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At the end of an orthodontic treatment, orthodontists use a retainer to prevent the teeth from moving back to the previous position or stop relapse in medical term. So, retainer means retention and here it refers to the finishing process of each orthodontic treatment to fix the tooth movement that has occurred in its place so that teeth can’t go back to the position before the orthodontic treatment.
Why is retainer necessary?
It is interesting to know that due to the structure of periodontal ligament (PDL), which is a collagen fiber structure, tooth movement in orthodontics is a unique human anatomy magic. Once these teeth movement process is in progress, pressure or occlusal forces against the teeth can disrupt the PDL. Therefore, at the end of orthodontic period, you need orthodontic retainer to prevent those forces and pressure that might change the position of your teeth again.
There are also collagen and elastic fibers in the human gingiva that allow these teeth movements. Otherwise, the movement of teeth would not be possible to do. Due to this collagen and elasticity structure in our gum, the relapse to the original position of teeth is also possible. This is why we need retainer after our orthodontic treatment for a few months.
What are different types of retainer?
- Fixed retainer: fixed retainer or bonded retainer is a stainless steel wire that is bonded to the back (lingual surface) of the upper or lower anterior teeth. Due to growth of jaws in teenager (ages 16 to 20) and crowded teeth of incisors, possible teeth rotations can be fixed in place. Also, fixed retainer can easily keep the teeth together in teeth gaps and show good results of retaining the closure in diastema in the upper central incisors (midline diastema)
- Removable retainer: removable retainer can be removed while eating. Removable retainers include common orthodontic appliances like Hawley retainer, Essix retainer, tooth positioners, Moore retainer and vacuum-formed retainer. For example, Hawley retainer has multiple functions in orthodontics likes pace maintenance device, as a retainer after orthodontics, as a corrective device. Especially for children who have lost anterior teeth, Hawley retainer with dentures (attached false teeth on the device) can save your child’s smile until they are old enough to have implants.
Removable or fixed retainer, which one is suitable?
There are times that we need to wear removable retainer or have the fixed retainer bonded to our teeth depending on our teeth condition after the orthodontics. For example, when there are many missing teeth next to each other or in adjacent teeth (large edentulous space), as in the case of adults, the best retainers is removable with prosthetic teeth. Because of larger missing area, these denture retainers can save space for later implants or bridges to fit well with enough space in the gum.
Fixed retainer is the best option for diastema closure retention because of possible opening of the gap in the diastema after the removal of the orthodontic appliance. To prevent possible periodontal disease and less gum support after orthodontic treatment in adults, fixed retainer is the best option. It is because of possible force and pressure from removable retainer that may put gum under some pressure.
How long should I wear a retainer?
The time for a retainer is from 4 or 5 months to 12 months. First, it is necessary to wear fixed retainer as full time and then you may continue with either removable or fixed retainer. Usually after your 4 or 5 months of retention, you can wear retainer as part-time stages and if your orthodontists recommend, you can wear retainer until the complete 12 months period. After your orthodontic treatment, you may have had severe irregularities or just less crooked teeth. Therefore, the type of orthodontic treatment that you have undergone is also important in the orthodontic retention.
Depending on whether the patient is in growing stage (children) or an adult, retainer should be worn in longer or shorter period of time. This is again comes to your orthodontist’s idea on the exact period of wearing a retainer.
Cleaning teeth during retainer
With fixed retainer, you may find flossing or brushing a little difficult, but careful flossing technique and brushing gently can prevent any irritation and decay in teeth.
Removable retainer needs much more care. Children especially may lose that retainer or even may break that while playing. Cleaning teeth and mouthwash use should be a regular and daily routine. If you follow oral health tips with your daily teeth cleaning tasks, you can easily prevent any teeth caries, plaque buildups on teeth and irritations in the gum doesn’t happen.