When braces are finally removed, the “retention”
phase begins for most individuals. The objective of this phase is to
ensure the teeth do not regress back to their previous position. A
retainer will be used to maintain the improved position of the teeth. A
retainer is a fixed or removable dental appliance which has been
custom-made by the orthodontist to fit the teeth. Retainers are
generally made from transparent plastic and thin wires to optimize the
comfort of the patient.
Retainers are worn for varying amounts of time,
depending on the type of orthodontic treatment and the age of the
patient. Perseverance and commitment are required to make this final
stage of treatment successful. If the retainer is not worn as directed
by the orthodontist, treatment can fail or take much longer than
What types of retainer are available?
There are a variety of retainers available; each one
geared towards treating a different kind of dental problem. The
orthodontist will make a retainer recommendation depending on the nature
of the original diagnosis and the orthodontic treatment plan.
The following are some of the most common types of retainers:
Hawley retainer – The Hawley retainer
consists of a metal wire on an acrylic arch. The metal wire may be
periodically adjusted by the orthodontist to ensure the teeth stay in
the desired position. The acrylic arch is designed to fit comfortably
on the lingual walls or palate of the mouth.
Essix – The Essix retainer is the most
commonly used vacuum formed retainer (VFR). A mold is initially made of
the teeth in their new alignment, and then clear PVC trays are created
to fit over the arch in its entirety. VFR’s are much cheaper than many
other types of retainers and also do not affect the aesthetic appearance
of the smile in the same way as the Hawley retainer. The disadvantage
of VFR’s is that they break and scratch more easily than other types of
Fixed retainers – A fixed retainer is
somewhat similar to a lingual brace in that it is affixed to the tongue
side of a few teeth. Usually, a fixed retainer is used in cases where
there has been either rapid or substantial movement of the teeth. It
usually consists of a single wire. The inclination of the teeth to move
rapidly means they are also more likely to regress back to their
previous position if a fixed retainer is not placed.
What do I need to consider when using a retainer?
There are a few basic things to consider for proper use and maintenance of your retainer.
Don’t lose the appliance – Removable retainers
are very easy to lose. It is advisable to place your retainer in the
case it came in while eating, drinking and brushing. Leaving a retainer
folded in a napkin at a restaurant or in a public restroom can be very
costly if lost because a replacement must be created. A brightly
colored case serves as a great reminder.
Don’t drink while wearing a retainer – It is
tempting to drink while wearing a retainer because of the unobtrusive
nature of the device. However, excess liquid trapped under the trays
can vastly intensify acid exposure to teeth, increasing the probability
of tooth decay.
Don’t eat while wearing a retainer – It can be
difficult and awkward to eat while wearing a removable retainer and it
can also damage the device. Food can get trapped around a Hawley
retainer wire or underneath the palate, causing bad breath. When worn
on the upper and lower arches simultaneously, VFR retainers do not allow
the teeth to meet. This means that chewing is almost impossible.
Clean the retainer properly – Removable
retainers can become breeding grounds for calculus and bacteria. It is
essential to clean the inside and outside thoroughly as often as
possible. Hawley retainers can be cleaned with a toothbrush. Because
harsh bristles can damage the PVC surface of a VFR, denture cleaner or a
specialized retainer cleaner is recommended for this type of device.
Wear the retainer as directed – This phase of
treatment is critical. The hard work has been done, the braces are off
and now it is tempting not to wear the retainer as often as the
orthodontist recommends. Retainers are needed to give the muscles,
tissues and bones time to stabilize the teeth in their new alignment.
Failure to wear the retainer as directed can have regrettable
consequences, such as teeth returning to their original position, added
expense and lost time.
If you have any questions or concerns about retainers, please contact our office.