The removal of braces marks a significant milestone, but the work is not fully complete. The next phase, known as retention, is necessary to maintain the alignment achieved during treatment. This involves wearing a custom-made orthodontic appliance called a retainer. This device holds your teeth in their new positions, preventing them from shifting back toward their original alignment. Learning about the different types of retainers and how to use and care for them is important to protect your investment.
Why Retention Is Necessary After Braces
Retention is a biological necessity because teeth do not immediately lock into their corrected positions once braces are removed. The tissues that anchor your teeth must be given time to stabilize around the new alignment. The tendency for teeth to move back to their former positions is known as “relapse.”
Teeth are held in the jawbone by a network of fibers called the periodontal ligament. When orthodontic forces move a tooth, these fibers are stretched and compressed, stimulating bone remodeling. After the braces come off, the periodontal ligament fibers still have a memory of their original position and will attempt to pull the teeth back. A retainer acts as a passive brace, holding the teeth in place while the surrounding bone and soft tissues fully adapt and solidify the new position, which can take many months.
Fixed Versus Removable Retainers
Removable Retainers
Removable retainers offer the advantage of being taken out for eating and cleaning. The two most common types are the Hawley and the clear plastic retainer.
The Hawley retainer is the more traditional option, consisting of a metal wire that wraps around the front of the teeth and is embedded in a custom-made acrylic base. This design is durable and the wire can be adjusted slightly if minor tooth movement is needed. However, the visible wire can be a cosmetic drawback, and the acrylic base may interfere with speech initially.
Clear plastic retainers, often called Essix retainers, are vacuum-formed trays that fit snugly over the entire arch of the teeth, similar to an invisible aligner. Their main appeal is their near-invisibility, making them discreet for wear. These retainers are more prone to wear and tear than Hawley retainers and may need replacement every few years as the plastic can wear thin or crack.
Fixed Retainers
A fixed or bonded retainer consists of a thin, braided wire that is permanently cemented to the lingual, or tongue-side, surface of the front teeth. This wire is typically placed across the lower front teeth, which are highly susceptible to shifting.
The major advantage of a fixed retainer is that it provides continuous, passive retention and eliminates the risk of forgetting to wear it. Since it is bonded behind the teeth, it is completely invisible. The challenge with this type of retainer is maintaining hygiene, as the wire can make flossing between the connected teeth extremely difficult.
Understanding Your Wearing Schedule
The schedule for wearing your retainer is divided into phases, starting with almost constant wear and gradually reducing over time. This phased approach allows the surrounding structures to stabilize gradually.
The initial phase requires full-time wear, generally meaning 20 to 22 hours per day, only removing it to eat, brush, and floss. This intense period typically lasts for the first three to six months following the removal of your braces. Adherence to this schedule is important during this time.
After the initial months, your orthodontist will likely transition you to a nighttime-only schedule, wearing the retainer for approximately eight to ten hours while you sleep. This phase may last for several years, but many orthodontists recommend that nighttime wear become a lifelong habit.
Retention is often considered an indefinite commitment because teeth can shift throughout life due to natural forces like aging and jaw growth. Skipping the prescribed wear schedule can cause the retainer to feel tight when you try to put it back in, which is a sign that your teeth have already begun to move.
Cleaning and Caring for Your Retainer
Proper maintenance is necessary to keep your retainer hygienic and effective. The care routine differs slightly depending on whether your retainer is removable or fixed.
Removable retainers should be cleaned daily using a soft-bristled toothbrush and a mild, non-abrasive cleanser, such as dish soap or specialized cleaning tablets. Abrasive materials like toothpaste or hard brushes can create microscopic scratches in the plastic or acrylic, providing places for bacteria to accumulate. You must never use hot water to clean a removable retainer, as the heat can warp the plastic material and ruin the fit.
For fixed retainers, the primary challenge is cleaning beneath the bonded wire. Specialized tools like floss threaders or a water flosser are needed to effectively remove plaque and food debris from between the teeth and under the wire. If a removable retainer is lost or broken, or if a fixed retainer feels loose, you should contact your orthodontist immediately to arrange for a repair or replacement, preventing unwanted tooth movement.