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  1. #1
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    The Secret About Retainer Wear

    People seem to wonder how long they need to wear their retainers. There are few things more sad than seeing someone having to go back into treatment because teeth moved after deband. Usually it's because of less than fabulous retainer wear.

    Here's the deal. Say you are cutting back on your retainer wear for whatever reason. If you put it back in and it is more tight than when you took it out, your teeth are trying to move and you need to wear the retainer more. If, however, it is just as loose as when you removed it, your teeth are staying in place and you may be able to cut back some more without adverse changes. :)
    drd

  2. #2
    Nice to see a professional on the board, welcome.

    While on the subject of retainers, I have a question of you. A particular view has been expressed on this board (not by a professional, I may add) that essix type retainers are an absolute no-no where the case was an open bite.

    As a former open biter who has been using an essix for a few years now on the recommendation of my orthodontist, I find this a particularly interesting view, especially as I have had no relapse in that time.

    What is your view?

  3. #3
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    Excellent post. This is exactly how we direct our patients when we talk about "retainers for life". Some people can get away with wear a couple of nights a week while others do need to use them every night. It's a good idea to taper down your retainer wear gradually so that you ensure it will always fit. We try to explain our reasoning behind retainers so that there is a clear understanding of this goal.

    The type of retainer required is going to depend on the initial malocclusion and how that was corrected. Open bites are one of the most unstable malocclusions to correct. We actually prefer a retainer that has posterior coverage because it tends to prevent them from overerupting, whereby preventing the bite from opening.
    Dr Jason K Tam
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  4. #4
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    Is my retainer plan fairly on board with what's normal? I was to wear my top tru-tane retainer for 30 days straight (which I did), and the bottom one once a week at night only because I also have a permanent lower retainer. After the 30 days, I can go to night time only. I am in my first week of only wearing at night, and I feel almost paranoid about my teeth, wondering if they are moving. I wonder if this feeling is ever going to go away. My husband wore his retainer for a year after high school, then night time only.
    I put it in as soon as I eat dinner so I am wearing it for about 11 hours at a time, with the exception of brushing before bed. Is this enough to keep my teeth in position.
    When I wear it, it feels snug for maybe a few minutes and then it feels normal again.
    thanks for any input, just want to make sure----I NEVER want to do this again!!!!:bye:
    Candy--ceramic uppers/metal lowers--sentenced for 24 months!







  5. #5
    Quote Originally Posted by MarkhamCentreOrthodontics View Post
    Excellent post. Open bites are one of the most unstable malocclusions to correct. We actually prefer a retainer that has posterior coverage because it tends to prevent them from overerupting, whereby preventing the bite from opening.
    In other words, an essix type retainer?

    Thanks.

  6. #6
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    Thanks coconut,
    Believe it or not, here is the short version response to essix retention in open bite cases:

    Like Dr. Tam mentioned, open bites are notorious for relapse tendency. The reasons for relapse are multifactorial and definitely case dependent, but a large percentage of these relapse cases also have tongue posture and/or tongue thrust issues which may or may not be diagnosed. I think this is where the confusion relating to the overlay or essix retainers (that is the term we use in our office to avoid terminology confusion) begins.

    As weird as I think it sounds, if the tongue is resting on the teeth or touches the teeth during swallowing, this is enough to move teeth over time. An orofacialmyologist and a very few orthodontic practices around the country, have been trained to teach patients how to correct the tongue issues. We use a 5 week program with weekly visits for patients, but some use an 8 week program. Hawley retainers have an advantage in that they can be tightened to force the teeth to stay a little better, but long term the end result, relapse, is just as likely as retainer wear decreases. Overlay retainers can be adjusted to address relapse or bite opening as well relatively easily. The bigger issue is most frequently retainer compliance and the amount of wear. Hope this helps a little. drd

  7. #7
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    Candymomof3,
    As you can imagine, it is difficult to say definitively without reviewing what your teeth looked like at beginning of treatment and where everything is now. That said, you are certainly free to wear the upper retainer as much as you like. If you want to cut back more slowly to gain confidence, go ahead. My normal wear regimen is different than your orthodontist, but it doesn't make one right over the other. As a general rule, if the retainer is more tight when you put it back in, teeth are trying to shift at least a little. If the retainer feels the same when you put it back in, you can cut back more. Good luck and if you have any question about wear specific to your teeth, I am sure your orthodontist can answer your questions more specifically than I may be able to do for you. drd

  8. #8
    Thanks for the explanation, drd, very helpful indeed.

  9. #9
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    thank you,that is helpful! I do have before and after pics in my blog, my 20 months in braces definitly made a huge difference...I feel like a new person :)
    Candy--ceramic uppers/metal lowers--sentenced for 24 months!







  10. #10
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    Candy,
    It looks like you and your orthodontist did a great job, congratulations. It also appears you have a history of clenching and/or grinding your anterior teeth. It may have related to original position, but you wearing at least your upper at night will protect you from any future damage. Since your upper laterals were back when you started treatment, they may want to try to go back in that direction so if you wear your upper at night only and it begins getting tighter to put in, increase the amount of time you wear it. drd

  11. #11
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    I was a clencher! is that why my front tooth may have moved more/worse over time? it got worse over the years, and turned more..I always wondered if that was due to clenching at night. I would wake up with tension in my jaw all the time. I don't think I grinded my teeth much...but my Ortho thought I did, until I 'fessed up that when I was about 13 years old, I filed my front teeth with a metal nail file (EEEK!) because they seemed so long and ridgy...little did I know what problems I was causing myself later on!
    I don't feel the clenching now, so I believe the braces has helped enormously in that aspect, and I do feel more comfortable with the retainer in now, because if I was grinding, then I can't now.
    My canines appeared up high before treatment, and they were brought down, and my peridontist that did my gingivectomy last month said they are now in a perfect position, and my laterals now appear bigger because of the gum tissue she took off. Next to braces, that was the best thing I could have done!
    My canines and laterals are what worry me the most, if they try to go back, then everything will be thrown off...so I may just be popping in that retainer during the day again...like you said, to get my comfort level down. I am forever checking for movement, I don't want to be paranoid forever...but after 20 years of hating my smile, it's very hard to adjust to a perfect smile. People are always telling me I have "pretty teeth" now...that is very strange to hear...almost have to pinch myself...I love it though, and I am so so happy I was able to do this.
    thank you for all your input, I don't go back to my ortho for another 4.5 months for a post treatment check so it's reassuring to get some answers while I wait.
    Candy--ceramic uppers/metal lowers--sentenced for 24 months!







  12. #12
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    Great post drd! :toast:

    Where I work we use three types of retainers - bonded, essix (most popular) and hawley.

    Our patients are given a plan that includes a period of full time retainer wear, then every night and then a few nights a week for life. We explain the need to continue with 'retainer wear for life' if they want their teeth to remain where they are when their active treatment is completed.

    I had a mild tongue thrust, which has been treated and my open bite was finally closed. My ortho wants me have upper and lower bonded retainers and hawley retainers. I can't wait till that time arrives ... and it should be very soon! :thumb:
    After 5 years, 11 months and two days of stainless steel brackets ... my teeth now have upper and lower bonded, gold wire, retainers and removable clear retainers!

  13. #13
    Nice to hear that your treatment is drawing to a close, Sunny. You have been very patient where others may have given up. I'm sure that it's been worth it.

    So would you like to share with us the name and website of the practice where you work?

  14. #14
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    Sunny,
    Sounds like a good plan. The bonded is great and I wish more orthos would discuss the wear for life as needed. That will help keep things aligned. Most people understand that their bodies change throughout life, but fail to relate this to teeth moving over time if not maintained. Part of the issue is the ortho not making sure their patients understand the long term issues. Maybe I'll put in as a thread down the road. It woud be better in an article format, but I don't know how to do that or if I have the website clearance. best wishes, drd

    PS- watch the tongue position to make sure you aren't touching your teeth with it during swallowing.
    Last edited by drd; 10-31-2010 at 02:05 AM.

  15. #15
    I have a question about the Essix Retainer which I've been using for around 2 weeks.

    I work all day on the phone so there is no way I can wear this at work as I am unable to talk properly. However, I wear it religiously on my days off and every night.

    The problem I have is my overjet seems to increase by at least 1-2mm by the end of the working day when I don't wear it. Then by the next morning it is fine and back to normal again after wearing the retainer.

    Will this constantly moving overjet issue eventually 'lock in' or will I be stuck with this problem for life?

  16. #16
    Were you told to wear your retainer all day? It sounds like it - and you've only had it for 2 weeks... You are jeopardising everything you have gained with orthodontic treatment, IMO.

  17. #17
    The Ortho said wear full time for 30 days then every night for 6 months. Hmm it really isn't possible to talk with this thing in but the teeth do go back to normal every morning after wearing it over night.

  18. #18
    The purpose of the retainer is to hold the teeth in one place over a period of time, so that they come to be stabilised there and stop trying to move back again. If you are continuously taking the retainer out and putting it back in again, and the teeth are moving out of position and going back again, they are not going to stabilise where you want them to stay.

    You might not be able to speak well with it in, but 30 days of not-speaking-well in exchange for a lifetime of secure teeth sounds like a fair deal to me. In addition, our mouth adjust to what we put in them - your speech will get better if you keep the retainers in and continue trying to speak with them in. If you really feel you can't speak with them in, then go back to your ortho and tell him/her because there might be another type of retainer s/he can give you, which will make it easier to speak. (There are several different types of retainer.)

  19. #19
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    Geek,
    It is an adjustment to go into full time retainer wear and speech can be affected. Usually, after a couple of weeks speech will improve. The essix type retainers are the easiest to speak with compared to the hawley type, but additional focus on enunciation is necessary at first. I agree with Josie that the teeth will continue to go back and forth if your retainer isn't being worn more full time and that you may want to speak with your orthodontist if speech doesn't improve with full time wear.

    We have a lot of patients that speak for a living like you do including judges, lawyers, physicians and even tv and radio talk show hosts. Again, there is an acclimation period, but it seems that a lot of patients are hyper aware of any difference in speech while the person/people they are speaking with rarely notice. It's similar to the fact that we are all more aware of our perceived flaws than the people around us are aware of these flaws.

    The long term problem with straightening the teeth at night and letting them shift during the day is that the roots can be damaged. The worst case scenario is, though rare, is loss of those teeth. Best wishes and good luck. drd

  20. #20
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    I also have a profession where I am speaking all the time all day and for several days at one time. So I do understand your reluctance, but I will say this after almost 5K I will wear my retainers for the rest of my days and get used to speaking with it just like I did when I first got my braces. It is your decision geek but please be careful of the possible relapse you would have. Good luck

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