Christopher Piehler

This week I went to my orthodontist for the first time in a long time. My bottom retainer had cracked after almost 3 years of nightly wear, and I needed to pick up a replacement. As it happened, on the same day that I got my new retainer, I read an excellently detailed article in the AJO-DO by Lawrence Jerrold, DDS, JD, ABO. The topic? Developing a consistent retention protocol.

Jerrold was writing from a risk-management perspective, and his point, essentially, was that to avoid lawsuits or to be prepared when they come, orthodontists should have a retention protocol that is similar to that of other orthodontists practicing in their area. That way, no reasonable jury would come to the conclusion that the orthodontist did less retention than he or she should have.

Now that makes perfect sense from a legal perspective, but as a patient whose goal is not litigation but rather keeping my teeth straight for as long as I have them, I have other retention issues. For example: is roughly 8 hours a night really enough for me to wear my retainers? All of the orthodontists I know tell patients to wear their retainers “night-time for a lifetime,” so I intend to stick with that, but if I knew for sure that wearing mine for an extra hour a day would provide a sort of relapse insurance, I would certainly do it.

On the other hand, I sometimes wonder if I am wasting my time wearing my retainers so long after treatment. As someone who has had a second round of orthodontics due to relapse, the voice in my head that questions the usefulness of retention is quite quiet, but it is still there. I think this lack of faith comes, in part, from the transient nature of the orthodontist/patient relationship. With other types of doctors, the goal on both sides is for the clinical relationship to last as long as possible. But with orthodontists (as Jerrold mentions in his article), the active clinical relationship must have an expiration date so the orthodontist has time to treat new patients. Some orthodontists I know offer a “lifetime guarantee” to reassure their patients that they are not alone, even decades after the last bracket has come off. That seems smart to me. I don’t want to see my orthodontist every 6 weeks, but it would be comforting to hear that he was there for me.

If you’d like to share your thoughts on retention or any other orthodontic topic, you know where to reach me.

Christopher Piehler