Home HealthTopics Health Centers Reference Library Research
Join us on Facebook Join us on Facebook Share on Facebook

Braces

Ill fitting retainer

09/12/2000

Question:

When my orthodontic appliances, braces, were removed, my orthodontist immediately placed a permanent retainer on my bottom teeth. For my top teeth however,I was given a removeable appliance, retainer, and instructed to wear this an average of fourteen (14) hours per day. This appliance, however, could only placed in correctly with extreme force, was uncomfortable, and extremely painful. I also found it impossible to speak when wearing it. This therefore, directly interferred with my classroom performance,as I was in college taking foreign language and speech classes at the time. As a consequence of the retainers ill fit, it regularly became disloged during the night as I slept, sometimes coming out of my mouth completley. Consequently, on three separate occasions my dog stole and ate my retainer during the night. I paid to have the retainer replaced twice and since my orthodontist used the same mold of my teeth each time to create the retainer, I experieced the same problems with each replacement retainer. I informed my orthodontist of these problems from the beginning and he said that my teeth would eventually conform to fit the retainer without force or discomfort. They never did. Besides, I thought that it was the purpose of the orthodontic appliances, braces, to move and set the teeth in the desired and correct position and the retainer`s purpose was to keep the teeth in this position after the removal of the braces? Since I was unable to afford the replacement of my retainer for a third time I went without for long time. Now the position of my teeth have shifted and as a consequence I bite tounge at night which is painful and the occurances and severity of my migraine headaces have increased. I do not want to return to the same orthodontist, however, other orthodontist have informed me that they cannot see me as a patient because it would be unethical and some rule or regulation of the orthodontist association. How can I see a new orthodontist without violating the ethical standards set by these associations and shouldn`t my retainer fit properly without the above described problems immediatly after the removal of my braces?

Answer:

It is very common for orthodontists to place permanently bonded retainers along the back of lower front teeth and make a removable appliance to maintain the position of upper teeth. The major drawback to permanently bonded retainers is that they make it difficult to clean in the areas where they are bonded. However, retainers can be bonded along the backs of upper front teeth just as they are on the lower teeth.

My understanding of retainers, being that I am a general dentist and not an orthodontist, is that these appliances RETAIN the position of the teeth, not using active force to move them. They should fit passively, unless they have special features and are designed to try and move teeth.

I am not aware of any regulation or law that states that an orthodontist cannot see a patient treated previously by another colleague. I do encourage patients, however, to return to the dentist who originally made the appliance because usually the dentist wants to try and better the situation. Also, dentists are very hesitant to judge or belittle another dentist`s work, as it should be, since most of the time you do not know the circumstances around the treatment that was rendered. I would encourage you to return to your orthodontist and tell him/her that you want a retainer that does not hurt your teeth, if in fact your teeth do not need to be moved.

If you want to have another retainer made and you do not want to return to the orthodontist whom you originally saw, there IS another orthodontist out there who will see you. If your teeth have shifted to the point that would require another set of braces, however, they will not make just a retainer. You would also be responsible for all of the costs of treatment recommended by the new orthodontist. My suggestion would be to call around the area or your family dentist for a referral to a new orthodontist.

Hope this helps - good luck!

For more information:

Go to the Braces health topic, where you can:

Response by:

Andrew Carl Lidral, DDS, MS
Assistant Professor - Orthodontics
College of Dentistry
The Ohio State University

Kristi Ammons Dillard, DDS Kristi Ammons Dillard, DDS
Assistant Professor
College of Dentistry
The Ohio State University