Dr. Noah's Dentistry Blog

Questions About Dentistry Answered

Dentist Damaged Daughter’s Tooth Removing Her Retainer

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My daughter had her retainer removed several weeks ago. In the process, her dentist damaged one of her teeth. It is now gray in color and receded from the rest of her teeth. He did an x-ray and said he could not tell anything for certain but then did a cold test that she failed. He believes the tooth may need a root canal treatment and is sending us to an endodontist. I have a couple of concerns. First, is there any way this will heal without a root canal treatment? Two, the endodontist he recommended does not use the Gentle Wave technology and I would prefer that if a root canal is necessary that is used. Am I within my rights to request a different endodontist who does use the technology?

Camryn

Dear Camryn,

Mother and Daughter

I am a bit concerned about the diagnostic skills of your dentist. Either a tooth needs a root canal treatment or it doesn’t. There really is not a “may” need a root canal treatment. That kind of wording leaves patients (or their parents, like you) in a quandary, wondering if they would be undergoing an unnecessary procedure.

The fact that the tooth underwent trauma, is turning grey, and has sensitivity to cold is enough to diagnose this tooth as dead or dying. In that case, it will need a root canal treatment.

I’m not sure how he managed to damage her tooth while removing her retainer. I am assuming this was some type of permanent bonded retainer that was bonded. Either way, he should have been able to remove the retainer without damaging the tooth if he knew even a minimal amount about orthodontics and bonding procedures. Obviously, he messed up and, in my opinion, is liable for the cost of the repair. Additionally, you do not have to stick with the endodontist he chose. You have the right to choose any endodontist you want, even segregating them by whether or not they use the GentleWave technology. GentleWave is getting good peer reviews in the dental literature. I think it is a good choice to use for your daughter.

This blog is brought to you by Tulsa Dentist Dr. Ryan Noah.
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Can Teeth Whitening Trays Double as a Retainer?

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I’ve worn out my normal retainer. My teeth haven’t budged but I know I’m supposed to still wear them. I’ve been whitening my teeth and those trays are pretty snug. My dentist will charge me over $300 for another retainer. I don’t have that kind of money at the moment. Is it possible to use my whitening trays as a retainer for now? I only wear the retainer at night. I can just use the whitening gel at the same time and sleep with it. Is that safe or do I need to suck it up and get a new retainer?

Andie

Dear Andie,

Teeth whitening trays in a blue case

Teeth Whitening Trays Can Double as a Retainer

I think that it would be fine for you to wear your teeth whitening trays as a retainer in the short term. However, I say that with a precaution. If you notice even the slightest change in your teeth, then it will be time for you to get a true, customized retainer.

For the benefit of others who may be reading this, I’m saying this because these teeth whitening trays are recent. That means they fit her teeth in the new position. If her teeth whitening trays were from before the time she had her teeth straightened, this would not work at all.

As for the cost, I have to say I am a bit surprised at the price tag they quoted you for a retainer. It is a fairly simple thing for them to do. The process is simply a matter of your dentist making a good impression of your teeth, then pouring a model of that impression they will send that to a dental laboratory.

If it turns out the teeth whitening trays aren’t adequate to keep your teeth in place, I suggest shopping around to other dentists or orthodontists and see how much they’d charge you to make a retainer. I’m pretty sure you’d end up saving a good amount of money. There are some procedures where you are perfectly safe by price shopping. This is one of them.

This blog is brought to you by Tulsa Dentist Dr. Ryan Noah.

How Long Will I Need this Retainer?

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I had braces in my teens. My teeth have done fine in past years but then started to shift again. I went to see a new orthodontist as an adult. He said I had a couple of options. I could re-do braces or wear my retainer again for a while and see if that helps. I opted for the retainer. It does move my teeth back into position. He suggested six months of wearing it full-time, then switching to nighttime wear for an equal amount of time. I followed through on that, but when I “graduated” from the retainer, I noticed that by the next day two of the teeth had shifted again. I’ll put the retainer back in and the cycle repeats. Is there anything I can do about this?

Morgan

Dear Morgan,

While this isn’t considered “normal” it does happen. For some reason, your teeth aren’t ready to stay in place on their own yet. I have a couple of suggestions for you.

When Teeth Won’t Stay in Place After Braces

You will need to wear a retainer full time for an indefinite period of time. One thing you can do in this case is have a lingual retainer made. This is a retainer which will be bonded to the back of your teeth. This is invisible to everyone else. The downside to this procedure is it is very difficult to get the teeth clean. You will need a floss threader to get in there.

Teeth whitening trays in a blue case
Teeth Whitening Trays Can Double as a Retainer

Another option is to use teeth bleaching trays as retainers. These are completely clear so no one will know you are wearing them. They do have the additional benefit of allowing you to whiten your teeth at the same time. Giving you both a straight and white smile simultaneously.

While many cosmetic procedures do require some expertise and post-doctoral training, teeth whitening does not. Any family dentist can do this for you.

My advice is to speak with your orthodontist and discuss these options in depth and decide which you think is best for your situation. It would also be good for him to investigate what is going on with the shifting.

This blog is brought to you by Glenpool Dentist Dr. Ryan Noah.

Why Do I Need a Retainer?

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I just spent four years wearing braces. Do I really need a retainer?

Beth – Kansas City, MO

Beth,

There’s an important reason for retainers after braces. They’re designed to keep your teeth in their new position. If you don’t wear it, your teeth will shift quickly. Retainers are even more important if you’re still growing into adulthood because your growth causes your teeth to shift even more.

Another reason a retainer is necessary is because your new bite needs to stabilize and it may take some time for all of the tissues and the bone to reorganize. Shifting of the teeth occurs naturally so retainers are needed to help keep them in place. Relapse of the teeth is very high the first month after the removal of braces and it usually takes about one year for teeth to stabilize completely after orthodontic treatment. If you had spaces in between your teeth before braces then it takes longer to keep the dentition stable. The rule of thumb is you wear your retainers as long as you wore your braces. So if you wore braces for four years then you wear your retainer for four years.

The good news is not all orthodontic patients need to wear their retainers 24/7. Your orthodontist will recommend what retention plan is best for you. Patients with removable retainers are recommended to wear their retainers on a constant basis for at least the first six months and then usually just at night while they sleep for a few years. Yet some orthodontic patients need only wear their retainers for the first week on a constant basis then after that just at night. A lot of orthodontists apply fixed retainers that are cemented in place to stabilize the teeth which are usually worn for at least five years. This is commonly used for adolescents because it’s common for teenagers not to wear their appliance, plus there’s the possibility of wisdom teeth causing shifting of the teeth while trying to erupt.

Hope this helps. This blog is brought to you by Dr. Ryan Noah.

Are Retainers Even Necessary?

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I wore braces for three years.  I got them off six months ago.  I know I am supposed to wear my retainer but I just hate it.  Are they really going to move back if I don’t wear it?

Thanks, Angie

Dear Angie,

I know you probably hate it, but your teeth absolutely will move if you don’t wear it.  They may not move completely back to where they were when you first got your braces on but they WILL move.

More than likely, if you had severe crowding, your lower front teeth will start to overlap.  Teeth that were the most difficult to move, like turned teeth, will begin to turn again ever so slightly.  Before you know it you will not be able to wear your retainer because it will no longer fit.  Then you will be too embarrassed to go back to the orthodontist because you think he may say, “I told you so!”  Meanwhile, your teeth will continue to move.

In order to stop the movement, you will need to spend a couple of hundred dollars for a new retainer.  Don’t forget, you will also need to get new impressions and you know how much people love those!  So, wear the retainer….even if you only wear it at night.  It is a small price to pay to keep that beautiful smile.

This blog is brought to you by Dr. Ryan Noah.

Teeth coming loose

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I’ve had braces, but after they came off, my teeth started moving and the gap between my front teeth opened back up.  I’ve been wearing tooth effects bands to help keep the gap closed, but today my teeth feel a little loose. Do you know what is going on or recommend anything?

Julie S. – Portland, OR

Julie,

I want you to stop using the teeth effects band right away. Hopefully, we can catch this in time to save your teeth. These bands are very dangerous. You could permanently lose your teeth.

You have a couple of options: You can get a removable retainer or a permanent retainer. Either one could easily be made by a dentist who does orthodontic work. That should help you with your gap.

This blog is brought to you by Glenpool Dentist Dr. Ryan Noah.

Do I Need to Keep Wearing My Retainer?

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When I was a teenager, I had to get braces and was told to wear a retainer for a month all day and then later, only at night. My upper front teeth relapsed a bit, so I spoke with a new orthodontist who said new braces would fix this problem. He also suggested I could use my old retainer to get the teeth pretty straight and then have a new retainer made. He mentioned six months of daily full time wear and then at night would do the job.
I’ve worn the new retainer fulltime for nearly three years and notice one tooth seems to shift after a few hours of not wearing the retainer. So now, I feel like I can’t go more than a few hours without the retainer. Am I imagining this or does this occur sometimes? And if it happens, what are the repercussions? What should I do?
– Justin in Oklahoma

Justin,
You’re probably not imagining that your teeth are moving. Clearly, one tooth in particular, seems to be changing position a bit. You should continue to wear the retainer all the time, day and night. If you don’t want to wear it during the day, you have a couple choices.
Your first choice is to get a permanent retainer bonded to the insides of your teeth. This could be done on the upper or lower teeth. The only issue is cleaning your teeth – you’d need to use a floss threader to adequately clean your teeth. If you’re okay with this, this may be a good solution.
If you’re not keen on this, your other option is to have a tooth bleaching splint created. This clear bleaching tray holds your teeth in position and isn’t as noticeable as the basic orthodontic retainer.
A dentist should see you to determine why your teeth haven’t stabilized. It isn’t good for your teeth to change position so you need to keep using the retainer to avoid this issue. Hopefully, over time, the movement will stop.

This blog brought to you by Tulsa dentist, Dr. Noah.