Stopping Orthodontic Retainers? By Dr Mike Mew

Summary

The video explores whether individuals can safely stop wearing orthodontic retainers, highlighting the delicate balance between oral posture, tongue function, and dental alignment. It explains how retainers maintain teeth positions while potentially limiting natural expansion if oral posture is optimal. The speaker discusses different retainer types, including clear Essex, HLY, and fixed retainers, detailing their effects on tongue space and teeth stability. Viewers are advised to experiment cautiously, reduce retainer use gradually, and monitor changes with measurements like intermolar width. Emphasis is placed on personal responsibility, careful observation, and working on oral posture to support long-term dental health.

Takeaways

• 😀 Stopping retainer use carries risks of relapse if oral balance between tongue, lips, and cheeks is not favorable.
• 😀 Retainers can act as a barrier to further dental arch expansion if tongue posture and oral function have been improved.
• 😀 Gradually reducing retainer wear can be used experimentally to gauge oral balance, but teeth movement should be carefully monitored.
• 😀 Jiggling teeth by inconsistent retainer use can cause damage, similar to loosening a stake by moving it back and forth.
• 😀 Neurological feedback from your teeth and oral sensations is essential for safely adjusting retainer use.
• 😀 Essex/Star retainers are clear, vacuum-formed devices that minimally interfere with tongue space but hold teeth slightly apart.
• 😀 Hawley retainers occupy more tongue space due to their plastic roof component, but do not hold teeth apart.
• 😀 Fixed retainers bonded behind the teeth stabilize front teeth alignment and can serve as a guide for proper tongue placement.
• 😀 Using a combination of reduced removable retainer wear and fixed retainers allows safe experimentation while promoting expansion through tongue function.
• 😀 Measuring intermolar width and monitoring progress is important when modifying retainer use.
• 😀 Individuals must take personal responsibility for changes in retainer use and focus on improving oral posture and function for optimal results.

Q & A

Why do people consider stopping retainer wear after orthodontic treatment?

Some people believe that stopping retainer wear may allow for further expansion of the dental arches and improvement in oral posture and function, potentially promoting natural dental development.

What risks are associated with stopping retainer use?

Stopping retainer use can lead to relapse if the balance between the tongue, lips, and cheeks is disrupted, allowing soft tissues to push the teeth back and undoing orthodontic corrections.

How can retainer wear act as a 'brake' on dental changes?

If the tongue has been trained to create favorable forces on the teeth, retainers can limit further expansion or movement because they hold teeth in their current position, preventing additional natural development.

What is a safe approach to experimenting with reduced retainer wear?

Gradually cutting down retainer wear, such as wearing it only two nights a week, can be used to observe changes, but teeth jiggling back and forth can cause damage, so this must be done cautiously and monitored carefully.

What types of retainers are mentioned in the script?

The script mentions Essex star retainers (clear, vacuum-formed), Hawley retainers (plastic in the palate with wires), and fixed retainers (bonded behind teeth). Each has different effects on tongue space and dental positioning.

What is the advantage of a fixed retainer?

Fixed retainers stabilize the front teeth while allowing the wearer to experiment with oral posture, function, and tongue positioning, serving as a reminder for proper tongue placement.

Why is tongue posture important in orthodontics?

Correct tongue posture can naturally expand the dental arches, move teeth forward, and support ideal occlusion. It acts as an internal orthodontic appliance when trained properly.

What is the caution given regarding cutting down retainer wear?

Cutting down retainer wear can cause teeth to move back and forth, potentially damaging them. Any experimentation should be done gradually, with careful self-monitoring, and full responsibility for outcomes must be assumed by the patient.

How can someone measure the effectiveness of their oral posture changes?

One suggested method is measuring intermolar width between the first molars to track expansion and changes over time, providing a quantifiable way to monitor progress.

What should patients consider before discontinuing retainers?

Patients should consider whether they have successfully tipped the balance in favor of the tongue through consistent effort, understand the risks of relapse, and be willing to take full responsibility for any consequences.

How do different retainers affect tongue space?

Essex retainers occupy minimal tongue space, Hawley retainers occupy more space in the palate which can interfere with tongue positioning, and fixed retainers allow for tongue movement while stabilizing teeth.

Why is professional guidance recommended when changing retainer habits?

A dentist or orthodontist can provide guidance on safe retainer use, the option of fixed retainers, and monitoring of dental stability to reduce risks of relapse or damage.