functional dentistry and occlusion from new generation
When You Have to Do Your Braces or Tooth Restorations Again... and Again... - Why it Happens and How to Prevent It
Many patients invest significant time, effort, and money into dental procedures, only to find that they may need additional treatments later. In medical terms, this is known as relapse, and it may necessitate retreatment.
Relapse occurs when the results of a dental treatment, such as braces or tooth restorations, begin to reverse or deteriorate over time. For instance, if your teeth were straightened but then started to move back to their previous crooked positions, this would be considered a relapse. Retreatment refers to the need for additional dental procedures after the initial treatment. For example, if you had braces to straighten your teeth and, after some time, your teeth start shifting back to their original positions, you might need another round of braces or other orthodontic work.
Relapse requires more time, better planning, and a lot of work than the original treatment. We are not just treating the patient’s initial problem—sometimes, the patient didn’t even have a problem initially—but poorly planned cases can lead to new issues in the future. As the subsequent dentist, we have to correct all previous mistakes. This responsibility is greater because the case has become more complex. Our duty is to plan treatments so meticulously that slow but thorough movements of teeth, gums, bones, and jaws work together and eventually mutually support the right places for each other once we finish the treatment.
Common Causes of Orthodontic Relapse
Orthodontic relapse often occurs for several reasons. The initial treatment plan may have been flawed, the diagnosis incorrect, or the treatment improperly executed. Additionally, the patient’s follow-up care could contribute to relapse. After treatment, teeth should remain properly aligned: roots centered in the bone, crowns in the right position, and gums and incisal edges aligned. If there’s a conflict between the bite and the muscles or the joint, teeth may start to move again, often due to adaptive processes within the body.
The root should be centered in the bone, and the crown should be in the correct position. The gums and incisal edges should be aligned. If there is a conflict between the bite and the muscles, or between the teeth position and the joint geometry, the teeth may start to move again. This movement often occurs not because the fibers in the bone are pulled, but due to other factors.
The system will adaptively bring the teeth back because it is an adaptive process. The bone moves with the roots, but the muscles and the joint can act like biological orthodontic treatment, bringing the teeth back to their original position. Therefore, it is crucial that the treatment is performed in harmony with the muscles and joint function. If the teeth are not correctly aligned, if the bite is not aligned with the joint and the overall body posture, conflicts will arise. This phenomenon can be summarized as “muscles always win.”
Proprioception and Its Impact
Proprioception, the body’s ability to perceive its position in space, plays a significant role in this process. Misalignment or dysfunction in the TMJ (temporomandibular joint) can disrupt this balance, causing the teeth to move back into less optimal positions. The muscles and joint can act like biological orthodontic treatment, causing teeth to shift if they are not aligned harmoniously with the entire body’s posture and function.
The Role of Bite Alignment in Prosthodontics
Prosthodontic treatments, like orthodontics, require precise planning and alignment. If the bite is not correctly positioned, it can cause complications even after completing extensive restorations like veneers or full-mouth rehabilitations. In such cases, misalignment can lead to the body adjusting to the new positions, resulting in issues such as fractured restorations or teeth shifting. Proper bite alignment and joint function are crucial to ensure that prosthodontic treatments are successful and durable.
Functional Dentistry Helps Us Avoid and Successfully Treat Relapsed Cases
If you have experienced relapse, it is undoubtedly an unpleasant experience. It can be frustrating, infuriating, and disappointing. You may lose faith in doctors and be reluctant to undergo the procedure again.
However, let me give you hope. With proper planning and meticulous execution, the problem can be solved permanently. Using the concepts, tools, and skills of functional dentistry, we can understand the entire system and help your teeth, bones, gums, and jaw joint position properly—and stay in the right places due to synchronized treatments that respect biology, physiology, and the mutual relationships of all the elements in your masticatory system.
Feel free to contact me if you have any questions about relapse and retreatment.