Retainers After Braces or Clear Aligner Treatment

What are Orthodontic Retainers?

Retainers are appliances that maintain the positioning of your teeth after orthodontic treatment. This is because teeth have a tendency to move back into their original positions due to growth-related factors affecting the gums and tissues of the periodontal ligament.

Getting older can also affect teeth movement. Because of this risk, the devices are necessary to ensure teeth stay straight long-term after treatment.

Retainers are also given to patients after their braces are taken off or directly after clear aligner treatment is complete.

Braces

Braces are the most common form of fixed orthodontic treatment used to correct misaligned teeth and reposition the jaw. There are a few different types of braces, including traditional, clear, and lingual appliances. Although, traditional metal braces are the most effective and affordable treatment option.

After treatment is complete, an orthodontist makes a mold of you or your child's newly straightened teeth. Then a technician makes a fixed or removable retainer to keep the teeth in alignment.

Clear Aligners

Clear aligners (invisible aligners) are a removable type of orthodontic treatment that corrects misaligned or crooked teeth. Invisible aligners are a flexible and convenient alternative to braces.

A new set of aligners is sent to your house every 1 to 2 weeks and must be worn for about 22 hours a day. Similar to braces, retainers are custom-made for each patient after treatment is complete to keep the teeth in alignment.

Relapse and Retention

Relapse refers to the partial or full return of pre-treatment malocclusion (teeth misalignment) following successful orthodontic treatment.

Depending on the patient, maintaining teeth in their corrected locations after treatment can be very difficult. If the devices aren’t worn properly or for the right amount of time each day, relapse can occur over time.

An orthodontist should also discuss the “retention” phase before treatment. Retention refers to the phase of orthodontic treatment that minimizes the risk of tooth movement and misalignment following the removal of clear aligners or braces. Gathering this information early on helps the orthodontist decide on the best retainer for the patient’s needs. The following factors are typically considered:

The Patient’s Original Malocclusion & Growth Pattern

This pertains to how crooked or misaligned a patient’s teeth were before treatment. If you or your child's teeth were severely misaligned before treatment, a small amount of “relapse” commonly occurs. This is normal and typically nothing to worry about because minor relapse does not affect the overall aesthetic improvement.

On the other hand, if only mild misalignment was present before treatment, relapse should not occur. All patients should also be made aware of their relapse risk before treatment.

Types of Devices

Depending on the patient’s risk of relapse, original malocclusion, and growth pattern, there are a few different types of retainers available. The duration you must wear the device also depends on your unique situation. Although, the only way to guarantee teeth positioning is to wear them indefinitely. There are two different types of retainers available, including:

Fixed Retainers

Fixed retainers consist of a metal wire that an orthodontist bonds to the back of your front teeth. The wire typically extends from canine to canine.

You cannot remove fixed retainers at home. Thus, only your orthodontist can remove the device in-office. In addition, fixed retainers do not affect eating or speaking abilities. After a few days of wear, you should not be able to feel it.

Orthodontists usually give patients back-up removable retainers in case the fixed retainers fail or if you have a high risk for relapse. Some patients also wear them full-time. If this is the case, a fixed retainer is the ideal option.

Removable Retainers

Removable retainers are clear appliances that usually only need to be worn at night while sleeping. Unlike fixed appliances, you can remove these retainers at any time. Removable retainers are easy to maintain and do not impact oral hygiene. Although, they do affect speaking abilities when in use. You should also remove the device before eating. For patients who only have to wear them part-time, removable retainers are the ideal option. There are three different types of removable appliances, including:

• Hawley Retainer — this retainer consists of a metal wire in an acrylic base that keeps the six anterior teeth in the correct position.
• Vivera Retainer — an Invisalign brand clear retainer that holds teeth in place after Invisalign treatment.
• Essix Retainers — a retainer made of transparent plastic that holds teeth in place after clear aligner treatment or braces.