Question

A year ago, our daughter received braces from the dentist - a so-called "Gartenhag". She will be able to remove the brace at the end of this month. I asked the dentist what to do next. He explained to me that the teeth would have to be wired and that our daughter would have to wear a block at night. Our daughter does not want to wear such a block. Will this have any disadvantages? Would wiring be enough? H. S. in M. 

Short answer

A so-called retention monoblock is used to passively stabilize corrected jaw misalignments in the right place. Whether this appliance can be dispensed with and stabilization by means of wiring is sufficient must be discussed with the treating dentist. As the retention monoblock only needs to be worn at night, this is a much lesser evil than running the risk of ruining a successful treatment.

Natural teeth are not directly fused to the jawbone. The roots of the teeth are suspended in the bone by many small tissue fibers. This makes it possible to move the teeth within the bone. Incidentally, this ability is present throughout life. The force required for this is generated by the removable or fixed braces. The bone is dissolved in the direction of the force in which the tooth is to be moved. The suspension fibers are constantly being formed anew. 

Fixation of the teeth 

Once a tooth has reached its destination, it must be held there for years, as otherwise there is a risk that it will move back on its own. To prevent this from happening and to maintain the ideal tooth position, the teeth need to be fixed in place. This is usually done with a bonded wire (wire retainer) on the inside of the teeth, which is not visible from the outside. 

Jaw position 

However, the position of the two jaws in relation to each other, i.e. the fit of the upper teeth to the lower teeth, is not sufficiently secured against displacement in certain cases. Especially if jaw misalignments (upper or lower jaw that is too far forward or too far back) have been corrected during treatment, it is possible that the jaws could move back into their previous misalignment. 

I assume that the "block" you mentioned is a so-called retention monoblock. This device is used to passively stabilize previously corrected jaw misalignments in the right place. Whether this appliance can be dispensed with in your daughter's case and stabilization by means of "wiring" (wire retainer) is sufficient cannot be conclusively assessed on the basis of the information available. 

Retention monoblock makes sense 

However, if the jaws are significantly displaced in relation to each other, it makes sense to wear a retention monoblock. As it only needs to be worn at night, this is a much lesser evil than running the risk of ruining a successful treatment. Your daughter would probably be annoyed if the jaws were to shift again to her disadvantage, which often also has a negative effect on her appearance. 

Author: Dr. med. dent. Jürg Eppenberger
Published in: Neue Luzerner Zeitung on October 12, 2005