Straight Talk About Retainers

August 18, 2019

At Somerville Orthodontics, it is our goal to do everything we can to educate our patients. Lets work together as a team to help create your best smile. The purpose of our blog is to provide information so that you, the patient can make an informed decision.

One of the most important aspects of orthodontic treatment that often gets overlooked, is what happens when the braces come off? Here are the 5 most common questions I get about retainers.

1. What are the different types of retainers?

After you are done with orthodontic treatment (braces or aligners), it is imperative that you wear a retainer. This is meant to maintain the position of your teeth and smile so that it will stay straight and beautiful for years to come.

In general, retainers come in two types: removable and fixed.

Removable Retainers

As the name suggests, removable retainers are placed and removed by the patient. It is the patient’s responsibility to wear these retainers as directed by your orthodontist.

Within the removable retainer category, there are two subgroups: the clear plastic retainer and the wire retainer.

The clear plastic retainer covers and wraps around all of the teeth. It is very similar to a mouth guard, bleaching tray or clear aligner tray. The wire retainer uses a combination of wires and acrylic that rest around and between the teeth. Both types of removable retainers can maintain your smile after treatment as long as patients wear them for the prescribed time.

Fixed Retainers

As the name suggests, fixed retainers are bonded to the teeth so the patient cannot remove them. You can almost think of them as having braces and a wire bonded to the inside surface of your teeth. The orthodontist will bond fixed retainers at the completion of treatment. The most common location is behind the lower front teeth, and less frequently behind the upper front teeth.

There are various subgroups of fixed retainers based on the type of wire and how many teeth are bonded. Some orthodontists only place the bonding resin on a few of the front teeth, while others place the bonding on all of the front teeth. Most orthodontists will also give a removable retainer to wear on top of the fixed retainer as a back up.

It is important to note that there is no right or wrong type of retainer. Your orthodontist will recommend a specific type of retainer based on a combination of factors including: your specific tooth starting and finishing position, experience, oral hygiene and patient preference.

2. What are the advantages and disadvantages of each type of retainer?

Removable Retainers

  • The retainer is completely removable with nothing bonded to the teeth, so patients can easily maintain good oral hygiene.
  • The retainer must be worn the prescribed number of hours in order to maintain the final position of the teeth. The patient maintains full responsibility.
  • Can be easily lost, accidentally thrown away, or chewed up by pets.

Fixed Retainers

  • The retainer is bonded to the teeth, so usually the patient does not have the responsibility of wearing a removable retainer.
  • The fixed nature of the retainer makes it more difficult for patients to maintain good oral hygiene.
  • Can bend or break, which can cause unwanted side effects and tooth movement.

3. How long do I have to wear the retainers for?

This is a difficult question to answer. The short answer is: it depends. Every patient is different and responds differently to orthodontic treatment and retention. Some lucky patients never wear their retainers after braces and their teeth stay perfectly straight. Other unlucky patients skip one night of retainer wear and their teeth begin to shift. Unfortunately, we do not yet know why certain patients relapse and why others do not.

The only way to guarantee that your teeth stay straight is to never stop wearing your retainer/keep your fixed retainer in forever. This does not mean you have to wear your retainer all day, every day for the rest of your life. Most orthodontists will gradually reduce your retainer wear and make recommendations based on how your teeth respond.

4. My removable retainer doesn’t fit anymore/I lost my removable retainer, what should I do?

If you lost your removable retainer, it is important to call and notify your orthodontist immediately. Sometimes your orthodontist will have a spare retainer available that you can come pick up. Other times, a new retainer has to be made. It is important to notify your orthodontist right away so that the proper action can be taken before any shifting of the teeth occurs.

If you have been wearing your retainer according to your orthodontists’ instructions, it should fit and feel the same each time you put them on. Some minor adjustments may be necessary over time, but if the retainer is really not fitting anymore, it is likely that your teeth have already shifted. It is important to contact your orthodontists’ office immediately to determine the next course of action. This may involve making new retainers so your teeth do not continue to shift, or restarting treatment to correct your tooth position.

5. A part of my fixed retainer broke. Can my orthodontist just fix it?

Fixed retainers are not permanent. They can, and will break. If you notice that your fixed retainer has broken, it is important to contact your orthodontist right away. Depending on how and where the break has occurred, your orthodontist will recommend either fixing just the broken section, or replacing the entire fixed retainer. In general, it is difficult to repair segments of a fixed retainer. It is analogous to doing patchwork on a floor or roof. It may work temporarily or for a short amount of time, but in the long run, it is better to carefully remove and replace the entire retainer.

Final Thoughts:

Retainers are very important and often over looked. Regardless of the type of retainer you wear or have, retention is necessary to maintain your straight and beautiful smile. Most patients spend up to two years straightening their teeth and many do not realize that it can all be ruined in just a few weeks if they do not follow up with their retainers. Your orthodontic treatment is an investment. Lets maintain it for as long as possible!

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