Orthodontic retreatment
Correcting problems that remained or came back after previous treatment.
Does this sound familiar
Patients most often come for this with these words:
I had braces and my teeth have become crooked again
I stopped wearing my retainer too early
I am not happy with the result of my previous treatment
My teeth are straight, but the bite or smile does not suit my face
My fixed retainer came loose and my front teeth have moved
Sometimes a person has orthodontic treatment once, but the result is not what they expected, or years later the teeth move again. This is not rare. Retreatment needs especially careful planning, because both the results of the previous treatment and the reason for the relapse have to be taken into account.
Why this happens
- No retention after treatment, or the retainer was removed too early
- A fixed retainer came loose and this was not noticed in time
- The first treatment focused only on the teeth, without considering the bite and face
- Missing or misshapen teeth were not restored
- The natural movement of teeth throughout life and age-related changes
- Habits that caused the problem, such as tongue thrust, continue
Wisdom teeth are often blamed, but a systematic review does not show that they have a significant effect on crowding of the front teeth. More: wisdom teeth and braces.
Types of retreatment
| Situation | Possible solution |
|---|---|
| Mild relapse in the front teeth | A short course of aligners or a new retainer |
| Moderate relapse | Full treatment with braces or aligners |
| Bite and smile problems | Full re-planning, mini-screws if needed |
| Missing or small teeth | An orthodontic phase followed by aesthetic restoration |
How I plan
- I look at the records, photographs and X-rays of the previous treatment if available
- I check the roots on an X-ray: was there root resorption in the previous treatment
- I assess the condition of the gums and bone
- I identify the reason for the relapse
- I build a new plan that starts from the face
- I plan retention with special care
If there was root resorption in the previous treatment, gentle forces and a cautious plan are especially important. See: root resorption.
One patient’s story
One of our patients had retreatment with the Pitts21 Pro bracket system. For a complete result we did not stop at the orthodontic phase: after treatment a general dentist and a prosthodontist completed the aesthetics and function. It matters to me that after treatment the smile is not only beautiful but also harmonious, functional and stable.
How we protect the result this time
- We choose retention according to the reason for the relapse
- I often recommend a fixed and a removable retainer together
- We plan check-up visits
- I ask you to get in touch immediately if the retainer comes loose or the clear retainer feels tight
More: why retention matters.
What the science says
- Cochrane review (2023): evidence about which retainer is best for everyone is weak, so the choice should be individual.
- Systematic review and meta-analysis (2024): the effect of lower wisdom teeth on crowding of the front teeth is insignificant or very small.
What to do with minor relapse
It is important to get in touch as soon as you notice a small change in your teeth. Sometimes wearing the retainer again or making a new one is enough. The longer you wait, the more the change grows and the longer treatment becomes. If a fixed retainer has come loose, I look at the state of the teeth before repairing it: if the teeth have already moved, they may need to be corrected first.
Frequently asked questions
Does retreatment take longer than the first treatment?
It is often shorter, especially if only the front teeth have relapsed. But with bite problems full treatment may be needed.
Is retreatment possible with aligners?
Aligners are often a good choice for mild to moderate relapse.
Should I bring my old records?
If you have them, yes: old photographs, X-rays and treatment records help a lot with planning.
Is there a guarantee it will not relapse this time?
Teeth move throughout life, so the guarantee lies in the retainer. If you wear it as recommended, the result is protected.
Do you continue treatment started by another doctor?
Yes, but I first carry out a full diagnosis and rebuild the plan. Sometimes the system or the mechanics need to change.
Read more
Scientific sources
The information in this article is based on the following peer-reviewed scientific articles and systematic reviews.
- Martin, C., Littlewood, S. J., Millett, D. T., Doubleday, B., Bearn, D., Worthington, H. V., & Limones, A. (2023). Retention procedures for stabilising tooth position after treatment with orthodontic braces. Cochrane Database of Systematic Reviews, 5(5), CD002283. [PMID: 37219527] | [DOI: 10.1002/14651858.CD002283.pub5]
- Palikaraki, G., Mitsea, A., & Sifakakis, I. (2024). Effect of mandibular third molars on crowding of mandibular teeth in patients with or without previous orthodontic treatment: a systematic review and meta-analysis. The Angle Orthodontist, 94(1), 122-132. [PMID: 37848193] | [DOI: 10.2319/032323-205.1]