What are Orthodontic Retainers?

Clip treatment or Braces can be a lengthy procedure. So the day you get your braces off is a  huge deal. You can finally eat all the food of your choice. However, your dentist will say “ Not Yet”. With the clip treatment you were in the active phase of the tooth correction. This treatment can take about 1-2 years, with adjustments made every 4-10 weeks time. You will have to undergo a retention phase of treatment after the active treatment. 

So, why is the retention phase important?

Patients generally think that once the teeth are straightened out marks the end of the treatment. But it’s not so. The teeth are moved by remodelling your bone. Just straightening will not guarantee permanence. Research has shown that the teeth have to be held in the new position for a substantial period of time. This allows for new bone to form and stabilise the teeth. Once your treatment ends, your teeth will have a tendency to move back to their original position. This is called ‘Relapse’.

Relapse occurs because of the elasticity of the periodontal fibres. This will lessen with time, but is a matter of concern for the first 18 months or so post treatment. Typically as people get older, the teeth shift irrespective of whether you have undergone clip treatment or not. Braces will straighten your teeth, but will not prevent the changes. To ensure that there is permanence to the new tooth position, you’ll have to wear the retention appliance.

What are Orthodontic Retainers?

A retainer is a custom made appliance made of plastic or a metal wires  that helps to keep the straightened teeth In position after you have completed the orthodontic treatment. These appliances apply mild pressure on the teeth to prevent them from drifting back into their original positions. This tendency of the teeth to drift away lessens with time, but can be critical in the first 12-18 months post treatment. The braces will fix the crooked teeth, but to keep them in the new corrected position without shifting, you will need the ’retainers’.

How do the retainers work?

Tooth straightening involves the teeth, bone and the periodontal ligament. Lifelong risk of relapse is due to the recall of the periodontal fibres, pressure from the surrounding soft tissues (cheeks, tongue ) your bite and the continued growth and development. Retainers hold the teeth in their new position for a length of time allowing the periodontal  fibres to adapt to the changes in the bone. This helps minimise any changes in the final position after the completion of the clip treatment.

What are the different types of retainers?

Your dentist will make an impression your teeth.  The appliance is made from the mold of your teeth. The type of retention appliance will depend on the treatment type and your  age. Most of these appliances are removable, but some can be fixed in your mouth. The common goal of any type of appliance is to keep the teeth in the corrected position and prevent their drifting. 

Hawley retainer

This is the removable type of appliance named after its founder Dr Charles A Hawley. This is made of an acrylic plate, supporting clasps, a metal wire with loops for adjustment. Hawley’s appliance is easy and quick to fabricate. However, this type of a retainer can interfere with speech, prone to breakage, inferior retention in the lower arch and aesthetics. More recently, the front metal wire is replaced with a clear wire. The Hawley’s appliance is easy to adjust.

Vacuum formed retainers

The Vacuum-Formed Retainer (VFR) is another type of removable retainer. This is made from polypropylene or polyvinyl chloride (PVC) material. Your dentist will take an impression and make a mold. The clear retainer is made to fir the entire arch or only from canine to canine (clip-on). This retainer is virtually invisible when worn. Some orthodontists recommend the clear retainers for night use only. When worn during the day, you have to remove while eating. Also you have to avoid eating cariogenic foods. The retainer can act as a reservoir of cariogenic food and causes tooth decay. VFR is more aesthetic, less expensive and easier to wear then the Hawley’s appliance. However, people with bruxism are not ideal candidates for the VFR.

Fixed Retainers

These type of retainers cannot be removed and are fixed in your mouth. These are passive metal wires that are fixed on the inner side ( tongue side ) of your teeth. The fixed retainers have to be kept in your mouth for an year after your wisdom teeth are removed. However, they are generally recommended for life if your teeth correction was complicated. The drawback of the fixed retainer is plaque build up in your mouth and gingivitis. You may find flossing difficult. You can use floss threaders to pass in the space between the retainer and your teeth.

What happens when you don’t wear the retainers?

If you choose not to wear retainers for long periods, it can cause problems. Retainers are designed to keep your corrected teeth in place. You can skip wearing them now and then. But missing out on wearing  retainers for long periods of time can cause you teeth to drift. So make sure you talk to your orthodontist about your concerns and doubts. 

How can you take care of your retainers?

For the removable retainers, they have to be worn at all times. Remove the retainers when eating. If you are not wearing them, it has to be kept safe in a container. You have to clean them well with soap and water. These appliances can be exposed to bacteria and plaque like the rest of your mouth. You should not keep the retainers in direct sunlight or in hot water. Excess heat can warp the appliance. If your retainers don’t fit you well as before, then talk to your orthodontist. This could be because of a slight misalignment of your teeth because of drifting. This generally happens when you don’t wear the appliance for extended periods of time. 


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