Orthodontic retainers preserve the alignment achieved after braces or clear aligner therapy, preventing teeth from shifting back toward their original positions. When a contagious illness like COVID-19 occurs, wearing and handling these appliances introduces a conflict between maintaining dental health and minimizing the risk of virus transmission. This situation requires careful consideration of personal health, hygiene protocols, and the stability of your orthodontic results.
Deciding Whether to Wear Your Retainer While Sick
The general recommendation is to continue wearing your retainer as prescribed to maintain orthodontic progress. Consistency is important because teeth can begin to shift relatively quickly, sometimes within a few days, especially if you recently finished active treatment. However, personal health and hygiene take precedence over minor alignment concerns during an active illness.
If you are experiencing severe symptoms such as frequent coughing, nausea, or vomiting, it is reasonable to temporarily discontinue wearing the appliance. Repeatedly removing and reinserting the retainer while ill increases the risk of contamination and can be uncomfortable due to dry mouth or a sore throat. Store the retainer safely and cleanly until the most severe symptoms have passed. Once you feel better and can maintain a consistent hygiene routine, you can reintroduce the retainer.
Retainer Hygiene Protocols During Illness
If you continue wearing your retainer, stringent hygiene practices are necessary to mitigate the risk of viral spread. Thorough hand washing with soap and water for at least 20 seconds is the most important step. This must be done immediately before and after touching the appliance, every time the retainer is removed or placed back into the mouth.
The retainer itself should be cleaned meticulously each time it is removed. Use a separate soft-bristled toothbrush and mild dish soap or antibacterial hand soap to gently scrub the entire surface. Rinse the retainer completely with cold water to remove all soap residue before reinserting it. Avoid using toothpaste, as its abrasive particles can scratch the material, creating surfaces where microorganisms can collect.
Keeping the retainer case clean is also important, as viruses can survive on surfaces. While the case is normally cleaned weekly, it requires more diligent attention during an illness. Scrub the case thoroughly with dish soap and warm water, then allow it to air-dry completely before placing the clean retainer inside. The case should be kept separate from other personal items and not touched by other household members.
Managing Temporary Breaks in Retainer Use
Temporary cessation of retainer wear for three to seven days during the peak of an illness is generally manageable for individuals who have consistently worn their retainers for a long period. The risk of significant relapse increases with the length of time the appliance is left out. The speed of this movement varies widely depending on individual factors and the time since active orthodontic treatment ended.
When you are ready to resume wear after a short break, the retainer may feel noticeably tight upon reintroduction. This tightness indicates that minor tooth movement, known as settling, has occurred. If the retainer fits and the tightness subsides after a few minutes, you can continue wearing it as prescribed. If the appliance does not fit easily, or if you have to force it into place, stop immediately to avoid damage. Contact your orthodontist for guidance, as forcing the retainer may cause undesirable tooth movement.
Post-Recovery Disinfection and Safety
After you have fully recovered and are no longer infectious, a thorough disinfection of the retainer and case is necessary to prevent potential re-exposure. This deep cleaning goes beyond the daily routine of soap and water. You can use a specialized retainer or denture cleaning tablet, following the manufacturer’s instructions for the correct soaking time.
An alternative disinfection method is soaking the retainer in a diluted solution of white vinegar and water (one part vinegar to two parts cold water) for 15 to 20 minutes. Note that Hawley retainers, which contain metal wires, should not be soaked for extended periods in acidic solutions like vinegar, as this can corrode the metal components. Finally, replace the toothbrush used to clean the retainer during the illness to eliminate any lingering viral contamination.