Many people have retainers during orthodontic treatment, whilst this term is often used to describe the orthodontic appliance itself, this is not strictly true, so this blog post will help the reader understand more about teeth retainers, the types of retainers and went retainers should be used.
Let’s get this straight
Pun intended! lots of people talk about their orthodontic appliance and call it a retainer. There are 2 different types of orthodontic appliance:
- Active appliance. This is an active appliance which is actively placing pressure on to your teeth to move them in the desired direction.
- Passive appliance. This type of appliance is completely passive, it is not moving your teeth in any direction at all, it is simply there to hold the teeth in their final position after braces have been removed. This is the true definition of a retainer, they retain your teeth in their new position.
Types of retainer
Retainers (passive appliances) are usually classified into 2 categories:
- Fixed Retainers – these are retainers which are fixed onto the inside of your teeth, they are bent by your orthodontist to accurately fit your teeth. They are then bonded to your teeth using a special bonding resin. Because they are bonded to your teeth they are worn 24 hours per day.
- Removable retainers – these retainers are usually clear appliances and can look very much like active appliances, such as Invisalign. They are very often worn at night only.
Permanent retainers vs removable
The biggest difference is that with a permanent retainer you will not be able to take it out. This means the chances of the teeth relapsing is very small. Removable retainers can be lost, forgotten or broken far more easily increasing the chance of relapse. If you have a removable appliance it is important that you clean your teeth and clean your retainers separately, retainers should not be cleaned with regular toothpaste as they can be rather abrasive.
One disadvantage of a permanent retainer is that it is slightly more difficult to clean, you need to ensure you have a good oral health care regime in order to clean around a permanent retainer. Your orthodontist will give you instructions on how to do this.
What happens if I don’t wear a retainer after braces
Your teeth will very likely begin to drift. We often find that patients are told by their general dentist that they can have orthodontic treatment which gets them “80% of the way there”. A specialist orthodontist will always endeavour to get most people to 100% of the way there and not stop until they do. Many general dentist’s also don’t include retainers in their treatment costs, this can be detrimental to results as you will find you are much more likely to get relapse within a few years if you don’t wear a retainer.
People that have removable retainers are far more likely to have relapse, not because the retainer doesn’t work but because they are not wearing it as much. This is why a specialist orthodontist will often prefer a fixed retainer as it ensures it is worn 24 hours a day and that the treatment doesn’t relapse, giving you much better value from your treatment. After all, no one wants to pay to have teeth straightened and then have to do it again a few years later!
Should I wear my retainer if my gums are swollen
If your gums are swollen it is likely in indicator that you have early-stage gingivitis. This could be because the teeth are not being cleaned adequately. You should make an appointment to see your dentist as soon as possible to ensure your oral health routine is as good as possible. When gums swell like this they can rub on removable retainers making them uncomfortable.
Whilst the retainer could be adjusted by an orthodontist it would be a far better option to treat the gums swelling by visiting your dentist first.
Sometimes people ask about a retainer causing swollen gums, whilst this is technically possible if the retainer is touching the gums, it is highly unlikely as most retainers fit so tightly around the teeth that they don’t move around and rub. It’s far more likely that the gum has swollen making contact with the retainer.
How to floss under a retainer
If you have a fixed retainer the easiest way to floss underneath is to either use a small interdental brush or to use super floss. Super floss has a pointed flexible end which enables you to threaded through in between your teeth and underneath a retainer. This simply isn’t possible with regular floss.
If I start wearing my retainer again will my teeth move back
If you have stopped wearing your retainer for only a short period of time, perhaps one week then yes, the teeth will move back again. if you have stopped wearing a retainer for any longer than this time then there is a good chance that your teeth will have relapsed too far for the retainer to make any difference.
If you left your retainer out for any period of time longer than one week we recommend you visit your orthodontist again as you may require active treatment prior to having a new retainer made.
How long should I wear my retainer a day
The usual recommendation is for as long as possible but at least 10 hours overnight. The longer you are able to wear your retainer per day the more chance you have of keeping your teeth in their lovely new position and avoiding any relapse.
Faiza Lewis (nee Darugar) has been a Dentist for over 26 years and a Specialist Orthodontist for 17 years. She graduated from Birmingham Dental School in 1993 and from Guy’s Hospital in Orthdontics in 2002. She has had a variety of hospital jobs in maxillofacial surgery and working for the Wandsworth Community Dental Service before starting the 3 year Specialisation Programme in Orthodontics. She started work at Ewell Orthodontics in 2002 knowing her friend, Richard Williams was working there too and in 2012 became a joint owner with him.