What is Retention?
After we finish celebrating with you when you get your braces off we spend the time necessary to make sure you can protect and retain your beautiful orthodontic results. Immediately following the removal of your braces you begin the retention stage of your treatment. At Bruner Orthodontics we supervise your retention for 12 months and 3 scheduled retainer checks. After two years of retention you don’t need to return to the office for retainer checks but you will need to continue to wear your retainers at night for as long as you want to maintain your results.
Removable Retainers
Maxillary wrap-around retainers are your upper retainers, which are removable. You must be very careful when handling your upper retainers, as they are fragile and costly to replace. You are given a special case for your retainer; please make sure you keep them in this case when not wearing it! To clean these retainers, use denture cleaner. In addition, sometimes we use a hawley retainer.
Your retainers should be worn at all times with the exception of eating and brushing your teeth. After 6 months of full-time wear, Dr. Bruner usually changes your retention prescription to night time only. Your final orthodontic result depends on your retainers, so follow through with the hard work you’ve put in so far.
Here is an article Dr. Bruner wrote for his general dentist peers and published on our blog:
Do I need to wear a retainer after orthodontic treatment?
The issue of orthodontic retention has plagued orthodontists, dentists and patients for as long as there have been patients in orthodontic treatment. The most current science on the topic of retention is best summarized in research published by Little et al from the University of Washington. Little states that no matter what kind of orthodontic treatment the patient had: extractions or non-extraction, expansion, retraction, crowding, spacing, surgery, headgear or functional appliances, all patients undergo orthodontic relapse. Simply put, this means that every patient will need orthodontic retention to keep their teeth in the same condition they are in the day their treatment is completed.
What types of retainers do we use?
There are three main types: The Hawley Retainer, The Essix Retainer, and the fixed retainer.
- This acrylic retainer covers the palatal and lingual surfaces and its rigidity won’t allow the arch form to collapse.
- No occlusal coverage allows the teeth to erupt vertically or settle over time into a tighter occlusal relationship
- Esthetics – the metal bar running across the front of the patients teeth is often not a welcomed attribute
- Palatal coverage can challenge some patients phonetically
- No occlusal coverage means there is no protection from night time grinding and occlusal wear
- It is esthetically pleasing, like Invisalign. They hold rotations very well
- The occlusal coverage protects the patients teeth at night from bruxism
Disadvantages:
- They are not rigid in the transverse dimension and posterior crossbites can relapse
- The full occlusal coverage slows down the vertical settling that normally occurs post-orthodontic treatment
- There is occlusal separation that some patients can’t tolerate at night
- They wear out faster than Hawley retainers (usually in 2 to 5 years)
- It eliminates the need for compliance with retainer wear
Disadvantages:
- Requires compliance with the avoidance of food like carrots and apples in order to not break the bonds to the teeth
- The ability to maintain excellent oral hygiene is compromised
- There is always the risk of breakage
- When broken the lower anterior teeth can move before the retainer can be fixed
We predominantly use upper and lower Essix retainers unless we need the rigidity of a Hawley after expansion, correction of a crossbite, or occlusal settling. A bonded retainer may be used for a patient with periodontal compromise (splinting) or for a patient with severe compliance issues (medical or behavioral).