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Ashlie Mealey
In short: the retainer was fucking gross. There was yellow and green buildup between my teeth and a subtle shadow of black at the very base of their backs. My gums were inflamed, the metal caked in what looked like plaque. (Oliver continued to nap during this crisis.) I couldn't believe this was what my mouth looked like, but Dr. Huang assured me it wasn't, at least not to anyone except her camera. She assured me this is a common issue for people who, like me, had worn their fixed retainer for years, but couldn't see or feel the damage that was being done. We agreed to remove and replace the retainer at my follow-up appointment, and I left the office with my tail between my legs and headed to the office.
"Retainers are prescribed for two reasons: first, to allow the bone that holds teeth to rebuild after teeth have moved, and second, to keep the healthy new positions of teeth after active orthodontic treatment ends. Your body changes your whole life, and your teeth change, too," explains Norman Nagel, DDS, MS, orthodontist and president of the American Associations of Orthodontists based in Simi Valley, California. These can be bonded retainers, like mine, or removable retainers that are typically worn at night. Your orthodontist (or your dentist, depending where you are in your dental journey) can help you decide if a bonded or removable retainer is right for you.
"It really depends on the lifestyle," says Dr. Huang, who says she herself uses a removable retainer she uses every single night. "If you're someone who's very, very disciplined and you have a list of A to Z the things that you do before you go to bed, the removable retainer is [likely] fine. If you're someone [who is] going to forget to put in the removable one, fall asleep [without it], or you travel a lot, or you leave it everywhere, or you just fall asleep and you can't put anything in your mouth, then you [may] need a fixed retainer." These bonded retainers, which many of us refer to as permanent retainers, are meant to last for decades at a time.
Bonded retainers are common for a reason. "Retention is a very important part of the orthodontic treatment," says Dr. Grauer. Aside from maintaining the position of the teeth that was corrected through prior orthodontic methods like braces, bonded retainers can help maintain the health of your teeth, gums, and bones.
"The mouth works like a machine. There are the top teeth and the bottom teeth and the saliva acts like a lubricant," explains Dr. Grauer. "The mouth is composed of three things: teeth, gums, and bones. When everything fits well, there is no friction, and there's no wear on the teeth. The teeth can work forever. The moment you have things that don't fit well, you can end up having dental, gum, or joint problems. Teeth can get decay, gums can [recess or swell], you can reduce your bone." In short: Retainers help keep all this stable by keeping the teeth steady. And with orthodontics evolving constantly, it's becoming easier to do so.
"Now, we [also] look at the teeth, the lips, the eyes, the position of the chin, and we align the teeth with the frame of reference that's the face," Dr. Grauer continues. We can get much better aging process. We can put the braces behind the teeth; we have Invisalign. There are so many things that we can do today that we couldn't do before."
That said, they're not a blanket fix for anyone who needs their teeth retained. "It doesn't work for everyone. There are people who can't tolerate having something in their mouth. I've taken them out for people because they're so fixated," says Dr. Huang.
It's usually not apparent when it's time to reconsider the retainer you've got. Even patients who brush and floss diligently often have no idea there's invisible damage being done. "You didn't know it looked like that," Dr. Huang points out, referring to my own flawed set-up. "Most people don't know. I mean, even dentists [may not], unless [they have] the tools to magnify it by that much."
According to Dr. Grauer, there can be more than one cause for a retainer failing to look out for, including the efficiency they're installed with, damage that can happen from wear and tear, and the materials they're made from. He lays out the three materials bonded retainers are typically made from: twisted wire, rigid wire, and CAD/CAM [or computer-designed] wire.
"We used [twisted wire] retainers for 40 years, so now, we are changing. The problem with the twisted wires, which is the most [common] one that people have, is that you can eat something [hard] and you can impact the retainer and bend it," he explains. "When you bend the retainer, nothing happens right away, but long-term, the retainer stores this energy from your bite. Then that energy's released back to your teeth, and that can move your teeth in the long-term." That's why he recommends seeing an orthodontist "every three to four years" to check that your retainer is still correctly in place, as you may not notice the shift when it happens.
CAD/CAM wires, though, which are made using more advanced computer tech, "are made of a wire that has shape memory. The fabrication process involves milling the 'wire' to a digital scan of the teeth, so its adaptation is excellent and the profile is very flat. If you bite on something, the wire is going to go back to its normal shape, and it's not going to move your teeth in the long run," Dr. Grauer adds.
Placement is also key, which means your orthodontist installing your retainer with both retention and hygiene in mind. "Sometimes, they place it with too much glue, and it makes it very difficult to clean," Dr. Grauer says. This was my exact issue, which I had no idea wasn't normal for over a decade, but Dr. Huang reassured me this is common among patients who have had bonded retainers for a long time.
"It's so hard. There's nothing you could do at home that could make this better," she says, noting that large amounts of glue make it near impossible to keep your gums and teeth clean and prevent negative health effects.
"If you can't floss your retainer, there's a problem," she explains. "You should be able to floss in between every single tooth to get into the gum to clean the bacteria. So, if you're not able to do that because of the retainer, then you need to swap it out."
Hygiene is the most important factor when it comes to maintaining bonded retainers. Dr. Huang lists cavities and periodontal disease as two major effects from retainers that are unable to be cleaned properly.
"If a wire is incorrectly positioned on or too close to gum tissue, there can be a domino effect of issues, starting with gum inflammation. Prolonged gum inflammation can lead to bone loss, which then leads to tooth mobility," he says. Dr. Huang, though, adds that intervention can make all the difference if your dental situation is going south. "Prevention is really important to us because we want to catch [the issue] before it happens. There are so many opportunities to do something before something becomes a cavity, or before something becomes gum disease."
Dr. Nagel says it's also recommended to switch to an electric toothbrush, which has been shown to remove more plaque than manual toothbrushes and rinse with a mouthwash containing flouride to strengthen the enamel and decrease the bacteria in the mouth.
Dr. Huang says that lingual retainers for upper teeth or lower teeth, "usually run about $850 an arch," and that there's typically a fee to remove the retainer. Pricy, absolutely, but it may end up saving you the extra money that intervention would require later.
When I returned to Les Belles, I was genuinely terrified of what Dr. Huang might uncover once the glue had been chiseled off. With Oliver dozing off on my lap once again, she got started. For context, it normally takes about ten minutes to remove a bonded retainer. I ended up spending almost 45 minutes in the chair because there was so much glue for Dr. Huang to file and pick away from my teeth and gums. Afterward, I checked out the tiny monster that had been wreaking havoc on my bottom teeth. It was totally unassuming, and I was relieved to see it tossed in the trash.
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Same problem, whites are blue, and getting worse. Replace back lights? or research Consumer rights act 2015? Can you go more into detail about fixing or getting a new TV? fabfiv...@gmail.com,,, thanks. Frank
In maine we have laws and doesn't matter how long manufacturer warrantees tv. Minimum 4 years from defect as long as it wasn't abused. Many manufacturers and big box retail stores been fighting to change the law thats been on books since the 1970s protecting maine consumers from crap manufactured products. Theve refused to amend or update the law . Retailers been crying to state sayingits not fair and stuff is made cheaper amd dont last as long as it used to but they selling the stuff for all the money. So hopefully I cam find the reciept. I had a washer that was three years old quit working. Called best buy up and told them it stopped working. They tried to make me pay for a repair man to diagnose the problem amd pay for repair. Store wouldn't listen to me when I told them its the law and its their problem amd they need to deal with it. Wasnt abused I take care of my stuff as I work hard to be able to purchase. They refused to do anything. Attorney General contacted them and I had new washer 5 days later!
Ok, every TV made in the last 30 years has some sort of secret" service menu built in. I'm assuming the color balance of the entire screen has drifted, and the problem is not a bad screen. If there's a bad module or screen, making adjustments will not fix the issue.
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