Final Retention: It's On You

In order to maintain both esthetics and function achieved via orthodontic therapy, final retention is not merely an option. It’s a necessity.

Since most patients never return to the orthodontist after treatment after is completed, the general dentist is the sole line of defense for providing continuing and indefinite retention services – specifically, a regular post-orthodontic/permanent retention program for his or her patients.

PRIORITIES

Include retention information as part of every patient’s formal pre-treatment informed consent documents. They should remind patients at the end of orthodontic treatment that indefinite retention is a must – even when they leave the orthodontists care and return to the care of their general dentist.

1. 1. Inform the patient of the necessity of indefinite retention – regardless of pre-existing malocclusion, treatment modality, or length of time spent in treatment.
2. 2. Create an Orthodontic Screening Form to determine orthodontic treatment, frequency (if any) of retainer use, current connection (if any) with orthodontist…and inform patient of the necessity of indefinite retention.
3. 3. Evaluate every patient for retention need as routinely as you would discuss brushing ad flossing regimens. For existing patients, screening is most easily done at their regularly scheduled prophy exam. It can begin with some simple questions:
   
   • Have you had orthodontic treatment?
   • Do you wear retainers?
   • Do you see your orthodontist to have them adjusted?
   • Do you know that indefinite retention is necessary?
4. 4. Perform an intra-oral exam/take impressions to chart and evaluate over time.
5. 5. Treat the condition to prevent further damage – with final retainer, active retainer or bruxism splint.
6. 6. Develop a regular Post-Orthodontic Retention Program with fee structures developed to accommodate retention needs. Include a retainer exam fee, a retainer adjustment fee, a retainer replacement fee and, if needed, limited re-treatment fees.
7. 7. Determine the code by accessing the CDT Code Book directly.
8. 8. Offer retainers to patients whenever necessary and discuss the many options – regardless of whether a patient has had braces or not If a patient also requires bruxing appliances, a combination upper splint and lower retainer can be fabricated.

For a Free Copy of our Comprehensive Guide to Final Retention, Click Here.