relapse can range from minor tooth movements to more significant shifts back towards the original malocclusion. Many cases of relapse are minor and may not require retreatment.

To minimise the risk of relapse, dentists or orthodontists typically recommend long-term or even lifelong use of retainers, especially at night. Regular follow-ups with your preferred dentist or orthodontist can also help catch and address any early signs of relapse.

 

 

What Causes An Orthodontic Relapse?

Incomplete orthodontic treatment 

This occurs when the full course of orthodontic treatment is not completed as planned. It might happen due to various reasons such as financial constraints, patient impatience, or unforeseen circumstances. When treatment is cut short, teeth may not have reached their ideal positions or the bite may not be fully corrected, increasing the likelihood of relapse.

Miscalculation of the teeth malocclusion

This refers to errors in diagnosing or planning the treatment for a patient’s specific malocclusion (misalignment of teeth). If the orthodontist underestimates the severity of the problem or doesn’t account for all factors influencing tooth position, the treatment may not fully address the underlying issues, leading to instability and potential relapse.

Lack or insufficient monitoring 

Regular check-ups during and after orthodontic treatment are crucial. Insufficient monitoring can result in undetected issues like shifting teeth or changes in bite. Early detection of these problems allows for timely intervention, preventing more severe relapse.

Lack of patient compliance 

Patient cooperation is vital for successful orthodontic treatment. This includes following instructions for elastic wear, proper oral hygiene, avoiding certain foods, and wearing retainers as prescribed. Non-compliance can lead to suboptimal results and increased risk of relapse.

Not going for follow up visits with the dentist or orthodontist 

Follow-up appointments allow the orthodontist to assess treatment progress, make necessary adjustments, and monitor for any signs of relapse. Skipping these visits can result in undetected issues that may lead to relapse over time.

Teeth does not have time to set 

After orthodontic treatment, teeth need time to stabilise in their new positions. The bone and ligaments around the teeth need to remodel and adapt. If retainers are not worn as prescribed during this critical period, teeth may shift back towards their original positions.

Bad habits 

Certain habits can exert forces on teeth, potentially causing relapse. These may include:

•    Tongue thrusting
•    Thumb sucking
•    Nail biting
•    Teeth grinding (bruxism)
•    Mouth breathing

Continuing these habits after orthodontic treatment can gradually push teeth out of alignment.

Not wearing post-treatment retainers 

Retainers are crucial for maintaining the results of orthodontic treatment. They hold teeth in their new positions while allowing bone and soft tissues to adapt. Failing to wear retainers as prescribed is one of the most common causes of orthodontic relapse. The frequency and duration of retainer wear vary based on individual cases, but generally, consistent use is necessary, especially in the first few years after treatment.

 

 

Treatment of Orthodontic Relapse 

What to Do in Case of an Orthodontic Relapse?

If you’re experiencing an orthodontic relapse, there are several steps you can take depending on the severity of the relapse:

 

Retainers 

Retainers are often the first line of defence against orthodontic relapse. If you’ve stopped wearing your retainers and notice minor shifts in your teeth, resuming regular retainer wear may be enough to correct the issue. It’s crucial to wear your retainers as prescribed by your orthodontist, typically every night. Consistent use can often prevent further relapse and may even guide teeth back into their proper positions if the movement is slight.

New Retainers 

New retainers might be necessary if your original retainers no longer fit properly or if they’ve worn out over time. Your orthodontist can create new retainers based on the current position of your teeth. These new retainers can help maintain your teeth in their current position and prevent further relapse. In some cases, a series of new retainers might be used to gradually shift your teeth back to their ideal positions, similar to how clear aligners work.

Braces 

Braces or other orthodontic treatments may be required for more significant relapses. If your teeth have shifted considerably, wearing retainers alone may not be sufficient to correct the misalignment. In such cases, your orthodontist might recommend a shorter course of braces or clear aligners to realign your teeth. This treatment is often less extensive than your original orthodontic treatment, but it depends on the degree of relapse.

Clear Aligners

For moderate relapses, clear aligner systems like Invisalign and Angel Aligner might be recommended. These can effectively correct many types of tooth movements and are less noticeable than traditional braces.

Limited Orthodontics 

In some cases,  orthodontists or dentists might suggest limited treatment focusing only on the affected teeth. This could involve partial braces or a short series of clear aligners.

Combination approach 

Sometimes, a combination of methods might be used. For example, limited braces followed by a period of intensive retainer wear.

The best course of action will depend on factors such as the extent of relapse, the original orthodontic issues, the patient’s age, and their willingness to undergo certain treatments. It’s crucial to consult with an orthodontist for a professional assessment and personalised treatment plan. 

Regardless of the approach, the key is to act promptly when you notice signs of relapse. Early intervention can often prevent the need for more extensive retreatment. It’s also important to maintain regular check-ups with your orthodontist, even years after your initial treatment, to monitor for any signs of relapse and address them early.

Every case is unique, and the best course of action will depend on your individual situation. Consulting with your orthodontist is crucial to determine the most appropriate treatment for your specific case of orthodontic relapse.

 

 

Orthodontic Relapse: Frequently Asked Questions