Retention

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One day in the not-too-distant future, your braces will come off. In a few moments, you'll be free of bands and brackets, able to eat what you want and run your tongue over smooth, clean teeth. But, even on this happy occasion, please remember that you're not quite done with orthodontic treatment yet: The next phase, called retention, is just beginning.

Retention is a critical follow-through stage that typically involves wearing an orthodontic appliance called a retainer. Several different kinds of retainers are available, all of which are custom-made just for you. We will recommend the type (or types) that will work best in your situation, and we'll tell you exactly when and how long you need to wear them.

But if your teeth are straight now, why do you need a retainer at all? Simply put, it's because if you don't wear one, your teeth will start moving right back to where they were!

Teeth aren't set rigidly in the jawbone — instead, they're held in place by a network of fibers called the periodontal ligaments. After they have being moved, it takes several months for the periodontal ligament to adjust to the new position. So if you want to keep that new smile — and not waste all the time, effort, and money it took to get it — it's essential to wear your retainer as directed.

Being fitted for a retainer usually happens on the same day your braces are removed. After your teeth are thoroughly cleaned, we may take another set of X-rays and/or bite impressions, to check how well your braces worked and to see how much your wisdom teeth have developed. Then, we'll discuss your retainer and start getting it ready.

Three Types of Retainers


The most common and popular style of retainer is the clear aligner-type, which looks similar to the Clear Correct or Invisalign® tray system. These retainers are custom-made of thin, transparent plastic which is designed to fit precisely over your teeth. Their main advantage is that they're invisible, easy to speak with and removable, and will protect teeth against a destructive and common habit, bruxism, or tooth grinding.

A Hawley type retainer may be suggested for certain bite issues or if minor tooth movement is desired.

Fixed retainers may be an option for some people, especially on the lower front teeth. As their name implies, they aren't removable by the wearer — but they aren't visible either. Like lingual braces, this system uses a wire which is bonded to the tongue side of the teeth. It may remain in place for months, or longer. This type of retainer is sometimes recommended when there's a high risk that teeth could revert to their former position.

A Period of Adjustment

After a short time, most people adjust quite well to wearing a retainer. Some may find that they produce more saliva than usual for a day or so after first wearing any type of retainer — a normal reaction to a foreign object in the mouth. You may also find it a little harder to talk normally at first, but that problem will soon disappear. Of course, removable retainers should always be taken out when you eat or brush your teeth — a big change from braces!

At first, you will probably be told to wear your removable retainer all day, every day. This period of 24/7 retainer use generally lasts from several months to a year. Later, we may say that it's OK to wear it only at night. Wearing a retainer while sleeping may be necessary for a lifetime, to ensure NO tooth movement.

Maintaining — and Retaining — Your Retainer

To stay fresh and germ-free, all retainers need proper cleaning. A Hawley-type retainer can be brushed gently with a regular toothbrush and toothpaste— but toothpaste may scratch the clear aligner types. Denture or retainer cleaners, in powder or tablet form, can be used to clean most removable retainers. Fixed retainers are cleaned by brushing and flossing; a floss threader or interproximal brush can also be a helpful cleaning tool when needed.

Finally, remember to always carry — and use — a retainer case. You'd be surprised how many retainers end up folded in a napkin and accidentally discarded! Also, don't expose your retainer to excess heat by washing it in very hot water or leaving it on a heater: That can cause the retainer to warp and make it unusable. With proper care and conscientious use, a retainer can help you transition from braces to a permanent, healthy smile.

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