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QUESTION: Your question was

Hi Dr Supan
I hope you can help please. I had my brace removed 7 years ago I have a fixed retainer but still put the removable one in once a week. I need to have a crown so my first appointment is in 3 weeks. When I have the temporary crown it will be 2 weeks until I have the permanent one fitted. I won't be able to wear my retainer then once the permanent one fitted as I doubt will fit. The crown will be on the 4th tooth back. Could I cut retainer to just cover the front 4 until get new one? I will have to wait for a new retainer. Will my teeth move lots as when I have the new impression done it could be 2/3 weeks? Also will pulling a tight retainer out loosen a crown? Thank you
Nicola

ANSWER:
Hello Sarah and Nicola,

You question is a common concern for many adult patients who face dental treatment involving crowns. As always,  what I write here are only my opinions based on very limited information. My comments should not be viewed as any form of diagnosis, definitive or otherwise,  or any form of  treatment recommendation.  Indeed, in the ultimate analysis all final decisions, particularly clinical ones, should  only be made by qualified doctors who have had a chance to see you in person and who have had an opportunity to take and analyze proper diagnostic records.

Okay… having said  that…  your  questions focused or your retainer and crowns in conjunction with post orthodontic treatment..  You  wrote:

" Could I cut retainer to just cover the front 4 until get new one? I will have to wait for a new retainer. Will my teeth move lots as when I have the new impression done it could be 2/3 weeks? Also will pulling a tight retainer out loosen a crown? Thank you
Nicola "  


It is not clear to me which style of removable retainer you have. Is it a clear over the teeth style, or a Hawley type appliance which has a circumferential metal bow. Since you have had the retainer for many years, I would recommend considering the following. Consult with your doctor as well of course.

1.  Make a new retainer once the final crown is in place. Consider having a clear cover the teeth style retainer made. These resemble the clear aligners which you may have seen.

2.  Do not throw the old retainer away. Instead, ask the dentist or orthodontist  if he/she can modify the old removable appliance so that it can serve as a back up retainer appliance in case the new once is lost or damaged.

I would not personally "cut" or modify your existing old removable retainer. I also think that four weeks of not wearing your removable retainer, particularly given the fact that it serves as an auxiliary appliance in addition to the primary fixed retainer, will present an issue. I doubt serious relapse will occur in such a short time span given that you have been out of braces for many years now.

I wish you the best with your new crown and retainer.

Paul Supan, DDS, MA, MPH
Board Certified Orthodontist

Specialist in Orthodontics
Specialist in Dental Public Health
http://www.braces.com
http://www.leesburgbraces.com

Please allow a week for a reply. I am in full time Private Practice, lecture on occasion, and involved in many volunteer activities. I am therefore not always able to respond to questions straight away. Your understanding is appreciated



---------- FOLLOW-UP ----------

QUESTION: Hello again, I just wanted to let you know I had a temporary plastic crown and the old plastic retainer fitted which I wore for 2 weeks. I went back this week to have my permanent crown fitted (the dentist didn't numb me first, not nice at all but that's another story)  new crown is fab but I am going back this week for impressions for a new Essex plastic retainer as the old one won't fit. Will be a couple weeks so fingers crossed teeth won't more. Thanks again for the advice, very helpful,
Sarah

Answer

Hi Sarah,

You wrote   QUESTION: Hello again, I just wanted to let you know I had a temporary plastic crown and the old plastic retainer fitted which I wore for 2 weeks. I went back this week to have my permanent crown fitted (the dentist didn't numb me first, not nice at all but that's another story)  new crown is fab but I am going back this week for impressions for a new Essex plastic retainer as the old one won't fit. Will be a couple weeks so fingers crossed teeth won't more. Thanks again for the advice, very helpful,
Sarah  


I am pleased things worked out so nicely for you.  The clear retainers can also serve to protect the crowns from trauma and wear. One does not need to have both upper and lower teeth protected by a retainer, as long as one retainer ( be it an upper or lower ) provides that sandwiching layer of plastic between the upper and lower opposing teeth. This hes to diminish the effects of the tooth to tooth biting forces that may in time wear, abrade, or crack a crown.

Of course this all refers to the wearing of appliances outside of eating and brushing ones teeth. Also, there is no reason that two retainers, one upper & one lower, could not be utilized. This would help to better maintain alignment of the upper and lower teeth following orthodontic treatment.

Good luck Sarah, and thank you so much for the follow up comment...how terribly civil of you. Thank you and thank you again.


Paul Supan, DDS, MA, MPH
Board Certified Orthodontist

Specialist in Orthodontics
Specialist in Dental Public Health
http://www.braces.com
http://www.leesburgbraces.com  

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Paul Supan, DDS, MA, MPH

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First may I say please set your questions to Public so other readers can benefit from the response. Also, if you look at my comprehensive answers, they are not short 1 or 2 paragraph quickie replies that anyone can type out in < 5 minutes. Instead I often will ask other colleagues in other specialties for their advice in order to provide you the questioner with a more interdisciplinary perspective. This all takes time. I ask for readers to therefore allow 5-7 days. You will be rewarded with a very detailed response.

Because of the nature of Orthodontic questions, any pictures of the teeth and X-ray images would be very helpful. If you write to me and explain that you have crooked overlapping front teeth can be interpreted in many many ways, and my goal is to provide a specific response that meets your needs.

I hold double specialty credentials. I am Board Certified in Orthodontics and Board Eligible in Dental Public Health. I welcome questions regarding Braces, Invisible Braces, & Invisalign, as well as issues involving combination Cosmetic Dentistry and Orthodontic treatment. Orthodontics alone sometimes is not enough to achieve that perfect smile. Gingival (gum) re-contouring, tooth reshaping, bonding and other services are sometimes needed. I also have substantial experience in the areas of Infection Control and Sterilization in the Dental Environment. My personal websites braces.com and Leesburgbraces.com are non-commercial for information purposes only and may provide you with some background to more precisely frame your question for allexperts.com.

Please allow a week for a reply. I am in full time Private Practice, lecture on occasion, and am involved in many volunteer activities. I am therefore not always able to respond to questions straight away. Your understanding is appreciated.

Experience

Board Certified Orthodontist (ABO Diplomate) with over 25 years of Private Practice experience. Second Specialty Certificate in Dental Public Health with research experience at NIH, and Epidemiology Training & Research at Harvard, NIH, and the Centers for Disease Control (CDC) in Atlanta. Postgraduate Masters degree from the Harvard School of Public Health, as well as a Master of Arts Degree in Education.

Organizations
American Dental Association, American Association of Orthodontists, Academy of General Dentistry, College of Diplomates of the ABO, OSAP - Office Sterilization & Asepsis Procedures Organization, Others

Publications
Available upon Request.

Education/Credentials
BS College of William & Mary, DDS Medical College of Virginia, Masters of Public Health (MPH) Degree Harvard School of Public Health. Dental Public Health Specialty Certificate from NIH. Orthodontic Specialty Certificate from University of Rochester Eastman Dental Center. USPHS clinical research experience at NIH, and Epidemiology Training & Research at Harvard, NIH, and the Centers for Disease Control. Fellow of the Academy of General Dentistry (FAGD), and Fully Board Certified Diplomate of the American Board of Orthodontics. Board Eligible in Dental Public Health. Visiting Adjunct Associate Professor at the Meharry Medical College School of Dentistry, Nashville, Tennessee.

Awards and Honors
Available upon Request Please see my personal websites braces.com and Leesburgbraces.com for further personal background.

Past/Present Clients
Available upon Request

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