Orthodontic Retainers

Orthodontic Retainers

Orthodontic Retainers

So you’ve spent a couple of years being metal mouth with your braces and the time has finally come to get them off. That’s the good news-now-here’s the bad. You have to wear a retainer for the rest of your life. Orthodontic retention is just as important as the actual treatment. This is because the muscle forces are always there trying to push the teeth back into their original position. It’s a constant battle-the good guys against the bad guys-and the only way to win is by wearing the retainer regularly. When the braces are taken off, the bone that holds the teeth is in a state of flux. The teeth are quite loose because the pressure that is applied by the braces erodes the bone on the pressure side and stimulates new bone on the other side. However, the new bone growth is slow to catch up, therefore, loose teeth. The retainer must be worn full time until the bone can heal with the teeth in their new postion. The good news is that this full time period doesn’t last forever. Once the orthodontist decides that the teeth are stable enough, you can go to the night time wear. But from that point on, you must sleep with it in forever, or risk undoing all of that time, effort and money to straighten them.

Bisphosphonates and Osteonecrosis in the Mouth

An example of bisphosphonate related osteonecrosis

Bisphosphonate Related osteonecrosis

Medications to help reduce the effects of osteoporosis have been a great help to the sufferers of the disease. Unfortunately, as there is with most medications, there are side effects. The main oral concern of these side effects is a malady called bisphosphonate-related osteonecrosis,BON, which is essentially localized bone death. After oral or periodontal (gum) surgery, wound healing can be compromised to the point that raw, denuded bone can be present and continues to be a nagging problem for the sufferer. It was a condition that was common in cancer patients who received radiation treatment. However, with the advent of the osteoporosis medications, this affliction became more common. The good news is that those receiving oral medications versus intravenous were significantly less likely to be affected by BON. The most popular of these medications go under the brand names of Fosamax, Uredic, Boniva and Zometa. If any type of oral surgical procedure is contemplated, the dentist must be made aware that the patient is taking a bisphosphonate drug.  Since there is no treatment available for BON, a decision must be made weighing the risk versus the benefits of doing the surgery.