The final step in orthodontic care is not the removal of braces but the use of a retainer, a phase known as retention. This stage is necessary for maintaining the newly aligned position of the teeth. Teeth have a natural tendency to shift back toward their original locations, a phenomenon called relapse. Without consistent retention, the significant time and financial investment made during active treatment would be lost.
The Process of Getting Your Retainer
The moment your braces are removed, known as debanding, marks the beginning of the retention phase. After the brackets and residual bonding material are polished from the tooth surfaces, the orthodontist captures the final alignment. This is done either by taking a physical impression or, more commonly today, by using a highly accurate digital intraoral scanner.
These models or digital files are sent to a dental laboratory for the creation of your custom-fitted appliance. The timeline between the impression and receiving the finished retainer ranges from the same day to approximately one week. This rapid turnaround minimizes potential shifting of the teeth immediately post-treatment. Once the retainer is ready, you return for a fitting appointment where the orthodontist ensures it seats correctly and provides instructions for wear and care.
Understanding Retainer Types
Orthodontists commonly prescribe one of three main types of retainers, each with distinct advantages and disadvantages. The first is the traditional Hawley retainer, which consists of a custom-formed acrylic base and a stainless-steel wire arch that wraps around the front teeth. Hawley retainers are known for their durability and adjustability, allowing the orthodontist to make minor tweaks if needed, but the visible wire makes them less discreet.
A second popular option is the clear plastic retainer, often called an Essix or vacuum-formed retainer, which resembles a thin, transparent mouthguard. This type is favored for its near-invisibility and comfortable, snug fit over the arch of the teeth. However, clear plastic retainers are generally less durable than Hawleys and are prone to cracking or warping over time, often requiring more frequent replacement.
The third type is the fixed or bonded retainer, a thin, braided wire permanently cemented to the tongue-side surface of the lower, and sometimes upper, front teeth. This retainer requires no patient compliance since it cannot be removed, providing continuous retention. A drawback is that it presents a challenge for oral hygiene, as specialized tools like floss threaders are necessary to clean effectively around the bonded wire.
The Retainer Wear Schedule
The frequency and duration of retainer wear are structured in phases, beginning immediately after debanding. The typical initial instruction is full-time wear, meaning the retainer is worn for 20 to 22 hours per day, removed only for eating, drinking anything other than water, and brushing. This intensive period usually lasts for the first three to six months, allowing the teeth and surrounding tissues to stabilize.
Once the orthodontist confirms stability, the wear schedule transitions into a part-time or night-time routine. This often involves wearing the retainer only while sleeping, a substantial reduction in the daily requirement. The length of time spent in this nightly phase varies widely among patients, depending on their individual risk for relapse.
The retention period is often indefinite for long-term maintenance of the alignment. Many orthodontists recommend wearing the retainer several nights a week for many years or even for life to counteract the natural tendency of teeth to shift. The specific, personalized schedule is determined by the orthodontist to secure the best possible outcome.
The Biological Reason for Retention
The necessity for long-term retention is rooted in the biological reactions that occur when teeth are moved. The primary force driving relapse is the “memory” of the periodontal ligaments, the specialized fibers that anchor the tooth root to the jawbone. During treatment, these fibers are stretched and compressed, and they tend to revert to their original length, pulling the teeth back with them.
Retention also provides the necessary time for the alveolar bone to fully reorganize and solidify around the new tooth positions. Tooth movement involves a continuous process of bone breakdown (resorption) on one side and bone rebuilding (formation) on the other. While bone resorption occurs quickly to allow movement, the formation of new, stable bone on the tension side takes a much longer time.
This biological remodeling process requires many months to complete and fully stabilize the new bony socket. The retainer acts as a passive scaffold, holding the teeth precisely in place until the bone structure is rigid enough to support the corrected alignment independently. Failing to adhere to the prescribed retention schedule risks overwhelming the developing new bone, leading to a reversal of the orthodontic results.