Orthodontic retention is the concluding phase of treatment, following active tooth movement with braces or aligners. This stage preserves the alignment achieved, ensuring teeth remain in their newly straightened positions. Maintaining these results prevents teeth from gradually reverting to their original placements. This step is an important part of the overall process, protecting the effort and time invested.
The Purpose of Orthodontic Retention
Following active orthodontic treatment, oral tissues naturally try to guide teeth back to their initial alignment. This phenomenon, often termed “relapse,” is influenced by the “memory” of periodontal ligaments, which anchor teeth to the jawbone. These ligaments, along with gingival fibers and bone, require time to reorganize and stabilize around the newly positioned teeth. Forces from chewing and speaking also contribute to this tendency for teeth to shift.
Retainers provide passive support to counteract these forces, holding teeth in their corrected positions. This support allows surrounding bone and gum tissues to adapt and mature around the new dental arrangement. Over time, these tissues solidify, creating a stable environment that helps maintain alignment long-term. Without this stabilization period, biological pressures would likely cause the teeth to drift.
Types of Retainers
Orthodontic retainers fall into two categories: fixed and removable, each offering advantages and considerations. Fixed, or bonded, retainers consist of a thin, custom wire permanently attached to the tongue-side surface of the front teeth, usually from canine to canine. Always in place, these retainers offer continuous stabilization and are discreetly hidden. However, their fixed nature can make thorough cleaning more challenging, often requiring specialized flossing techniques.
Removable retainers offer flexibility and come in two main types. The Hawley retainer features an acrylic base that fits against the roof of the mouth or along the tongue-side of the lower teeth, combined with a metal wire that wraps around the front teeth. This design allows for adjustments and is a durable option for maintaining alignment. Clear plastic retainers, often known as Essix retainers, are custom-made from a thin, transparent, vacuum-formed plastic that fits snugly over the entire arch. These are nearly invisible when worn, offering an aesthetic solution.
Clear plastic retainers are comfortable due to their precise fit, but they can be more susceptible to cracking or staining compared to Hawley retainers. Their lifespan may also be shorter, requiring replacement every few years due to wear. The orthodontist determines the retainer type based on the patient’s specific bite correction, oral hygiene habits, and the long-term stability required for their individual case.
Living with Your Retainer
Adhering to the prescribed wearing schedule is important for maintaining orthodontic results. Initially, patients are instructed to wear removable retainers full-time for several months following the removal of braces or completion of aligner treatment. This initial period allows teeth and surrounding tissues to settle into their new positions. The schedule then transitions to nighttime wear, where the retainer is worn only while sleeping, for an indefinite period.
Proper cleaning and care are also important for both fixed and removable retainers to prevent bacterial accumulation and maintain oral hygiene. For fixed retainers, meticulous flossing around the wire is necessary, sometimes requiring floss threaders or specialized interdental brushes. Removable retainers should be brushed daily with a toothbrush and cool water, avoiding hot water which can warp the plastic. Soaking solutions for retainers can also be used periodically to deep clean and sanitize the appliance.
Careful handling and storage of removable retainers are important to prevent damage or loss. When not worn, retainers should always be stored in their protective case to avoid breakage or misplacement. If a retainer becomes damaged, cracked, or lost, contact your orthodontist promptly for repair or replacement, as delaying this can compromise your treatment results.
What Happens Without Retention
Failing to wear retainers as directed can lead to relapse, where teeth begin to shift from their straightened positions. The degree of this relapse can vary, ranging from minor rotational changes to significant movement back to pre-treatment crookedness or the re-opening of spaces. This unwanted shifting can undermine the investment made in orthodontic treatment.
Consequences of inadequate retention include the reappearance of gaps between teeth, the return of crowded or crooked dental alignments, and the potential for bite issues to resurface. For instance, an overbite or underbite that was corrected might gradually return, affecting chewing efficiency and jaw comfort. When significant relapse occurs, patients may face the prospect of needing expensive and time-consuming re-treatment, such as another round of braces or clear aligners, to correct the dental alignment. Consistent retainer wear is the only reliable way to protect the long-term stability of an orthodontically corrected smile and the investment in time and finances.