Retainers are appliances used after braces to maintain the results achieved and prevent any unwanted movement of the teeth. After treatment, especially in the first few months, teeth have a tendency to move back towards their original position. It usually takes somewhere between 3-4 months for new bone and gums to form and fully adapt around the new position of your teeth.
Teeth also have a tendency to continue moving throughout life, even if no orthodontic treatment has ever been done. That is why it is very important to wear retainers after orthodontic treatment, especially in the first 6-12 months.
Keeping a perfect smile is as important as achieving one. I see many patients that come to me because they had braces some time ago as kids and they never wore their retainers. This situation is usually frustrating for the treating orthodontist as well as the patient, who had gone through years of treatment and invested a significant amount in their new smile.
When it comes to maintaining a perfect smile, there are 3 main kinds of retainers used today. Let's briefly go over each option, including the pros and cons of each.
Hawley retainers are the gold standard of orthodontic retainers. They are made of acrylic material that covers the roof of the mouth, and wires that serve to maintain your teeth in their position. The main pros of Hawley retainers are:
- Durability: they are made of hard acrylic and wire, and can usually last many decades.
- Can be adjusted: your orthodontist can adjust the wire and acrylic, and can usually correct minor tooth movements if they do occur.
The cons are:
- Esthetics: they are not very esthetic, and can look funny if worn in public.
- Speech: Covering the roof of the mouth may slightly affect your speech. This is also only a problem if it has to be worn during the day.
Clear Retainers (also known as Essix retainers)
Clear retainers are retainers made of clear acrylic. They cover all surfaces of your teeth. They usually do not cover the roof of the mouth. The main advantages are:
- Esthetic: The clear acrylic is barely visible on the teeth, making Essix retainers a very esthetic option and very popular among adult patients. This will also usually increase patient compliance.
- Can be used as a mouthguard: for patients that grind their teeth at night, using clear retainers that cover the biting surfaces of teeth can prevent them from the damages caused by teeth grinding.
The main cons are:
- Durability: these retainers do wear down, and depending on amount of use and habits such as grinding problems, will usually last about 3-7 years. They may also stain with time.
Fixed Retainers (also known as permanent retainers)
Fixed permanent retainers are made up of a semi flexible wire that is glued to the back side of teeth. It is usually placed in the lower front teeth, which are the first to move with time. They are also a popular choice to use between the upper two front teeth after having closed a gap (called a diastema), which is also very prone to relapse.
The pros are:
- They are always on and always working, and can be very effective at keeping teeth straight. Compliance is not a problem since the patient does not need to worry about putting them on or losing them.
- Esthetic: fixed retainers are placed behind the teeth, making them invisible on the outside.
- Versatile: permanent retainers can and usually are used in combination with one of the other retainers shown above.
The cons are:
- Hygiene: fixed retainers make it a little harder to floss and properly maintain the area clean. Food, plaque and calculus can accumulate in the area if proper oral hygiene is not practiced. If this is noted, the retainer can always be removed. Getting regular cleanings and check ups with your general dentist is especially important to make sure no problems arise.
- Breakage: fixed retainers can sometimes break and come off. This may require you to see your orthodontist to get it glued back in place. Some orthodontists may charge a fee for this service.
- Limited effectiveness: they will only keep straight the teeth included, usually the front teeth.
Having said all this, all 3 retainer types work well and should keep your smile straight if worn as prescribed. Some are better for some cases than others, and your orthodontist may recommend that you get one specific type according to your situation. Following the recommendations of your orthodontist will guarantee you maintain a beautiful smile for life and prevent headaches in the future!