Reply To: Teeth shifting with permanent metal retainer

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Hello Christine,

I agree with Elsie that correcting the underlying cause of the dental misalignment is the goal. The mandible may only be part of this. Since the upper and lower teeth both had permanent retainers, the cranial base, cervical spine and other structural imbalances may be relevant.

Changes to the bite in relation to the retainers is not unusual. It is important to focus the patient on the improvement in other functional changes, related to overall health (ROM, joint stability, neurological findings, etc.). This will help them put see dental changes in a larger context of their general progress. It is worth explaining that the dentist/orthodontist is solely focused on the bite, but may not be aware that the braces and/or retainers may be producing mechanical and neurological stress via the trigeminal nerve, which overflows into the nervous system and thus other parts of the body. A dialogue with the dentist may be helpful.

Dr. Roth