What are Retainers?
Strictly speaking, Retainers are placed only after the completion of orthodontic treatment, with a view to retaining the corrected positions of the teeth. Many people erroneously think that any removable brace is a “retainer”, which can cause confusion.
Why does one need Retainers?
Immediately after braces have been removed, teeth are unstable as the bone & gum around them have yet to adapt to the new positions. At this stage it is advisable to wear the retainers all day & all night, every day.
How long must Retainers be worn?
It is an unfortunate fact that teeth move continuously throughout life. This movement is largely a feature of natural growth. It happens irrespective of orthodontic treatment or removal of teeth, and is largely independent of the presence or absence of wisdom teeth. Therefore, to maintain the improvement of the tooth alignment that was achieved during orthodontic treatment, it is necessary to continue to wear retainers. Assuming that the gum and bone support around the teeth remains healthy, this movement does reduce as one gets older so the number of hours of wear can be subsequently slowly reduced.
How long do retainers last?
As the mouth is a relatively harsh environment and retainers are subjected to the varying force levels throughout the day, it is important to realise that ALL retainers will eventually break and/or wear out. This happens faster for some people than for others.
What type of retainers are available?
There are two broad categories of retainers – removable and fixed retainers.
A. Removable retainers:
Removable retainers are always removed for contact sports and when cleaning the teeth. Some types (depending on the material they are made from) should also be removed when eating.
Advantages: The main advantages of removable retainers are that they cannot get damaged when eating or drinking, and it is possible to properly clean them every day.
Disadvantages: The disadvantages are mainly related to the fact that their effectiveness is dependent on the cooperation of the patient. If they are not worn as prescribed, their effectiveness is substantially reduced.
B. Fixed retainers:
Fixed retainers are usually made of a fine wire which is attached behind the front teeth.
Advantages: The fixed retainer is probably better at holding the alignment of the front teeth, particularly in the early stages after removal of the fixed braces.
Disadvantages: The “glue” that is used is usually a variation of the same adhesive that was used to attach the braces to the teeth, therefore, the same limitations in terms of care with eating and biting, and with cleaning applying. If the retainer is subjected to excessive force, it can break or can become damaged and can even move the teeth in unwanted ways.
If the fixed retainer is not cleaned properly and regularly, the enamel under the adhesive may decay and the gums around the teeth can become infected.
In summary, removable retainers are usually safer to wear, but the fixed retainers (if not damaged) are usually more effective at holding the teeth in position. If one is very worried about any slippage of the teeth, a compromise that can be considered is to start with a combination of fixed and removable retainers initially, and then subsequently remove the wires and depend just on the removable retainers.
What Retainer options does Dr. Crotty provide?
Dr. Crotty provides different options for retainers. When the fixed braces are removed, standard retainers (Option 1 below) will be placed. At your first review appointment, Dr. Crotty will assess how you are coping with these retainers. At that stage, you can make a decision whether to continue with these standard retainers or to move to one of the other options. At any stage in the future, you can make the decision to move from one option to another.
The options currently available are:
Retainer Option 1:
These are clear plastic retainers. These are the standard retainers and will be placed when the fixed braces are removed. They are worn 24/7 apart from when eating & drinking, when playing contact sports and when cleaning teeth
There will be a fee for replacement of lost or damaged retainers.
Retainer Option 2:
These are combination retainers, with a wire attached behind the front teeth, combined with clear plastic retainers ( as in Option 1). The wire is hidden from view and is, obviously, worn 24 seven. The clear plastic retainer is worn only at night.
The advantage of this option is that there is no need to wear the plastic container during the day.
The disadvantage is that the wire is liable to break due to many factors, including heavy biting and aggressive cleaning forces.
As it is not possible to remove the wire for cleaning, there is a risk of decay occurring under the “glue” that is holding it in position. The gums around the teeth are also more likely to become infected. Therefore patients who opt for this wire brace must be committed to maintaining excellent cleaning around the wire, including brushing, flossing and dietary control, and must attend Dr. Crotty every six months for as long as the wire is in position.
Retainer Option 3:
Vivera Retainers from Invisalign. These are similar to those provided in Option 1, but are made of a higher grade material. Invisalign claims that material is 30% harder wearing than similar high grade retainer material and they also supply three of each retailers (upper and lower, making six retainers in all).
Retainer Option 4:
Cobalt chrome metal, removable, retainers from Somnowell. These are extremely hard wearing and long-lasting. This metal is also easily cleansable making them, probably, more hygienic than other options in the long run.
If I wear my retainers, will my teeth stay straight for life?
Wearing retainers as prescribed will maximise the chances of the teeth staying straight. Unfortunately, Nature is unpredictable and in some cases teeth slip out line even with good retainer wear. But in these cases, the consolation is that the slippage would be much worse if retainers had not been worn properly.
What if I stopped wearing my retainer and my teeth have now moved?
As discussed at the very start, a Retainer will NOT straighten teeth.
If your teeth have only moved a small amount, you may be happy to accept this and simply have new retainers fitted. These will help you to hold the teeth in the current alignment but will not correct them.
However, if you want to have the teeth lined up again, the options available depend on how much the teeth have moved. If the amount of movement is small, it may be possible to use a short series of clear aligners and then progress to new retainers. If, on the other hand, the slippage has been substantial, it may be better to have a short course of treatment with either Invisalign or with fixed braces and then progress to new retainers.