The end of your active orthodontic experience is always an exciting time. Finally, after all of your hard work, you can get those braces or aligner attachments off and see the beautiful smile underneath. Take the time to celebrate, because you’ve earned it. However, many patients are surprised to learn this isn’t technically the end of your orthodontic treatment.
While wearing braces or aligners, your teeth are constantly being adjusted and moved. This is because the bone around your teeth is extremely malleable. However, once treatment is complete, teeth tend to “drift” back to where they were before. This is where retainers come in. These handy little orthodontic appliances are designed to help you keep your smile perfect after you complete your orthodontic treatment.
In this guide, the American Association of Orthodontists (AAO) explores retainers, what they are, how they work, and the different types your orthodontist might recommend. Read on to learn more about these often overlooked yet crucial orthodontic appliances and the role they play in preserving the hard work of you and your orthodontist.
Types of Retainers at a Glance
What Retainers Do:
- Keep your teeth straight after orthodontic treatment
- Prevent your teeth from moving back to their original positions
Types of Retainers:
- Fixed (bonded inside the mouth, usually bottom teeth only)
- Removable (can be taken out, fitted to your mouth)
Types of Removable Retainers:
- Hawley (acrylic plastic base with wires and clasps that go around teeth; more visible)
- Clear (similar look to clear aligners/night mouthguards; lighter, more difficult to see)
The Purpose of Dental Retainers
A retainer is a device that is fitted to your teeth after your active orthodontic treatment is complete. They’re used to preserve the positions of your teeth after treatment. Orthodontic treatment is possible because the bones around teeth are malleable enough that their position can be changed with relative ease using braces or clear aligners. However, once your treatment is complete, the same properties of teeth that made treatment possible also work against you. Teeth, left to their own devices, will begin to move back toward their starting positions if nothing is done to prevent it.
As the name suggests, retainers are placed in your mouth to “retain” the current position of your teeth immediately after treatment. Initially, you’ll have impressions or scans of your teeth taken to create the retainers. All retainers are custom-fitted to the individual patient’s mouth. This is important because the retainer needs to be tight enough to hold your teeth in place, so not too tight that it’s uncomfortable.
Types of Retainers
When many people think of retainers, they often envision wires attached to pieces of colored plastic that are removed between meals and stored in special cases. While this is a common type of retainer used, it’s only one type of retainer. There are two categories of retainers and three distinct types. Each has the same goal, but functions slightly differently and has different requirements for patients.
The two main categories of dental retainers are:
- Fixed
- Removable
The three types of retainers are:
Fixed Retainers
Fixed retainers (otherwise known as bonded retainers or permanent retainers) are a type of retainer that is not removable, as the name suggests. Instead, these retainers consist of thin metal wires that are affixed to the inside of the teeth. Your orthodontist will measure your teeth after treatment is complete and install this retainer for you. These retainers are more commonly used to secure the bottom teeth after treatment and are not visible to people because the wire runs along the back side of them. They also do not require significant molding to your mouth because they only require a metal wire and bonding glue.
With removable retainers, neglecting to care for them, losing them, or choosing not to wear them can cause all of the work of your orthodontic treatment to be undone. However, fixed retainers eliminate a lot of that uncertainty. Orthodontists may prescribe them if they know a patient has a difficult time following routines for removable retainers or if the case requires treatment for a significant malocclusion that could cause major oral health issues if it were to recur.
Although they are nicknamed “permanent” retainers, fixed retainers are still able to break or become dislodged. It is recommended to avoid the same foods that are not “braces-friendly.” If you notice that your fixed retainer is damaged, notify your orthodontist immediately, as the teeth can begin to shift.
Even so, permanent retainers may require a combination of fixed and removable retainers, as it’s common practice to use a removable retainer to keep the top teeth from moving.
Removable Retainers
As their name suggests, removable retainers are retainers that you can take out and put back into your mouth at will. These are the more common types of retainer most people are at least somewhat aware of. These retainers require dental impressions and significant custom molding to create an appliance that works for your unique mouth.
There are two common types of removable retainers:
- Hawley retainers
- Clear retainers
Hawley Retainers
Hawley retainers are the classic plastic and metal retainers that many people are familiar with. Acrylic forms a strong, durable base, while wires and clasps are used as the mechanisms to keep your teeth from moving. These retainers are specially fitted to your mouth and may require adjustments over time.
Clear Retainers
Clear retainers consist of a pair of clear plastic trays fitted to the structure of your upper and lower teeth. They resemble clear aligners but are designed to prevent tooth grinding. They are generally more lightweight, more comfortable, and are much harder to see than Hawley retainers. Ask your orthodontist if clear retainers may be right for you.
Frequently Asked Questions About Retainers
How long do I have to wear my retainer?
Ideally, forever. Your teeth will always tend to shift back to their original positions after treatment. However, if you wear your retainer consistently, it allows time for bone remodeling around the teeth, stabilizing their new positions and reducing the risk of unwanted movement.
In most cases, you will need to wear your retainer full-time for a few months after treatment, then switch to wearing it only at night. To guarantee your teeth won’t shift, it’s recommended that you continue to wear your retainer at night while you sleep indefinitely.
What happens if I don’t wear my retainer?
If you don’t wear your retainer as prescribed, there is a much higher likelihood your teeth will shift back to their positions before treatment, causing your mouth to relapse into malocclusion. In some cases, this may call for additional orthodontic treatment.
Even in minor cases, shifting teeth can cause your retainer to no longer fit properly, either becoming too tight or too loose in certain areas. When this happens, you’ll need to get another retainer fitted.
Do retainers hurt?
Retainers can be uncomfortable when you first start using them. They are designed to fit snugly into your mouth and may feel a bit tight. They’ll also likely be uncomfortable right after your orthodontist adjusts, but soon your mouth will adapt to it, and you’ll hardly feel it at all.
How do I clean my retainer?
Retainers should ideally be cleaned every time they come out of your mouth. Whenever you take them out, make sure to use a dedicated toothbrush and a small amount of mild soap to give them a good scrub. Try to brush everywhere on the retainer to prevent the buildup of plaque or bacteria.
Once a week, let them soak in a special retainer cleaning solution for about 15-20 minutes. Never boil your retainer as it can warp the plastic.
Get Your Retainer from the Experts at AAO
At AAO, we only let experienced orthodontists who have undertaken a fully accredited fellowship program join our ranks. That’s because we’re dedicated to providing the best orthodontic services to the people of the US and Canada. At any of our thousands of AAO orthodontist locations, you can expect a professional, compassionate care team ready to put their years of experience to work helping you keep your beautiful smile pristine, both during and after treatment.
We know that each treatment plan needs to be as unique as the bite it helps to perfect. We’ll discuss retainer options with you and determine if a permanent or removable retainer is best for your needs. Use our Locator tool to find an AAO orthodontist near you.
Schedule your consultation today to learn more about retainers and what works for you.
