I’ve heard of braces, but what is a retainer?

A retainer is a dental appliance that is used to hold teeth in position after they have been realigned following orthodontic treatment; they are usually made up of metal wires and strong resin. When the desired about of alignment has been achieved, it is important to maintain that movement, as teeth can often start to shift back to their original position, if left to their own devices. In some cases, there can be quite a substantial relapse after the initial treatment has been completed, and retainers play a vital part in keeping the teeth straight and proportionally spaced. Most patients will have to wear a retainer following a course of orthodontics, generally during the night time at first, but possibly for a short period during the day as well, depending on the amount of movement achieved. Some patients may find that they are prescribed a retainer for the foreseeable future, if their teeth are at prone to serious shifting.

Are all retainers the same?

There are three types of retainer which may be prescribed by your dentist, depending on the type of orthodontic treatment you have already received, and the current condition of your teeth.

A Hawley retainer – This is probably the most familiar type of retainer, and it’s what springs to mind for most people, where dental appliances are concerned. A Hawley retainer – named after the dentist that invented it – is made out of acrylic resin and metal wires, which is moulded to fit the patient’s palate exactly, with two or more wire loops that clip in place over the molars. This kind of device also typically comes with a single wire that extends around the front of the teeth, as a way of holding them in position from both sides. Some of these appliances are also adaptable, which is ideal for adding a final adjustment, without having to swap and change retainers.

There are various versions of the Hawley retainer, and new designs are in the works all the time, for example, technicians are developing ways of making it more discreet and aesthetically pleasing, so that patients can wear it during the day, without the device being too obvious. There are also more modern materials available for use in the manufacturing process, such as clear wires, and stronger resin, with a small amount of flexibility.

An Essix retainer – These are similar in appearance to many clear aligners that are available on the market today, although they are not designed to actually apply any pressure to the teeth, only to maintain their current position. Essix retainers are made from highly durable transparent resin, usually polypropylene, that is moulded to fit the patient’s teeth, and clips over the top of them like a gum shield. When worn, clear retainers are barely visible to the naked eye, simply because they are transparent and very thin, so they only add a small amount of bulk to the natural teeth, and they don’t change the colour at all.

Because Essix retainers fit over the entire arch of the teeth, they do create a barrier between the top and bottom teeth, which makes it harder to bite and chew – something which doesn’t affect Hawley retainers, because they are moulded around the teeth, rather than over them. If the patient is wearing their device during the night, this might not necessarily be a problem, unless they suffer with bruxism or they clench their teeth. Although they are highly durable, Essix retainers will crack under the strain of constant grinding, and other alternatives will probably have to be considered for patients with this condition. If the bruxism is causing severe damage to the teeth and jaw, a mouth shield can be used to protect them whilst the patient sleeps, although this can’t get rid of the underlying cause of the problem, it can be helpful with the symptoms. People who grind their teeth often have more difficult issues to cope with, such as psychological or emotional problems, which need to be treated if the bruxism is to be dealt with on a permanent basis.

A fixed retainer – If a patient has undergone orthodontic treatment for extremely crooked teeth, their teeth may have been moved quite a substantial amount, so there’s a greater risk of relapse. In cases where the jaw has also been realigned, a dentist might choose to fit a fixed retainer, in order to eliminate the risk of the teeth returning to their original position. Fixed retainers are usually only used on the lower teeth, and consist of a single wire, which is bonded to the affected teeth, using dental adhesive. As their name suggests, ‘fixed’ devices are not removable, they are permanently attached to the patients teeth, but since they are not fitted on the visible side of the teeth, they are not noticeable and don’t change the appearance of the smile.

Some dentists will prescribe a permanent retainer for a period of twelve months after the initial treatment is finished, but if they deem the patient to be at a greater risk of relapse, even after this time has passed, they may leave them in place for even longer – possibly their entire life. Unlike other removable devices, fixed appliances pose more of a problem when it comes to cleaning, because they are permanently bonded to the teeth. The hard to reach areas underneath the wire are the perfect places for bacteria and plaque to build up, which can lead to tooth decay, and a whole host of other problems. However, as long as patients take care to brush and floss regularly – using tools specially designed for the job – they shouldn’t have too many issues with their retainer. It’s also particularly important for people who have permanent appliances to visit the dentist at least twice a year, so that any symptoms of gum disease of tooth decay can be dealt with before they become too troublesome.

If you think a retainer could help you keep your teeth in line, call the Pearl Dental Clinic to organise a course of treatment; the experienced team members are available to provide information on all their products and services, and they will be able to advise you on the best way forward.