A retainer is a necessary device following the completion of orthodontic treatment. This custom-made appliance maintains the new, corrected alignment of your teeth after your braces or aligners are removed. The retention phase is a continuation of the treatment required to stabilize your new smile. Without consistent use of a retainer, the teeth are highly likely to shift out of their newly established positions.
The Mechanics of Tooth Relapse
The necessity of a retainer is rooted in the biology of how teeth move and are supported within the jawbone. Orthodontic treatment applies continuous pressure, causing a controlled breakdown and rebuilding of bone tissue that allows teeth to move. Once braces are removed, the surrounding support structures are unstable, making the teeth susceptible to shifting back toward their original positions. The periodontal ligaments (PDL) have an elastic memory, and the supporting alveolar bone takes significantly longer to mature around the new root positions.
This period of instability is the retention phase, when the bone and soft tissues must fully adapt. The retainer acts as a passive stabilization device, allowing the supporting structure to consolidate and secure the corrected position, preventing relapse.
Types of Retainers and Wearing Schedules
Types of Retainers
Orthodontists typically prescribe one of two main categories of retainers. Removable retainers offer flexibility, including the Hawley retainer (acrylic plate and wire) and clear plastic retainers (Essix type) which are vacuum-formed for a discreet appearance. Fixed, or bonded, retainers involve a thin, braided wire permanently cemented to the tongue-side surface of the front teeth. This option provides constant retention and prevents the rotation of teeth.
Wearing Schedules
The specific type of retainer and the wearing schedule are customized by your orthodontist. The initial schedule is typically full-time (20 to 22 hours per day), only removed for eating and cleaning. This full-time wear lasts for three to six months to ensure maximum stability. Most patients then transition to wearing their removable retainers nightly, which is often recommended indefinitely.
Retainer Maintenance and Long-Term Commitment
Retainer Maintenance
Proper maintenance is necessary for both the effectiveness and hygiene of a retainer. Removable retainers should be cleaned daily using a soft-bristled toothbrush and a non-abrasive cleaner, such as mild dish soap. Avoid using regular toothpaste, as its abrasive particles can scratch the plastic material, creating grooves where bacteria can accumulate. Never use hot or boiling water on a removable retainer, as the high temperature will cause the plastic to warp.
For patients with a fixed retainer, special attention must be paid to cleaning the areas around the bonded wire. Tools like floss threaders or a water flosser are required to navigate the wire and remove plaque buildup.
Long-Term Commitment
Retention is a long-term, often lifelong, commitment that protects the investment spent on orthodontic treatment. Skipping retainer wear allows minute movements to accumulate, resulting in the retainer feeling tight or no longer fitting correctly. Failure to adhere to the prescribed usage schedule will result in the teeth shifting back, which can necessitate expensive re-treatment.