Complex Cases and Orthodontic Retreatment

We treat complex orthodontic cases and retreatment - patients whose teeth have shifted after previous braces, whose earlier treatment did not achieve what was intended, or whose case involves significant bite or jaw problems. Assessment is by an orthodontic specialist and the first consultation is free.

If your teeth moved back, you are not unusual

Many adults come to us because their teeth shifted after braces.

It is worth saying plainly: that is usually not a failure of the original treatment, and it is usually not your fault either. Teeth have a lifelong tendency to drift back toward where they started. Retainers exist precisely because of it, and retainer wear tails off for almost everyone eventually.

Relapse is treatable, and it is very often faster and simpler than the original treatment, because the teeth have been there before.

What We Mean by a Complex Case

Some cases are straightforward and some are not. The ones we would call complex include:

• Significant skeletal discrepancies - where the jaws, not just the teeth, are misaligned
• Severe crowding requiring extractions or substantial expansion
• Impacted teeth that have not erupted or have come through in the wrong place
• Missing teeth, congenitally absent or lost, requiring space management
• Previous treatment that did not achieve its goal, or that created new problems
• Cases involving restorative work - crowns, implants, bridges - needing coordination with your dentist

• Airway and jaw-joint considerations alongside alignment
• Cases where surgery may be part of the plan

More on surgical orthodontics →

These are the cases where specialist training genuinely matters - not because simpler cases do not benefit from it, but because complex cases can go wrong in ways that are difficult and expensive to undo.

Retreatment - Starting Again, Properly

Coming back for a second round of orthodontics is frustrating, and people often arrive slightly embarrassed. There is no need to be.

What we do first is work out what actually happened. Relapse from stopped retainer wear is a different problem from treatment that was never finished, which is different again from a plan that was wrong for the case. They need different solutions, so we look carefully before recommending anything.

Retreatment is often shorter than the original treatment, and for mild relapse, clear aligners are frequently sufficient. We will tell you at the consultation which category you are in.

A Note on Direct-to-Consumer Aligners

We treat a steady number of patients who started with a mail-order aligner service and stopped, or finished and were unhappy.

If you started treatment with an online aligner company, we are happy to help. The common thread is not that the trays were poor - it is that no one examined the bite before treatment began. Straightening visible front teeth while a bite problem goes unaddressed produces a result that photographs well and functions badly.

If that is where you are, bring what you have - records, trays, photographs. We will tell you what can be fixed and what it involves. No lecture.

What the Assessment Involves

The consultation is free and takes about an hour:

• Examination of the teeth, bite and jaw function
• Digital scan and any imaging your case needs
• Review of your previous treatment records where available - bring them if you have them
• A written explanation of what has happened, what can be done, how long it will take and what it costs

You will get a straight answer, including if the answer is that treatment is not worth it. Some relapse is minor enough to leave alone, and we will say so.