Retainers

The retention phase of orthodontic treatment at Orthodontics Only in Miami is as important as the active phase of tooth movement.  Teeth are only held in place by ligaments and teeth can always move if they are not held in place with a retainer.  Most times retainers can be worn at nighttime, but Dr. Sanders will review your individualized retention plan to prevent future tooth movement and orthodontic relapse.

 

Why Do I Have to Wear a Retainer?

After investing in orthodontic treatment to improve function and esthetics, the last thing a patient would want is for their teeth to move back to their original positions.  During orthodontic treatment teeth become loosened and when active treatment is completed, teeth are not yet firmly anchored.  If teeth move before the bone and gum tissues are firmly attached around the roots, teeth can move out of alignment.

 

What Types of Retainers are Available?

It is important to have a retainer for the upper and lower teeth and Dr. Sanders gives each patient an individualized recommendation.  Retainers can be divided into two categories, fixed or removable, and both are commonly used in our practice.  A fixed retainer is a small diameter wire which is bonded to the lingual surface (tongue surface) of the front teeth in order to maintain the alignment, without needing patient cooperation.  A removable retainer either consists of a traditional acrylic with wire or it can be a clear aligner, similar to Invisalign.

A fixed retainer can be worn for life, with the occasional need for re-bonding because hard foods sometimes chip away at the composite (bonding) material.  Fixed retainers are the retainer of choice when orthodontic treatment has resulted in big changes in the alignment of teeth and in these cases there is usually a high risk of relapse.  For patients with a fixed retainer, we recommend using a waterpik in order to remove plaque from around the retainer.  Tartar or calculus can build up around fixed retainers due to the difficulty of flossing and we traditionally recommend a professional cleaning with a dental hygienist, typically every three to six months.

With a traditional acrylic type of retainer, the wire wraps around the upper six front teeth and the acrylic conforms to the palate.  This type of retainer is called a “Hawley Retainer” after the name of the orthodontist who invented the retainer.  The other type of retainer is made from a clear plastic tray that fits over teeth and looks very similar to an Invisalign aligner.  The clear type of retainer is much more common since the clear plastic is strong enough to withstand biting and grinding forces and can prevent rotations significantly more than a traditional retainer.

 

When are Retainers Worn?

Many patients are instructed to wear their removable retainer(s) all day and night for a few months up to two years, but can remove them for eating.  Most patients are required to wear their retainers every night to maintain alignment for the rest of their lives.

 

Do Retainers Feel Weird?

At first, speaking with a new retainer may be difficult but it will improve over time as the mouth will become used to the retainer.  Patients might salivate more because having a new object in your mouth stimulates saliva production.  For people that have a removable retainer, most will find it easier to eat and clean when compared to having braces.

 

How are Retainers Cleaned?

Fixed retainers are cleaned with normal brushing and flossing, however using a waterpik can be extremely more effective than flossing.  Patients should have their teeth professionally cleaned by a dental hygienist, typically every three to six months.  The hygienist will evaluate the gum tissues adjacent to the retainer and can clean away any build up of plaque and calculus.

Removable retainers are exposed to bacteria, which can colonize on the retainers, creating plaque.  They can be rinsed and gently brushed with a soft toothbrush with a small amount of nonabrasive toothpaste.  Baking soda is abrasive and should not be used.  Alternatively, for greater cleaning, a removable retainer can be soaked in a denture cleaner such as Efferdent for about five minutes.

Retainers should be rinsed every time they are removed and it should be cleaned at least once per day.  If plaque builds up on the retainer, a dentist or orthodontist can professionally clean the retainer in their office ultrasonic machine.

You can find much more about how we professionally scan to make certain the retainers are the proper size at this page – Retainer scan by Miami Orthodontist office.


About the Author: Derek Sanders is an Orthodontist at Orthodontics Only in Miami, FL. He has numerous publications and has lectured extensively on topics including braces and Invisalign. Dr. Sanders teaches at the University of Miami and is on the Craniofacial Team at Miami Children's Hospital. He has a blog and can also be found on Google+. See more articles by Derek Sanders.

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