Hurrah! You get my braces off today.
Congratulations you must be very pleased with your teeth and smile.
But hold on….. we are not done yet….. you still need RETAINERS!

What are orthodontic retainers?

Retainers are custom made appliances that are fitted in after the completion of the active orthodontic treatment

• The aims of retainers are to hold the teeth in the new and more desirable position that has been achieved.
• Therefore retainers minimize relapse (the return of the teeth to its original position following completion of orthodontic treatment)

Retainers can be fixed (cannot be removed by the patient) or removable (can be removed by the patient).

Retainers are almost a must after active orthodontic treatment. In some rare cases the orthodontist may inform you that you need not wear any retainers. However in most cases you will need retainers.

Why do we need retainers?

• To minimize relapse
• To give time for the gum fibers to grow around the teeth in its new position. Certain gum fibers can take up to 1 year to reorganize
• To allow the bone and the soft tissues (lips, tongue, cheeks) to get used to the new position of the teeth

There are many types of retainers

How long do I need to wear my retainers?

Usually the orthodontist will ask you to wear the retainers ranging from 6 months to about 1 year.

However in certain cases the orthodontist may ask you to wear the retainers for a longer period or in some cases indefinitely (permanently).

Cases that require a longer period of retention are those with

• pre-treatment spacing,
• severe rotation of teeth,
• broadening / expansion of the arches undertaken during treatment and
• gum disease (periodontal cases)

The most common regime for retainer wear of 6 months full time and followed by another 6 months of part time wear. Full time wear means that you have to wear your retainers the whole day except during meals. Part time wear means you can wear your retainers only at night before bedtime  until you wake up the next morning.

However retainer wear varies from a case to case basis.

If you want to maintain reasonably good alignment throughout life then you will be required to continue wearing your retainers for at least 3 times per week permanently after the 1 year retention period.

If you are wearing removable retainers you will be asked to remove them when eating as this allows the teeth to move individually in normal masticatory function and this promotes the reorganization of the gum fibers in this new position. However be sure to brush your teeth right after eating and slip your retainers back on immediately after that.

The most amount of relapse happens in the first 6 months after removal of your braces. Failure to wear your retainers as instructed by your orthodontist will result in relapse i.e. the return of your teeth towards its original position before you had your braces.

Fitting of retainers

Your retainers can take several hours up to a couple of days to be fitted.

You may feel a little weird once they are fitted in. You may have some speech difference / difficulty talking normally due to its presence in your mouth. You will take about 2-3 weeks to get used to it and speak normally.

You may get some increase it saliva flow for about a week.

You may experience some pain and discomfort and even have incidence of mouth ulcers. If the pain is due to roughness on the surface of your retainer or sharp edges, contact your orthodontic clinic immediately.

Looking after your retainers

• Remove retainers when eating (except for fixed retainers)
• Place your retainers in the retainer box (usually provided by your orthodontic clinic) when your retainers are not in your mouth. If you are not given one then a simple plastic container would be sufficient
• Keep your retainers clean. Brush them in running tap water and a clean tooth brush after every meal.
• Do not expose your retainers to high heat or soak them in hot water. You will distort your retainers.
• Handle your retainers with care. Dropping them run a risk of cracking or even breaking them
• Do not place your retainers in a piece of  tissue paper as there is a high chance that you may forget and throw them away
• Do not place your retainers in the back pocket of your jeans. You may sit down and fracture the retainer.
• Remove your retainers when playing contact sports like football or taekwondo. Remove them when you are swimming.

Will my teeth remain well aligned throughout after the retention period is over?

There are constant changes to our bones and soft tissue structures throughout the growth period thereafter minute changes throughout life due to the ageing process. This will cause some tooth movement. The most common complaint is lower incisor crowding later in life.

To minimize this you need to wear your retainers permanently.

		Upper arch
Hawley retainers		Lower arch

		Fixed retainers (fitted on the inner surfaces of the teeth)

Vacuum formed retainers

Retainer box

Reference

1. Daljit S. Gill. Orthodontic at a Glance. 1st ed Blackwell.