Orthodontic Retainers: Types, Cost, Pros and Cons, Care
When you’re finished with orthodontic treatment, your orthodontist will provide you with a retainer to keep the results in place. That’s why it's called a “retainer”: it “retains” the movements achieved by your braces or Invisalign treatment!
Every orthodontic treatment consists of three parts:
- Diagnostic: The orthodontist takes x-rays and photos, discusses your dental history with you, and checks your teeth and bite. From this information, the orthodontist then establishes a comprehensive diagnosis for your condition, and creates a unique treatment plan to achieve the desired results.
- Treatment: Using an orthodontic appliance such as braces or clear aligners, the orthodontist carefully guides your teeth into their correct positions, closely monitoring the movement of each tooth. During treatment phase, supplemental intervention such as a tooth extraction may be necessary.
- Retention: When treatment is complete, the orthodontist will provide you with a retainer device to keep the results of treatment intact. Retention is actually the most important part of care, since without proper retention, the gains made during treatment will fail.
This guide explains everything you need to know about retainers – the various forms of retainers, what they are used for, and how to maintain them properly to keep your smile in place for years to come!
Table of Contents:
What is a teeth retainer?
A retainer is an appliance used after orthodontic treatment to protect the results of the intervention. There are several different styles of retainers, but each is used to “retain” the treatment benefits and to prevent teeth from shifting out of alignment.
A retainer is considered one of the most important parts of your treatment, since it keeps your smile in place and your teeth healthy. Whatever retainer treatment your orthodontist recommends, be sure to follow the instructions properly to protect the investment you've made in your smile with orthodontic treatment!
Types of Retainers
A permanent retainer is not really “permanent” – rather, it is bonded (glued) to your teeth on the back side (where your tongue touches them) and connects the front teeth so they won’t move. It can be installed or removed by your orthodontist.
Generally, the permanent retainer is a thin wire bonded to the back of your top and/or bottom teeth (depending on the specifics of your treatment). For this reason, another name for permanent retainer is lingual wire. The wire is hidden from view on the back of your teeth, so the permanent retainer protects the results of your orthodontic treatment without any interruption to your new smile.
A permanent retainer is not permanent; it can be removed whenever necessary. People frequently wear a permanent retainer for many years without any inconvenience to their smile, health, or comfort.
Pros and Cons
A permanent retainer has many attractive features:
- No need to remove and put back in
- Invisible from the outside
- No impact on speech
- Can't get lost
- Easy to clean
- Difficult to damage
- Keeps your teeth in place permanently with little maintenance
Some cases use a combination type of retainer, with a permanent bonded retainer and a removable retainer used for extra protection.
Some patients prefer a removable retainer: they can be cleaned thoroughly while removed from the mouth, and some patients may prefer this over cleaning their lingual wire inside their mouth.
Some patients find flossing to be more difficult with a lingual wire permanent retainer, and some simply prefer being able to fully remove the appliance from their mouth.
Other potential cons of a permanent retainer:
- Potential to break/fall off and require replacement
- Irritation from metal object in the mouth
- Some sticky or hard foods may get stuck
- Takes extra time to clean retainer and floss under wire
- Potential for plaque build-up
Original installation of your permanent retainer should be included in the overall cost of your braces or clear aligners – check with your provider before treatment to make sure.
If not – or if the permanent retainer breaks or falls off and needs to be replaced – this cost will be separate from the cost of original orthodontic care. This can cost anywhere from $150 to $500 depending on the specifics of your case and the orthodontist you seek out for care.
Permanent Retainers are simple to care for, but it is important to maintain oral hygiene every day to keep your teeth clean.
Brush your teeth twice a day, for two minutes each time. Floss before bed every night. A floss threader makes it much easier to floss under the lingual wire of your permanent retainer.
Go to the dentist regularly for cleanings and check-ups: dentists and hygienists are skilled at cleaning around braces and permanent retainers, and it won’t impact your ability to get your teeth cleaned.
However, failure to keep your retainer clean can cause plaque and bacteria to build up, and this can cause tooth and gum decay. Be sure to care properly for your permanent retainer to keep your teeth clean and your smile fresh and healthy.
Are permanent retainers better than removable?
Permanent retainers provide better protection from unwanted tooth movement as compared to removable retainers. Teeth that are bonded with effective permanent retainers show less tendency to shift over time.
For patients wanting to maintain their smile with minimal maintenance, a permanent retainer is the better option: it provides a quick and lasting solution that keeps the results of orthodontic care in place for as long as the retainer lasts, with minimal compliance. A removable retainer needs to be worn every night diligently, and it is easy to forget or neglect wearing, especially after a year or two, or to lose the retainer.
Permanent retainers offer long-term preservation of the results of orthodontic care, with an easy-to-maintain appliance, which makes them an attractive, preferable option for many patients. On the other hand, patients may prefer the easy-to-clean aspect of removable retainers: some patients report difficulty flossing with the lingual wire retainer.
Are permanent retainers for life?
While you may not wear a permanent retainer for the rest of your life, you can expect it to work for many years. A well-maintained permanent retainer can last for a very long time, but you may need to change it on occasion if the retainer breaks or wears out.
There are no long-term side-effects of wearing a permanent retainer – and since it can continue to protect your smile, orthodontists recommend that you keep it in for as long as possible.
How long should a permanent retainer last?
If the permanent retainer is well cared-for, it can last for years. After this time, you may have to change it out. If it becomes damaged, breaks, or falls out, it will need to be replaced. This can happen as the retainer ages, or at any time due to an accident or trauma to the mouth.
Can your teeth still shift with permanent retainers?
Very minor shifting is expected and normal. While you may experience minor adjustment as your teeth settle into place, the permanent retainer is designed to hold them in their new, fixed position, and protect them from any significant shifting. If you are noticing more major shifting, contact your orthodontist: the permanent retainer may be broken or improperly installed.
Can you get an MRI with permanent retainer?
Generally, you can get an MRI with a permanent retainer. It is entirely safe: the only problem is if the area to be imaged is very close to the retainer, in which case the metal in the retainer may distort the images. If this is the case, your doctor may refer you to your orthodontist to temporarily remove the permanent retainer, but this is very unlikely. Many people have had MRIs with braces or permanent retainers on.
What can you not eat with a permanent retainer?
Generally, there is no food restriction with permanent bonded retainers. You can eat any food you like without causing damage to the retainer. Be sure to brush regularly and floss every day to remove any debris from under the wire of your retainer, to prevent plaque build-up.
Can you chew gum with permanent retainer?
It is safe to chew gum with a permanent retainer. You just have to make sure no gum gets stuck under the wire. If you find this happens frequently when chewing gum, you can switch to sucking a breath mint, or tic-tacs, for an equally effective breath freshener without the sticky factor of chewing gum.
Can dentists remove permanent retainers?
While a dentist can remove a permanent retainer, check-ups for the retainer and any replacement of the retainer should be done by a licensed, dedicated orthodontist rather than a general dentist. Removal is relatively simple, but making sure the retainer is working properly and/or installing a new one requires more specialized expertise.
Can permanent retainers break?
Yes. While permanent retainers are designed to last, accidents happen, or wear and tear over time can cause a permanent retainer to break or get damaged. Bond glue can also break and need replacement. In that case, a retainer will need to be replaced. A dentist can remove the old retainer but you should see an orthodontist to have a new one installed.
Can I superglue my permanent retainer?
No, it is very unsafe to attempt to fix your retainer by super-gluing it back together. Superglue is toxic: it is not designed to work in your mouth. You will have no idea if you are putting it back into correct alignment, and could cause the retainer to malfunction, causing disruption to your teeth. You could also damage your teeth directly by attempting to use superglue anywhere inside or near your mouth. If you need assistance with your retainer, visit a licensed orthodontist for assistance.
A Hawley retainer is the original retainer: a combination of a plastic plate molded to the roof or basin of your mouth, connected to a wire that runs across your teeth. The custom fit of the Hawley retainer keeps your teeth in place orthodontic care is complete. A Hawley retainer is easy to use, comfortable to wear, and extremely effective at protecting the results of your smile, as long as it used as directed.
Pros of a Hawley retainer:
- Easy to mold to the patient's mouth
- Adjustable over time if necessary
- Plate color can be custom-selected
- Durable and hard to damage
- Easy to clean
- Removable for easy cleaning and care
Cons of a Hawley retainer:
- More noticeable than other retainers (wire sits in the front)
- Plastic plate can be uncomfortable or cause difficulty speaking
- If not cleaned properly, can create bacterial growth
- If not worn properly, teeth may shift
- Require dedicated compliance
- Can be broken, lost, or damaged
A plastic retainer is a clear retainer molded to fit snugly over your teeth to protect the results of your orthodontic treatment.
A plastic retainer may be used after any kind of treatment: metal or ceramic braces or clear aligners can all be followed by plastic retainers.
Your orthodontist will custom create the plastic retainers, with a different set for your bottom and top teeth. You will generally wear the retainers at night, or sometimes every other night, for years after your treatment. This will prevent your teeth from shifting.
There are several different kinds of plastic retainer.
An Essix retainer is one form of plastic retainer. It consists of a set of top and bottom clear molded plastic aligners, specifically designed to fit snugly over your teeth.
Custom-fitted by your orthodontist, they keep your teeth in place after treatment results have been achieved by orthodontic care, either braces or Invisalign clear aligners. You may be prescribed an Essix retainer by your orthodontist after either form of treatment.
An Essix retainer costs anywhere from $50 to $300; although your orthodontist should include the price in your original treatment costs – and last for a few years if properly maintained and cared for. This is one of the least expensive retainers available.
Invisalign Vivera Retainer
An Invisalign Vivera retainer looks like an Essix retainer: it’s a set of clear aligner retainers custom created to fit snugly over your top and bottom teeth. but Vivera has an edge over Essix retainers: patented by Invisalign, Vivera retainers are made of a custom-designed material that lasts longer and performs better than generic Essix retainers.
Invisalign retainers are used as part of Invisalign clear aligner treatment; once you are finished with Invisalign therapy to achieve the best results for your teeth and bite, the Vivera retainers will help keep those results in place for a healthy, happy smile that lasts. The Vivera retainer is usually a separate cost from the treatment costs.
Vivera retainers cost more than Essix retainers, due to the meticulous lab work involved to create the customized retainers with patented material. However, Vivera retainer are packaged cost-effectively by providing 4 sets (8 retainers total) for consistent, long-term use, so investing in Vivera retainers is a great choice for your smile and your health.
Many orthodontists prefer the fit and effectiveness of Vivera as compared to Essix retainer, and many patients prefer their fit as well.
Pros and Cons
Plastic retainers are very effective, but some patients prefer other types of retention appliances.
Benefits of clear plastic retainers:
- Removable and easy to clean
- Subtle appearance
- Easy to make multiple copies for back-up retainers
- Snug fit protects straight teeth well
- Long-lasting performance, due to superior material
- Doubles as a bleaching tray to bleach your teeth while sleeping
Some potential drawbacks to clear plastic retainers:
- May need new sets made if dental work changes size or shape of a tooth
- Needs to be cleaned daily to prevent bacteria growth
- May be lost or damaged by a pet
Talk to your orthodontist if you have other questions about whether plastic retainers are right for you.
How Much Do Plastic Retainers Cost?
It depends on the type of plastic retainer and whether it is included in your orthodontic treatment. When separate from treatment, an Essix plastic retainer can cost anywhere between $100-$300, for a single set of retainers.
Invisalign Vivera retainers usually come in a set of four, and cost between $600 and $1,200, while Essix retainers come as a single set for between $100 and $300.
How Do You Care For Plastic Retainers?
It’s important to care for your plastic retainers properly, to ensure they work. When you remove your retainers, store them properly in the case so they don’t get lost or damaged (or eaten by the dog!). Clean them every day, directly after removing them from your mouth.
To clean, either scrub with a soft toothbrush or denture brush, with warm water, or, for a deeper clean, with mild dish soap. Don’t use toothpaste, as it can scratch the retainer surface.
For a deeper clean, you can use a cotton to clean out the grooves and ridges of the retainer. Your retainer may also come with a soaking solution to dip it in and break down bacteria. Soaking retainers in hydrogen peroxide a few times a week is another good way to break down bacteria.
When plastic retainers become worn down or broken, schedule a visit with your orthodontist to have new retainer molds made. How long your retainers last depends on individual factors, such as compliance, hygiene, and extra wear and tear from grinding your teeth at night, etc.
Are Clear Plastic Retainers Effective?
When used properly, clear plastic retainers are effective for protecting the results of your orthodontic treatment. Comfortable and safe to use, plastic retainers have helped many patients protect their smiles.
However, as time goes on after treatment, some patients may begin to neglect regular use of their plastic retainers, which diminishes their effectiveness. Failing to use the retainers properly can result in teeth moving back out of alignment, requiring another round of treatment.
To maintain effectiveness of your retainers, be sure to wear them as advised by your orthodontist.
Are Plastic Retainers Safe?
Yes, plastic retainers are very safe. They are custom molded to your teeth, to fit snugly over the top and bottom teeth and protect the treatment results. They are made of medical-grade multilayer polyurethane plastic designed for biocompatibility and comfort. They are BPA-free and easy to wash clean.
When first wearing your retainers, you may experience mild discomfort as your mouth adjusts to the feeling of the retainers; this should go away within the first few days. If the edge of the retainer is bothering your gums or lips, you can trim it with a nail clipper or cuticle scissors.
What are Clear Plastic Retainers Made Of?
Clear plastic retainers are made of BPA-free, medical-grade plastic: usually, a multilayer polyurethane resin specially designed for use in dental devices. They are also called vacuform retainers (VFRs) because a specialized vacuum forms the retainers over a model mold of the patient’s teeth.
They are free of BPA and other toxic chemicals, and are entirely safe for regular wear.
How Long Do Clear Plastic Retainers Last?
If well-maintained, a plastic retainer should last for a few years. After that, it will need to be replaced. Be sure to make them last by caring for your retainers properly, by brushing them regularly to clean and storing them in a case when not in use.
Do Plastic Retainers Break Easily?
Plastic retainers are designed to last for a few years, but they can be damaged or broken. Exposure to heat may warp the plastic, and if it stepped on the plastic can bend or snap. A common culprit of retainer damage: the family dog! Be sure to store your retainer properly in a case to protect it from curious pets looking for chew toys.
Because plastic Essix retainers can break more easily, some patients prefer a permanent bonded retainer or a Vivera retainer, both of which break less easily and last longer.
Are Plastic Retainers Better than Metal?
Both plastic and metal (Hawley) retainers are effective as protecting the results of orthodontic care. Metal retainers may be slightly more expensive, but more durable. But plastic retainers are easy to replace, comfortable to wear, and nearly invisible when worn. Generally, the better choice is whichever retainer you prefer. Make sure to wear the retainer as advised for effective use.
Do Plastic Retainers Stretch Out?
Yes – over time, the plastic retainer will stretch out and loosen. This is one of the ways regular wear and tear will eventually damage the retainer and require replacement. The retainer should feel very snug around your teeth at first, but over time, they may start to feel slightly looser. That is expected due to minor movement of your teeth, as well as the natural wearing out of plastic over time. The retainer will feel tight in the very beginning, but they will soon adjust to a comfortable fit. After long-term use, they may stretch out too much to be effective, and then it is time to get a new retainer.
Can Plastic Retainers Cause Cavities?
A plastic retainer does not cause cavities: poor oral hygiene causes cavities. Proper oral hygiene requires regular brushing and flossing, as well as regularly cleaning of the retainers. If they are not cleaned properly, bacteria can grow on the retainers, which can coat your teeth while you wear them and cause damage.
What Do I Do if My Clear Retainer Cracks?
A cracked retainer is still working as long it fits properly. If the retainer is completed broken, you need to replace it, but if a crack is small and retainer fits, you can continue to wear it. A large crack that makes the retainer feel no longer snug around your teeth needs to be checked by an orthodontist and repaired or replaced.
How Much Does it Cost to Replace a Plastic Retainer?
Replacement cost depends on which plastic retainer you are using. A single pair of Essix retainers may cost between $100-$400 to replace; a set of Vivera Invisalign retainers may cost around $600 to $1200, although you can generally get a savings package of 4 sets (total of 8 retainers), which provides back-up in case of damage or loss.
General Questions about Retainers
Should I Get a Permanent or Removable Retainer?
Orthodontists generally recommend a permanent (bonded) retainer, which connects the front teeth and prevents them from moving. Permanent retainers last a long time, and thus are effective at protecting the results of treatment, while requiring less compliance from you.
Other retainers are also comfortable and effective, if used properly: you can select the retainers that you prefer for your specific case, comforts, and preferences, with the recommendation and instructions of your orthodontist.
Do Retainers Straighten Your Teeth?
Retainers are not designed to straighten teeth: they are, rather, designed to keep in place the results of prior orthodontic treatment. Minor tooth movement can be accomplished with spring aligners, which look like retainers, but use specialized springs to move teeth a limited amount. Regular retainers are simply to protect the gains of your orthodontic treatment: without retainers, your teeth will shift back out of alignment; wearing the retainers after your teeth have shifted will not succeed in straightening them again.
Do You Have to Wear a Retainer Forever?
The longer you wear the retainer, the better for your teeth. Teeth can shift at any age: humans use their teeth every day, and regular wear and tear causes shifting. To protect your investment in your health with orthodontic care, it’s important to wear your retainers as prescribed by your doctor.
When Can I Stop Wearing Retainers?
Directly after finishing treatment, your orthodontist will likely prescribe retainer wear full-time or at night. It is important to follow your orthodontist’s recommendations when wearing retainers. If the instructions are not followed, the teeth will shift back.
How Long Before Teeth Shift Without Retainers?
According to expert orthodontists, the most critical period to prevent teeth shifting is right after treatment, when the orthodontic appliance is removed and the teeth are settling into their new positions. But teeth can shift at any time, and as people age their teeth naturally tend to shift out of place. That is why retainer wear is important after orthodontic treatment forever.
Why Do My Teeth Feel Loose After Wearing My Retainer?
Some patients report that their teeth feel loose when they start wearing a retainer. This is normal: your teeth are settling into their comfortable positions after the orthodontic appliance has been removed or finished, and some discomfort or looseness is normal. You will quickly adjust as your teeth settle and the teeth will become stable over time.
Are Retainers Painful?
Some discomfort is normal when you first start wearing your retainers: your mouth needs time to adjust to the new appliance. Discomfort should resolve itself quickly. If you experience pain or ongoing discomfort, contact your orthodontist as the retainers may not be fitting properly.
If you neglect to wear your retainers for a long time and then try to put them on, they may be painful because your teeth have shifted. If this is the case, contact your orthodontist about getting a new retainer.
Can a Tight Retainer Damage Your Teeth?
Yes. Wearing a retainer that no longer fits your teeth is bad for your teeth and can damage them. The retainer should fit comfortably, without having to force it on but staying securely over your teeth. If you are having trouble putting the retainer in your mouth, don't force it: contact your orthodontist about getting a new retainer.
Can I Wear My Retainer After Not Wearing it For Years?
If you have lapsed in wearing your retainer, try putting it back in your mouth and see if it fits snugly and without forcing it into your mouth. If that's the case, then your teeth have not shifted and you can resume wearing it nightly as before. If, however, it is difficult to push into your mouth and you have to force it, or if it feels uncomfortable or painful when it's in, then don't continue to wear it: contact your orthodontist about getting a new set of retainers. Make sure to bring your old set of retainers to your appointment.
Can I Stop Wearing My Retainer After 2 Years?
Ideally, you should continue to wear your retainer forever. However, you can reduce wearing your retainer to 3-5 nights a week after the first year in order to keep your teeth from shifting.
How Long do Clear Retainers Last?
Clear retainers, such as Essix retainers, will last a few years years. Vivera are exclusively designed by Invisalign and use patented technology as well as offering multiple back-up sets, so they last longer. Be sure to store your retainer in a case when not wearing them, and wash them promptly after wearing them each time. If you see cracks or holes in the retainers, or if they are stretched out and no longer fit snugly, then it is time to get a new retainer.
Can I Use My Old Retainer to Straighten my Teeth?
If you lapse with your retainer, your teeth may shift out of alignment. Your retainer is not a solution to straighten your teeth: in fact, wearing a retainer that no longer fits can damage your teeth. If you have stopped wearing your retainer and your teeth have shifted out of place, schedule a visit with an orthodontist to discuss your case and your treatment options.
What Happens if You Stop Wearing Retainers After Braces?
If you stop wearing your retainers when you are done with orthodontic care, your teeth will gradually shift back. Shifting is inevitable: the only thing that can stop shifting is a retainer. This is why it’s important to wear your retainer 3-5 nights a week for as long as you can.
Can A Dentist Fix My Broken Retainer?
Dentists are capable of performing orthodontic treatment, such as fixing a retainer, but they generally have less direct experience with orthodontia than a licensed orthodontist. While a dentist can remove a permanent retainer, to get a new retainer or repair a broken retainer, it's best to go to a dedicated orthodontist, who will have the most direct experience with the issue.