Orthodontic Retention – A lifetime commitment?

During the process of orthodontic treatment, teeth are moved from one position to another. The teeth are held to the surrounding bone and gum tissue (gingiva) by tiny elastic fibers similar in concept to rubber bands. When a tooth is moved, these tiny elastic fibers are stretched. Because of this, the teeth will quickly want to move back to the original position where they started.

Our bodies replace the tiny cells that make up our bodies every day. In fact, it is believed that the whole body renews itself every 7 years. Maybe that’s why we have a hard time remembering things that have happened to us years ago.

The tooth fibers don’t seem to behave in this way, though. It is not uncommon for a tooth to continue to shift for many, many years, seemingly always wanting to return to the position where it was before orthodontic treatment started.

Is this a failure of the treatment? Absolutely not. In fact, it is just one of those known circumstances that when appropriately addressed can be overcome.

Hence, the orthodontic retainer: a valuable life-time orthodontic appliance that will help to keep your teeth right where the orthodontist put them.

How much to wear?

Typically, orthodontic retainers have been recommended to be worn all the time, 24/7, for period of time. This can vary for each individual, but is often at least one to two years after the braces have been removed.

But if the braces are left on just a few short months after the final movement is completed, retainers can often be worn just ½ the time, just at night in the evening after dinner and while sleeping. Then you don’t have to worry about them during the day and take the chance of losing them. When the retainers stay at home, the likelihood of losing those retainers is very low.

Types of retainers

There are several different types of retainers, and the choice is usually based on the preference of the orthodontist. Most orthodontists would love to finish the treatment, give the person a set of retainers and never have to worry about having that patient go through orthodontic treatment again.

Fixed retainers

These are retainers that are typically glued to the inside of the lower and upper front teeth. The lower fixed retainer is common and tends to be very stable over the long term. Upper fixed retainers can be problematic, as they are constantly pushed against every time something is eaten. Most orthodontists who use fixed appliances will use the lower one, but not the upper one.

The advantages of the fixed retainer are in the name – it is fixed onto the teeth so the wearer does not have to remember to put it on each day. And when a retainer stays on the teeth, those teeth tend to remain straight. The disadvantages can be hindered proper oral hygiene, as it can be challenging to brush and floss around the retainer, and it can be difficult for your dental hygienist to clean that area also.

Removable retainers

There are several types of removable orthodontic retainers.

Most common historically, is the acrylic and wire retainer. This type of retainer has been around for many many years, and has stood the test of time. This retainer can also be adjusted to fit if the teeth start to move (most likely due to not wearing the retainer as much as needed).

Another type of retainer that has become more and more popular is the clear retainer. Many people have seen the Invisalign commercials and are starting to request a retainer that looks similar. With this type of retainer, the teeth are fixed in position while wearing it and only minor adjustments can be made. As long as this retainer is worn on a regular basis, the teeth should stay in good alignment.

Still another type of orthodontic “retainer” is the positioner. This is used on occasion by fussy orthodontists or in the case where the movements desired are difficult to coordinate with the brackets and wires. This appliance looks similar to an athletic mouthguard (in fact, it can be used as one), but will move the teeth into the desired position. It is made of a flexible clear rubber material and gently puts pressure on the teeth to move them into the final desired position.

Commitment to retention

Many times people finishing orthodontic treatment feel that the retainers are optional. This is rarely, and I would venture to say, never the case. When teeth are moved, they will almost always want to shift back to the original position.

In talking with patients, the orthodontist will explain the importance of the retainers and exactly how much to wear them. And this is sage advice; the orthodontist knows how easily newly moved teeth will want to shift. At no time should the retainers be stopped unless the orthodontist says so, and this will probably never happen.

A good thing to remember is that the retainers will be need to worn as long as you want your teeth to remain straight.

**Author Credit**

Dr. Bergh is a board-certified orthodontist practicing in Glendale, CA. He graduated from the University of Southern California in 1992. Dr. Bergh maintains a full-time private practice in Glendale and is a Clinical Professor at the USC School of Dentistry, Department of Orthodontics. He lives near Glendale with his wife and 3 children.

Brian H. Bergh, DDS, MS
1111 N. Brand Blvd, Ste 201
Glendale, CA 91202
www.BraceyByBergh.com
(818) 242-1173