When the braces have been removed at the completion of active treatment, there may be relapse with the teeth tending to move out of alignment. Retainers are designed to hold the teeth in their correct positions and are removable or fixed.
We recommend that the fixed retainers which are bonded behind the upper and lower teeth stay in place forever. The removable retainers are worn full-time for several months and then at night only for an indefinite period. Sometimes we ask our patients to wear their retainers once or twice a week long-term.
The most usual removable retainer is a “Hawley retainer” or a variation of this. It is a simple appliance that clasps the upper first molars and has a wire running around the outside of all the upper teeth. It is worn full-time for some months following the removal of the braces and then for a variable time at nights only. Some adults and those patients who have had their upper teeth expanded may be required to wear this retainer part-time (say, two nights per week), long-term.
Although these retainers will hold the upper front teeth straight, they will allow the side teeth to settle in with the lower teeth, giving a natural and comfortable bite.
Vacuum-formed Or Essix Retainers
These retainers are like mouth guards made of a thin, clear and more rigid plastic which covers all the teeth and none of the roof of the mouth. It may be worn full-time or at night only and it is important to not eat anything or drink hot fluids while wearing it. The disadvantage of this retainer is that it does not allow settling of the back teeth.
Bonded Or Fixed Retainers
Lower front teeth are highly prone to moving and crowding with age. This is a natural process and occurs in a high proportion of the population. Post-treatment relapse of an original problem is very disappointing and even the natural irregularity of lower front teeth is undesirable if one has had braces. To prevent or at least reduce this movement, a fine braided wire (made of several very fine wires woven together) is bonded on behind the six lower front teeth. In this practice, we also bond a wire behind the upper four or upper six front teeth. These wires are not visible from the front and patients get completely used to them and forget they are in place except when they are brushing and flossing their teeth.
We recommend to our patients that they keep these wires intact for many years, if not forever! The gums never forget!
After the braces have been removed, the teeth are subject to many influences from their surrounding bone, gums, tongue, lips and cheeks. The retainers are designed to allow settling of the bite and to resist adverse or unsightly movement or relapse towards the original problem. It is not possible to guarantee that your teeth will remain in a perfect position for the rest of your life. Every part of the body changes with growth and ageing and the teeth are no exception.