Dear Doctor, I really need unbiased advice on what I should now do. I had: Narrow palate/teeth, and lateral incisors which were "pushed in" (towards palate). After braces, they looked perfect. Was assured that with a permanent retainer/wire behind teeth, they would stay that way. I'm extremely disappointed to say that 3yrs later they have regressed back. Refused braces. Got veneers instead. They are still too "in", would like them pushed out&widened again. Best solution? Much appreciated
Teeth Back to Pre-braces, Tried Veneers Too. What More Should I Do?
Doctor Answers (7)
Use Invisalign to correct prior orthodontic relapse
Our teeth continue to shift with time unless it is actively prevented. A fixed retainer will hold the front teeth to which it is attached, but not the back teeth. After you have had your teeth realigned it will be essential to wear a rigid retainer at nighttime to retain the result.
Orthodontic relapse and failed veneers.
The key question is: Are your teeth now in a stable position or not? If they are not, then you must seek consultations from very experienced orthodontists to see why the teeth are not stable.
If the teeth are now stable, then you could consider re-doing the veneers at a more pushed-out position. Note that this is going to make the teeth thicker. A quick way of finding out if this will work is to take impressions of you teeth and make a wax-up on the stone models and then transfer this to the mouth as temporary mock-up using temporary material. (like a snap-on smile) You can take pictures and have friends and family evaluate it for a day or two. The temporary material snaps-on over your current teeth and it is simply picked-off afterwards. There is no grinding or damage to existing teeth or veneers. It is completely reversible.
You will probably be charged a fee for the wax-up and mock-up but it is worth it so you can see what can be achieved prior to doing it.
BTW, this should be done anyway for any veneer case involving more than one or two teeth.
Hope this helps
Narrow Palate is Difficult to Treat
I am sorry you are unhappy with all of the work you have done but try not to be discouraged. You do have options-Firstly, if your underbite, crossbite was indeed corrected by braces your teeth should not have regressed. Narrow palates are difficult to treat but it can be done. Veneers are great but can only do so much. You can veneer the veneers and see if that helps push out the smile enough for you-I have done that successfully for many years. You need to get a experienced dentist to review and advise. Much success-
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Correcting Orthodontic Regression
Sorry to hear about your circumstances. It is hard to give advice or a solution without additional information as to what forces have caused the relapse, whether they be solely dental or other oral, neuromuscular issues. Obviously, at some point, there was a satisfactory result as they "looked perfect" after braces, and due to some retainer malfunction, things regressed. Now, it seems that veneers did not obtain that "perfect" result. It is hard to tell without photos what didn't work with the veneers. It would seem that if the position of the teeth is still "too in," then additional orthodontics could move them back out in line, however you still may be hesitant to return to braces. At this point it would be best to seek two to three opinions to aid in your decision as to which avenue will give a satisfactory result, and how to retain it. Best of luck.
When an orthodontic result is so unstable we must ask ourselves why? What is it that could be causing the teeth to move and collapse that much?
There are many factors to consider, but I have found that in general it is the force of muscles that can cause such relapse. The muscles of the cheeks and lips put an inward pressure on the teeth. This is counterbalanced by the outward force of the tongue. Teeth usually find a neutral zone between these forces. When the tongue posture changes, as in mouth-breathing, the inward force of the cheeks and lips win. Crowding of the anterior teeth, narrowing of the dental arches, high vault of the palate, can all result.
I wonder if you have any breathing disorders. Allergies, asthma, snoring, sleep apnea, enlarged tonsils. These can all contribute to an unstable bite. If this is your problem and you address it, it could make a big difference in the stability of your result.
I would suggest that you speak to your medical doctor to uncover any of these issues.
What to do it ortho fails
Sorry to hear about your dissapointment. There are questions that if answered , we probably can guide you better.
1) At what age did you have ortho, and did the orthodontist give you apalatal expander ?
2) Did you extract any teeth to make room in your upper arch?
3) Was you lower arch treated and kept with a permanant retainer?
3) How many veneers did you place?
4) Were you give a retainer after the veneers were placed?
The answers to these questions will help for finding a solution for you. Please do not hesitet to reply back and better yet post a photo with your reply..