A retainer is a customized appliance designed to stabilize teeth in their corrected positions following comprehensive orthodontic treatment. This device prevents a phenomenon known as relapse, where teeth naturally attempt to shift back toward their original locations. The process of receiving a retainer involves a collaborative effort between specialized dental professionals and a fabrication facility.
The Role of the Dental Professional
The professional who oversees the entire realignment process, typically an orthodontist, is the one who prescribes and manages the initial retainer phase. Orthodontists are dental specialists who have completed additional years of focused residency training, giving them specialized expertise in the movement of teeth and the alignment of the jaws. They determine the appropriate type of retainer based on the patient’s specific bite and the complexity of the original case.
General dentists, who are primary oral health providers, can play a supporting role in the retention phase. They routinely check the condition and fit of the retainer during regular check-ups and cleanings, ensuring it is not damaged or causing issues with the gums and surrounding tissue. If a retainer is lost or broken years after the initial treatment, a general dentist may manage the process of ordering a replacement, but they often refer patients back to the orthodontist for complex adjustments. Neither the orthodontist nor the general dentist usually manufactures the appliance chairside; instead, they act as the intermediary between the patient and a specialized dental laboratory.
How Retainers Are Physically Fabricated
The process of creating a custom retainer begins with the dental professional capturing the exact dimensions of the patient’s newly aligned teeth. This is accomplished either by taking a traditional impression, where a mold material is pressed against the teeth, or by using a modern digital scanner to capture a precise three-dimensional image. These physical molds or digital files are then sent to a professional dental laboratory, which specializes in fabricating orthodontic appliances.
The lab technician uses the mold or the 3D-printed model derived from the digital scan to construct the retainer using specific materials. For clear plastic retainers, a thermoplastic material is heated and then vacuum- or pressure-formed over the model to create a snug, transparent shell. Hawley retainers require the technician to manually bend stainless steel wire components and embed them into a layer of liquid acrylic that is then cured and polished. The laboratory’s expertise ensures the final appliance fits perfectly to maintain the achieved alignment.
Understanding the Types of Retainers
Patients typically receive one of two main types of retainers: removable or fixed. Removable retainers are the most common and include the Hawley and the clear plastic variety.
The Hawley retainer is recognizable by its combination of a metal wire that wraps around the front teeth and an acrylic body that rests against the roof of the mouth or the tongue side of the lower arch. This design offers durability and allows for minor adjustments to the wire if small tooth movements occur.
Clear plastic retainers, often known by brand names like Essix, are made from a thin, transparent thermoplastic sheet that is vacuum-formed over the teeth. These are highly favored for their aesthetic quality, as they are nearly invisible when worn. However, they are generally less durable than the Hawley design and cannot be adjusted, meaning a new one is required if significant damage or shifting occurs.
Fixed retainers, sometimes called bonded or permanent retainers, consist of a thin, braided wire that is cemented directly to the tongue-side surface of the front teeth. This option offers continuous, passive retention and eliminates the need for patient compliance, but it requires meticulous cleaning to prevent plaque buildup around the wire.
Essential Retainer Maintenance
Proper cleaning is necessary to prevent the accumulation of plaque and bacteria on the retainer, which can lead to bad odors and potential oral health issues. Removable retainers should be cleaned daily using a soft-bristled toothbrush and a non-abrasive cleanser, such as mild dish soap or a specialized retainer cleaning solution. Toothpaste should be avoided because its abrasive components can scratch the appliance’s surface, creating microscopic grooves where bacteria can thrive.
When not being worn, the appliance must be stored in its protective case to prevent damage and loss. Retainers should never be exposed to high temperatures, such as boiling water or being left in a hot car, as the heat can warp the plastic or acrylic material, compromising the fit. Patients should immediately contact their dental professional if the retainer is lost, damaged, or if it suddenly feels tight or painful to wear.