Maintenance After Braces Come Off
A patient’s orthodontic journey isn’t finished once braces come off. This simply concludes the active treatment stage. Now comes the maintenance phase, which includes wearing certain types of teeth retainers.
Getting a beautiful smile took time, effort, and financial investment. Patients want to protect their investment and keep their teeth aligned and stable for the rest of their lives. The key to maintaining that new smile is a retainer. Without the use of dental retainers, newly straightened teeth can shift back to their original positions.
Teeth are most vulnerable for the first several months after completing braces or Invisalign treatment. This is especially true for those teeth that were significantly rotated or moved long distances. While the first months after finishing active orthodontic treatment are important, ongoing use of a retainer is critical to preserving the results of orthodontic treatment.
At Burke and Redford Orthodontists, located in Temecula and Lake Elsinore, Dr. Redford and Dr. Burke’s patients last part of treatment is fitting them with a custom retainer. After all, as much as we love our patients, we don’t want to have to realign their teeth! A retainer is worn by all our patients—regardless of whether they received treatment with Invisalign or braces.
Why Teeth Retainers Are Important
The first few months after braces come off are a critical time. This is when relapse (unwanted) movement can most quickly occur. However, there are other reasons to wear a retainer besides preventing teeth from shifting positions.
- Bite Stabilization. After braces come off, the mouth needs to adapt to its new position—including the soft tissues (gum) and bones. Consistent use of a retainer helps these tissues and bones stabilize into their new locations—thereby providing support for the new alignment of teeth.
- Protection from Wisdom Teeth Eruption. Many patients wear braces or Invisalign as teenagers before the wisdom teeth erupt. Once the wisdom teeth arrive in the late teens/early twenties, their eruption could actually move straightened teeth out of alignment. This is prevented by wearing a retainer.
- Preventing Further Orthodontic Treatment. Most patients spend a minimum of one year or more fixing problems with their bite or wearing braces or Invisalign to straighten teeth. The last thing they want to do is need retreatment again later in life. Wearing a retainer helps to prevent this from happening.
Types of Teeth Retainers
Once braces come off, the orthodontist makes a mold of the newly straightened teeth. This mold is used to build a retainer out of plastic, wire, or acrylic. This means all retainers made in our office are custom retainers. Once their retainer is ready (usually the same day as braces are removed), the orthodontist ensures a proper fit and gives the patient instructions on its use.
There are two types of retainers—fixed and removable. Removable retainers are typically advised for upper teeth, while fixed retainers are advised for lower teeth. For removable retainers, patients may wear a clear retainer (similar to an Invisalign tray) or a traditional Hawley retainer. The type of orthodontic retainer used will depend upon the patient’s unique needs, the type of orthodontic treatment that was done, and the patient’s preference.
- Fixed Retainers (also known as bonded or permanent retainers) are used to keep lower teeth in alignment. It is bonded to the six lower front teeth. As the name implies, the retainer is “fixed” in place with orthodontic adhesive. This retainer takes the form of a thin wire that is bonded to the back of the teeth. It is smooth to the tongue and nearly impossible to see. Keeping this retainer clean by flossing with a floss threader is important. While there are no food restrictions with a fixed retainer, it is important to bite chewy, sticky, or hard foods with the back teeth instead of near the fixed retainer.
- Clear Orthodontic Retainers (also known as Essix, vacuform, or Invisalign-type retainers) are similar to Invisalign trays—a real plus for Invisalign patients who will be familiar with their feel, care, and maintenance. The orthodontist will recommend how many hours the clear retainer should be worn each day. The most common regimen is full time (day and night) for the first eight weeks after braces are removed, followed by nighttime only wear thereafter.
- Traditional Hawley Retainers are the second type of removable retainer and used less frequently than clear retainers nowadays. These consist of a wire going across the front of the teeth that is held in place with acrylic material and clasps that go around the back teeth. Although these types of teeth retainers are more noticeable than a clear retainer, they are more durable.
How Long Are Retainers Worn?
Immediately after braces come off, removable retainers will need to be worn all the time (except when eating and drinking). After two months, tooth alignment and the retainers will be checked by the orthodontist. At this time, most patients will be instructed to switch to wearing the retainer during nighttime only. This should continue indefinitely.
There are differences between traditional retainers and clear orthodontic retainers. The upside to traditional (Hawley) retainers is that they are more durable. They typically last between two and eight years. Clear retainers can last anywhere from one to three years, but have the advantage of adapting to teeth more intimately and being more esthetic. Whichever type of removable retainer is used, they will occasionally have to be replaced.
With proper care, fixed retainers typically last between six and ten years, although many patients from our practice have reported much greater longevity! When a fixed retainer eventually reaches the end of its life cycle, it should be replaced.
Whether patients have fixed or removable retainers, they should continue wearing/maintain them for the rest of their lives (if possible). Doing so prevents the teeth from shifting, especially as patients age.
Older patients who wore braces to straighten teeth when they were younger might notice their teeth shifting position as they age. If this is the case with your teeth, contact us to discuss options for realigning the teeth or obtaining a new retainer to prevent further unwanted shifting.
Care and Cleaning
Because dental retainers are going to be worn for a long time, it is important to take care of them. Proper cleaning techniques are critical to avoid bacterial buildup—creating odors and causing breakdown of the retainers. It is also essential to avoid damaging retainers as they may then need premature replacement. Below are tips for care and cleaning.
- Never put a custom retainer in hot or boiling water or the dishwasher. The high temperature can melt or deform the material.
- Keep removable retainers in their case whenever they are not in the mouth. This prevents them from being chewed by a pet or accidentally being thrown out.
- Do not try to adjust a retainer if it doesn’t fit correctly. Contact your orthodontist to resolve the problem.
- Avoid using excessive amounts of toothpaste on a retainer, as it can dull or scratch the acrylic and leads to bacteria build up.
- At least once a day, brush the retainer with room temperature water and a toothbrush to prevent bacteria from forming.
- Once a month, soak the retainer for 15 to 20 minutes in a mixture that is half white vinegar and half room temperature water. Rinse with only water afterward. This helps remove white spots and bacteria.
- Consider using a retainer cleaner tablet to keep retainers clean and odor-free.
If you have any questions about types of teeth retainers, contact Burke & Redford Orthodontists at (951) 699-8011 or fill out the contact form on our website.