Once orthodontic treatment has been completed, the use of retainers after braces is a very important part of the continuing maintenance of teeth and will go a long way toward keeping the same bite and smile that the braces formed over the previous few years. Retainers are usually fabricated by the orthodontist or general dentist who performed the orthodontic treatment. This is customarily done by taking a mold, or impression, of the newly straightened teeth and fabricating the retainer out of wire and/or acrylic material before inserting it during a separate appointment once the dentist or dental lab has created it. In most cases, retainers must be worn for several years, if not indefinitely.
There are two types of retainers after braces: Fixed and removable. Choosing the type usually involves the clinical needs of the individual case, the desires of the patient and the overall compliance that the dentist and patient can expect from retainer maintenance.
The fixed type of retainer is usually a thin wire worn across the back of the lower or upper front teeth, which is bonded in place with a cement similar to that applied on the brackets of braces. Because this type of wire stretches across several teeth, a floss threader or similar cleaning device must be used to access the interproximal spaces between the teeth, which is similar to how people with braces have to floss. Despite the fact that this type of retainer takes a little more work to keep clean, it has the best outcome because the bonded wire will hold the newly straightened teeth in perfect formation 24/7.
The removable type of retainer is usually a combination of a wire going across the front of the lower or upper front teeth held in place with a combination of acrylic material and hooks (or clasps) that insert in and around the back teeth to hold the retainer in place. Since it is removable, this type of retainer makes it easier to clean your teeth, but the patient has to remember to wear it daily. Initially, your orthodontist or dentist will want you to wear it all day and all night for at least three months; if no movement is detected, you may be instructed to wear the retainer only at night or for a few hours in the daytime.
The obvious disadvantage of a removable retainer after braces is the fact that it can be lost or damaged and can even melt or change shape if it is exposed to high heat. It is also very important not to leave the retainer lying around the house since pets love to chew them! When wrapping retainers in tissues or paper towels, they tend to get thrown out. Most orthodontists and general dentists charge a few hundred dollars to replace retainers, so people with removable retainers should find a safe way to store them in a plastic retainer case.
Throughout (and after) the use of both types of retainers, periodic maintenance in the form of routine dental visits is required to check for cavities and to clean the straightened teeth. Your dentist or dental hygienist can inspect in and around a fixed retainer after braces to ensure that it is properly secured in place and that the teeth supporting it are free of plaque and tartar.
For removable retainers, regular toothpaste should never be used for cleaning because it can dull the acrylic surface and cause bacteria to stick to it. Common denture cleaning tablets with antibacterial ingredients or a product such as Colgate ® Plax ® Herbal Salt, in addition to vinegar and water, can help clean the bacteria from a retainer.
Most patients have invested a lot of money in orthodontic care. Using retainers after braces is an important part of the treatment and is meant to ensure a lifetime of happy and straight smiles.
About the author: Dr. Huot is the founder and CEO of Beachside Dental Consultants Inc. He has lectured at many meetings, and his past articles have been featured in Dental Products Report, Dental Economics, Dental Practice Report, ADA News and state dental journals. Dr. Huot recently retired from the USAF Reserve Dental Corps after 30 years of military duty, and his most recent assignment was as the Commander of the 920th Aeromedical Staging Squadron at Patrick AFB, Florida. A Past President of the Maine Dental Association in 1994 and the 2006 President of the Atlantic Coast District Dental Association in Florida, Dr. Huot is a Fellow of the American College of Dentists, the International College of Dentists, the Academy of General Dentistry and the Pierre Fauchard Academy.