A high-quality orthodontic treatment can yield a result that lasts for a lifetime. But there are a few instances when the procedure has to be repeated.
Dissatisfaction with the outcome of a prior treatment
This is perhaps the most common group. The most dissatisfied tend to be those who wore a removable bite corrector in their childhood. These appliances are largely ineffective, even when worn properly, with many kids simply forgetting to put them on or taking them off due to pain and discomfort.
In addition, such appliances, in principle, work inaccurately, since they are manufactured using standard sizes, without taking into account the individual characteristics of the patient. They can apply pressure on the teeth only in one direction, without the possibility of customization. Minor issues can be corrected with them, and then only during the active change from deciduous to permanent dentition. Still, many of those who wore bite correction appliances in their childhood will consider a repeating orthodontic procedure, this time with more patient-specific methods. .
Issues due incorrect retention
When braces or aligners are removed prematurely and do not maintain the result with the wire or removable retainers, then this outcome may alter very quickly. The roots of the teeth have a potential to move – and in the opposite direction, too.
After 1-2 years the result of the treatment can completely change in 2-3 weeks if the patient does not comply with the retention regime prescribed post-treatment. If a removable retainer is worn, but irregularly, then the result may get worse. The position of the teeth may not return to their original state, but, still, the outcome is being compromised.
This scenario is more typical for adult patients. Teenagers still have more chances for the teeth to remain in place or at least move slightly since the roots at this age are more quickly located in the new position.
What can be done in this situation? In fact, it makes no difference whether the patient was treated in the past or not. If the current position of the teeth is incorrect, that needs to be fixed notwithstanding the prior treatment
The growth of the 3rd molars
When 3rd molars are retained, there are certain associated risks such as pain, gingival inflammation and displacement of the dental arches.
Does this happen after treatment? Yes, if this situation was considered at the diagnostic stage. retained 3rd molars are clearly visible on the X-ray images, so prior to the treatment, an evaluation of the potential hazards is necessary. If the 3rd molars have already erupted and negated the result of the first treatment, it is not required to have them extracted during the 2nd treatment, but their presence should be taken into account in the planning of the case.
These situations cannot be predicted during the first treatment. Under some rare circumstances, the teeth may move to the wrong position again due to facial or jaw injuries. In this case, a repeated treatment can be conservative (brackets/aligners) or operative.
Whichever the cause may be, convincing patients to repeat the treatment is not an easy task. It is quite possible to understand their anxiety to spend time, effort, and money on treatment again, especially if the first procedure was lengthy and associated with discomfort. Usually however, such a negative impression remains with those who used brackets. Luckily, now they can be replaced with aligners – which are softer, cause little or no pain and thanks to the smooth surface, do not irritate the lips and cheeks. From a comfort standpoint, aligners are much preferable to braces, and even in terms of efficiency, they are no way inferior. Many patients who categorically reject brackets as a treatment option, are more prone to accepting aligners.