Tooth movement is a natural process whether a person has had orthodontic treatment or not. There is more susceptibility to this movement once the braces are removed and a greater potential for relapse, therefore retainers should be placed very soon after debanding the appliances. There are three main types of retainers commonly used.
The Hawley retainer is a traditional retainer that has been used since the 1920s. The retainer is designed mainly with an acrylic plate inside and a metal wire outside. The teeth are held passively within these two components. Hawley retainers are removable, adjustable, and hygienic. The retainer does not cover the teeth, making them settle into their final occlusion easily during retention. The Hawley retainer, however, is less aesthetic (due to the metal wires) and requires compliance by patient to be effective. If not worn as indicated, the teeth can relapse.
The Essix retainer is made from thin plastic material (similar to Invisalign aligners). A plastic sheet is molded over the plaster model by a vacuum suction machine after being pre-softened with heat. These custom formed plastic trays cover the entire dentition to restrict teeth from shifting. Essix retainers are nearly invisible and can be used as trays for teeth whitening or as a night guard to protect teeth from grinding. However, a drawback is its durability. The plastic tends to deform over time from use, causing replacement to be needed every couple of years.
The Fixed retainer is formed by bonding a metal wire behind the teeth (usually lower front teeth). It prevents teeth from moving as they are "glued" on the wire. The fixed retainer is not always recommended for the upper teeth because it tends to interfere with the bite (the lower incisors may bite on the wire). Compliance is not an issue with this retainer as it is bonded to the teeth. The major drawback, however, is oral hygiene care. Bonded wires make flossing less easy and cause plaque to build up readily.
(1) The retainers should be used all of the time for the first three months after braces are removed. After three months of full time use, you may gradually transition to night time use. Six months after, you should be able to wear your retainers only at night during sleep.
(2) Do not wear your retainers while eating; remove your retainers before meals.
(3) The retainers should be cleaned every day with tooth brush and tooth paste to prevent plaque build-up. Also, the retainers should be cleaned with denture cleaner tablet (e.g. Efferdent or Polydent) approximately three times a week.
(4) Be sure to store your retainers in your retainer case whenever you are not using them.
(5) When dining out in a restaurant, make sure you don't wrap your retainer with napkin and leave aside. You will forget and lose them.
(6) Pets like to chew on retainers; be sure to keep your retainers from your pets.
(7) Do not put your retainer in hot water. It will become distorted as it is made of plastic.