Retainers are “nighttime for a lifetime”: after your orthodontic care is completed and the teeth have been properly aligned, retainers are used to keep them from shifting back. Ideally, you’ll wear your retainers a few nights a week forever.
Retainers are customized orthodontic appliances that are designed to keep the results of your orthodontic care in place. It’s important to wear your retainer after your braces or clear aligner treatment, to protect the gains made in aligning your teeth and prevent them from shifting back to their pre-treatment positions. Teeth have “memory”: if left to themselves, they’ll naturally start to shift back towards the places they were in before your orthodontic treatment.
To prevent that shifting, retainers are designed to keep them in place in their new, properly aligned position.
There are several different types of retainers, so how they work and how to wear them varies depending on retainer type. Below you’ll find information on the various different types of retainers and how to use them.
Hawley retainers are made of hard plastic or acrylic and metal wire. They are custom-designed for your mouth and fit snugly behind your top teeth on the roof of your mouth. The appliance is removable: you’ll remove it for meals and drinking, to brush your teeth, and clean the retainer.
When your orthodontic treatment is complete, you’ll wear the Hawley retainer full-time, day and night, for several months: most orthodontists recommend around 6-9 months. You’ll remove it for meals, drinking anything but water, and to brush your teeth, and clean the retainer. After this phase, you’ll transition to wearing the retainer only at night, every night. Eventually, if your orthodontist approves, you can taper down to 4-5 nights a week, and you should continue to wear the retainer every few nights forever.
A Hawley retainer is sturdy and designed to last several years, but will eventually need to be replaced. Your orthodontist can fit you for a new retainer in the office. If the retainer breaks or is lost, it will also need to be replaced. Hawley retainers are easier to repair than other appliances, however, so your orthodontist may also be able to adjust and repair the Hawley retainer if it becomes misshapen or ill-fitting.
Clear plastic retainers are custom-molded to fit snugly over the teeth. There are two trays, one for the top teeth, and one for the bottom. They are totally transparent and nearly invisible when worn. Unlike the Hawley retainers, there is no metal involved, and patients tend to find the clear retainers more comfortable and less bulky.
There are several forms of clear plastic retainers, including Essix and Vivera retainers. There are differences between the two, but both types of retainer work in a similar fashion.
You’ll wear the retainers full-time, day and night, for a few months, removing only for meals and to brush teeth and clean the retainers. The exact length depends on your orthodontist or dentist’s recommendation.
You’ll then reduce use, wearing the retainers every night. Eventually – after about a year – your orthodontist may allow you to start wearing them every few nights, about 4-5 nights a week. After that, it’s nighttime for a lifetime.
Clear retainers are not designed to last for a long time, so they’ll have to be replaced eventually. Visit your orthodontist as soon as the retainer breaks: it is simple to make a new set of plastic retainers and a quick replacement will avoid potential shifting. Your orthodontist may provide you with several sets of clear retainers at once. It’s also important to keep your clear retainers clean and protected in its case when not worn to make them last as long as possible.
There are several types of clear plastic retainers: Vivera retainers, which are made by Invisalign, tend to last significantly longer than Essix retainers. Vivera retainers cost more but come in a package deal of 4-8, and with a better fit and longer, durable wear, they tend to be a good deal.
Unlike the removable retainers discussed above, a permanent bonded retainer is glued to the back of the teeth, keeping the gains achieved by orthodontic treatment in place with less possibility of non-compliance. Because the retainer is in your mouth all the time, there’s no need to remember to put it in at night. A permanent retainer can be bonded to the top or bottom row of teeth, but a bottom teeth bonded retainer is more common and tends to last longer.
Bonded retainers are sturdy and could last for years – sometimes even decades. This makes it simple to comply with your orthodontist’s retainer instructions: they will install the device after your braces or clear aligner treatment is complete, and you won’t have to worry about replacing it for several years unless it breaks. If it breaks, make sure to visit your orthodontist as soon as possible to prevent your teeth from shifting.
With a permanent bonded retainer, it’s important to brush and floss your teeth and get under the retainer wire to remove trapped food or other debris. You’ll need to use a specialized floss threader to get under the retainer and keep it clean. You should also take care not to put too much pressure on the bonded retainer, so avoid hard crunchy foods like carrots or hard candy, or at least avoid your retainer when you bite down on them. It also helps to use a water flosser to keep that retainer clear and teeth and gums healthy.
When you first get your braces off or finish your clear aligner treatment, your orthodontist will provide instructions for retainer wear. For the first few months, most patients will wear their removable retainers full-time, day and night, removing only for meals and drinking, and to brush their teeth and clean the retainers.
In certain cases, the orthodontists may instruct you to wear retainers only at night and to switch to full-time wear if you notice some shifting.
Some minor shifting of your teeth is normal after orthodontic treatment: this is called dental settling. Even with proper retainer wear, there will still be minor shifting as the teeth settle into their permanent positions. If the retainer is fitting well, you don’t need to worry about this minor shifting but contact your orthodontist if you have any questions or concerns or if your retainer isn’t fitting right.
When you reduce retainer to wear to nightly use, you’ll store your retainer safely in a case for the day, and then put the retainer in after brushing your teeth to sleep. Wear them all night long while you sleep, and wash them gently every morning before putting them back in the case.
With a permanent retainer, you don’t need to worry about taking the retainers in and out: you’ll just have the retainer in your mouth all the time, reducing any stress about compliance. But with removable retainers, it’s important to follow your orthodontist’s instructions to ensure the retention phase is effective at protecting your healthy bite and smile.
Teeth have “memory”: the ligaments and structures that hold your teeth in place are elastic, and while orthodontic treatment guides the teeth into new positions, these forces will naturally attempt to draw them back to their old positions.
While you have braces on your teeth or are wearing clear aligners consistently, there is a force in place to keep them from shifting out of alignment: this force is moving them towards a new alignment. Once this force is removed, however, there is nothing to guide them, and the natural tendency of the dental structure starts to draw them back where they came from.
This is why retainers are necessary: they are a new force that is designed, not to move teeth, but to prevent them from moving. The retention phase holds the teeth in place so that they don’t drift back towards the old alignment they “remember”.
Even without any orthodontic treatment, research shows that teeth move as you get older due to the natural forces on your teeth: mastication (chewing), bone remodeling, clenching habits, sleep habits like grinding, all contribute to the shifting of teeth over the course of your life. To avoid dental shifting, wear your retainer.
How long a retainer lasts depends on which retainer type you have, as well as how well you care for the retainer. A bonded, permanent retainer usually lasts longer than a removable clear retainer.
Permanent bonded retainer: This type of retainer is glued to the back of your teeth, either on the top or the bottom. If cared for properly, a bonded retainer could last for years. Some patients have been able to wear their permanent retainer for over 20 years, but there’s no guarantee. Natural factors may impact the length of your permanent retainer, such as diet and the natural acidity of saliva.
Hawley retainer: This is a removable retainer made of metal wires and hard plastic or acrylic. This type of retainer is sturdy and durable and built to last for several years. Many patients find Hawley retainers to be more noticeable and less comfortable.
Clear plastic retainers: These retainers are generally worn as a set, with one on the top and one on the bottom rows of teeth. Some patients may be prescribed a combination retainer: a bonded retainer on the bottom teeth and a removable clear retainer on the upper teeth. There are different types of clear retainers: Essix retainers are less expensive and less durable, so they don’t last as long and are more likely to break or discolor. Vivera retainers are the Invisalign brand of clear retainers, and they tend to last longer than Essix retainers. Clear retainers are relatively easy and cost-effective to replace and often come as a package of several sets.
The following tips will help you keep your retainer clean and working well.