The “Cadillac” of Retainers…

So you just finished your orthodontic treatment and braces are off, now what? Most orthodontists will prescribe a set of retainers of one form or another to retain the final orthodontic result.

Post early treatment patient wearing upper and lower retainers. -Actual Patient of Dr. Edgren
Post early treatment patient wearing upper and lower retainers. -Actual Patient of Dr. Edgren

The bone that surrounds your teeth continues to remodel up to 18 months after the braces are removed. If teeth are not provided a passive method to maintain their new bite/position they will tend to shift back to where they came from, because there is still memory inherent in the hard and soft tissues that house the teeth.

There are many different types of retainers. Some practitioners prefer a “fixed retainer”. A fixed retainer is generally a piece of wire bonded to the inside of the teeth to keep them from moving after the braces are removed. This wire generally only connects four to six teeth together. However, it also may only connect two out of an arch that includes/possesses 12 to 16 teeth. Consequently, the remaining teeth shift and many times crowd back over time. Fixed retainers are not as hygienic as removable retainers and can pose a plaque, tartar, and/or cavity issue.

Some practitioners will fabricate a clear, less expensive, suck down type of retainer that encompasses the entire arch, including the biting surfaces, of the teeth. Because these retainers cover the biting surfaces the teeth are not able to “settle into place.” Consequently, the bite may never fully stabilize. Also, because these thin clear retainers cover the biting surfaces of the teeth they do not last; cracking and breaking down, in some cases, in just a few months. These retainers are hard to keep clean and lead to oral hygiene problems.

Upper (left) and lower (right) Hawley style retainers.
Upper (left) and lower (right) Hawley style retainers.

In my practice I use what some would consider the “Cadillac” of retainers. These Hawley styled retainers have plastic that encompasses the inside of the teeth and a thin wire that goes around the outside of the teeth. There is no plastic that covers the biting surfaces of the teeth; allowing the teeth to settle into a stable bite. The outside wire is adjustable, allowing minor changes as necessary over time. These retainers are removable and are easily cleaned. I feel it is important that patients wear their retainers full time for 18 months, while the alveolar bone remodels, so that the final result is maintained.

Therefore, it’s not just the braces that are important for your final result. It’s the other, second part of wearing retainers that’s equally important.

Bradford N. Edgren DDS, MS, FACD, FICD, Diplomate, American Board of Orthodontics, 3400 W. 16th St. Bldg 4-V, Greeley.