The moment your braces are removed marks the end of active tooth movement and the beginning of the retention phase of orthodontic treatment. This stage involves using a custom-made appliance, known as a retainer, to stabilize the newly corrected positions of your teeth. Retainers protect the investment made in aligning your smile by preventing the teeth from shifting back toward their former positions. The long-term success of the orthodontic process depends on consistent retainer use. This article will explore the different forms retainers take, helping you understand the choices available for maintaining your straight smile.
Why Retention is Essential
Teeth naturally tend to drift back to their original locations after braces are removed, a phenomenon known as orthodontic relapse. This movement occurs because the supporting structures around the teeth have not yet fully adapted to the new alignment. The periodontal ligaments, which are elastic fibers connecting the tooth root to the surrounding alveolar bone, are stretched and reorganized during treatment. These ligaments maintain a tension that tries to pull the teeth back.
The alveolar bone, which was broken down and rebuilt during tooth movement, needs time to mature and solidify around the repositioned roots. Studies suggest that while the bone remodels quickly, the gingival collagen fibers can take many months to fully reorganize. Long-term retention is recommended to ensure these biological structures stabilize and counteract the natural forces that cause subtle tooth movement over time.
Removable Retainer Choices
Removable retainers offer the flexibility of being taken out for eating, brushing, and flossing, but they require patient commitment to a strict wear schedule. The two most common types are the traditional Hawley retainer and the clear plastic, vacuum-formed retainer, often called an Essix retainer.
The Hawley retainer is constructed from a durable acrylic base combined with a thin metal wire. This wire loops across the front of the teeth, holding them in position, and is anchored by clasps around the back teeth. A primary advantage of the Hawley design is its durability and the ability for the orthodontist to make minor adjustments. However, the visible wire can be an aesthetic concern, and the bulkier acrylic base may temporarily affect speech.
Clear plastic retainers are made from a thin, transparent thermoplastic material molded to fit precisely over the entire arch. These retainers are nearly invisible when worn and are more comfortable because they lack metal wires and bulky acrylic. Their snug fit makes them effective at holding all teeth in their final position. A drawback is their shorter lifespan, as the thin material is susceptible to wear, cracking, or warping if exposed to heat, often requiring replacement every six to twelve months.
Fixed (Bonded) Retainers
A fixed retainer, also known as a bonded or permanent retainer, provides continuous stabilization without requiring effort from the patient. This device consists of a thin metal wire custom-fitted to the tongue-side surface of the teeth. The wire is securely cemented into place using a dental composite material, similar to that used for white fillings.
Fixed retainers are most commonly placed behind the lower front six teeth, where the risk of relapse is high. The primary benefit of this appliance is that it offers nonstop retention, completely eliminating the concern of patient non-compliance. Since the wire is placed on the back of the teeth, it is discreet and unnoticeable when smiling.
The main challenge is maintaining adequate oral hygiene around the wire. The bonded wire makes traditional flossing difficult, potentially leading to increased plaque and tartar accumulation if not cleaned properly. Regular dental check-ups are important to monitor the integrity of the bond and ensure the surrounding gum tissue remains healthy.
Retainer Care and Maintenance
Removable retainers should be cleaned daily using a soft-bristled toothbrush and a non-abrasive soap or mild toothpaste. Avoid using hot water for cleaning or rinsing, as the heat can permanently warp the plastic material of clear retainers. When the retainer is not in the mouth, it must be stored safely in its protective case to prevent loss, damage, or being accidentally thrown away.
Caring for a fixed retainer requires a specialized cleaning technique because the wire permanently spans the teeth. Standard floss cannot pass between the teeth, so patients must use aids like a floss threader or specialized dental floss, such as Superfloss, to clean beneath the bonded wire. Small interdental brushes are also helpful for removing plaque from the tight spaces around the wire. Regular dental visits are important to check that the bond is intact and to allow a hygienist to thoroughly clean the area for tartar buildup.