Complex Orthodontic Cases and Retreatment

Some cases don’t fit the standard path: a canine that never came in, a bite that’s too far off for aligners alone, teeth that were straightened once and drifted back. Delta Smiles treats these cases at both our Antioch and Brentwood offices, and the free exam applies whether you’re starting fresh or coming back.

When Teeth Shift After Braces

This is the most common reason adults call us, and almost nobody wants to admit why.

Teeth move for the rest of your life. That’s normal biology, not a failure of your original treatment. Retainers hold them in place, and most people stop wearing them in their twenties. Aging, grinding, gum changes, and a lost tooth all push things along too.

The good news is that retreatment is usually shorter, simpler, and less involved than the original course. Much of the work was already done. What’s left is often a matter of months rather than years, and clear aligners handle many of these cases well.

What retreatment looks like here

We start with an exam and a scan to see how far things have actually moved, which is often less than it feels like in the mirror. From there, the options run in order of how much is needed:

• A new retainer. If the movement is minor and stable, sometimes the right answer is holding what you have.
• A short aligner course. Weeks to months, then a retainer. The most common route for adult relapse.
• A full retreatment. Braces or a longer aligner series where the bite itself has changed, not just the front teeth.

We can usually tell which one your case is at the first exam. If a new retainer will do, we’ll say so and stop there.

Impacted and Missing Teeth

A tooth that hasn’t erupted on schedule is a genuinely complex problem, and 3D imaging can change the answer. Impacted canines are the usual culprit. Where the tooth sits relative to the surrounding roots determines whether it can be brought into place with a bracket and chain, or whether a different plan is needed.

Congenitally missing teeth are the mirror image: space that has to be either closed or held open for a future implant, and that decision is easiest to make while a patient is still growing. Both cases need coordination with your general dentist and sometimes an oral surgeon, and we handle that coordination instead of leaving it to you.

Severe Bite Problems

Deep overbites, open bites, underbites, and crossbites vary enormously in how hard they are to correct. Some resolve with braces and elastics. Some need growth guidance while a child still has growth left. A small number need surgical orthodontics in adults whose jaws have finished developing.

The judgment call is knowing which category a case belongs in, and getting that wrong costs a patient years. Both of our doctors completed full orthodontic residencies, which is where this particular skill is built. If a case is at the edge of what orthodontics alone can achieve, you’ll hear that before we start, not after.

Related conditions we treat: TMJ and jaw joint problems, airway and breathing-related cases, and two-phase treatment for children who need growth guidance before braces.

Second Opinions Welcome

Second opinions are a routine part of what we do: patients who have been given a treatment plan elsewhere and want a second opinion. That’s reasonable, especially for a complex or expensive case.

Our exam is complimentary whether or not you become a patient, and when a plan from another office is the right one, we say so and send you back to it.

Get a Complex Case Looked At

Call (925) 754-3197 in Antioch or (925) 513-9320 in Brentwood, or request an appointment. Bring any records or imaging you already have and we’ll work from them where we can.