Retaining appliance

A retainer is an essential maintenance device used after orthodontic treatment or orthognathic surgery. Whether fixed or removable, it requires minimal effort from the patient. It is discreet, aesthetically unobtrusive, and completely painless.

What is a retainer and why is it important?

A retainer is a custom-made appliance designed in a laboratory to meet the specific needs of each patient. It fits perfectly in the mouth and is made from either metal wires or transparent resin.

The post-orthodontic phase is a particularly critical period. Failing to follow the specialist’s recommendations can result in the gradual misalignment of teeth, compromising both the appearance and functionality of the smile.

Like other parts of the body, teeth have a "position memory." Over time, the pressure from chewing and the natural movement of the lips, cheeks, and tongue can cause teeth to shift back to their original positions. A retainer helps counteract this tendency, ensuring long-term stability of the orthodontic results.

What is the role of a retainer?

The role of a retainer is straightforward: it maintains the position of the teeth, keeping them stable until the jawbones and stomatognathic system fully develop. This prevents orthodontic relapse and ensures the long-term success of the treatment.

Orthodontic recurrence

Orthodontic recurrence is a major misalignment phenomenon and can affect both adults and children.

The phase following orthodontic treatment is very complex: after years of wearing fixed braces, the patient may face a real risk that the teeth will regain their original position.

Every day, in fact, the mouth is subjected to various muscular forces and there are also many bad habits: oral breathing, bruxism, onychophagia, bringing objects to the mouth such as pencils and pens by levering on the teeth. The displacement occurs because the dental elements are not yet established in their new position.

The only effective method to prevent a recurrence is the use of a restraining appliance, known as a retainer.

Types of retainers

Retainers are basically divided into two types although there is a third type for greater restraint:

- mobile or removable, transparent masks made of thermoplastic resin, similar to invisible devices and lasting several months (more or less 6 to 9). They are made in the laboratory following the new alignment of the teeth after orthodontic treatment.

Obviously, the effectiveness of the device depends on the patient's cooperation and ability to follow the doctor's instructions. It is very important to remember to wear the device every day and to devote the right amount of time to cleaning it with appropriate products that will not ruin the materials.

The retainer must be periodically replaced to prevent irreversible damage caused by wear and tear.

- fixed retainers or Splints: these consist of metal bars fixed behind the teeth on the upper and lower arches. The wire, also metal, is entirely invisible and causes no discomfort. However, the passive retainer can complicate oral hygiene, as it obstructs proper flossing. To prevent plaque buildup between the teeth, patients should undergo regular professional cleanings. Depending on the situation, the specialist may recommend appointments every 6 months or annually.  

- Palatal Retainers: These are resin plates that adhere to the palate and are used when stronger retention is needed. For optimal results, this type of appliance should be worn for half the day during the first 3 months, and then only at night before bedtime.  

How long should a retainer be worn?

The retainer must be applied on the same day the fixed braces are removed. The retention phase typically lasts between 2 to 3 years, during which patients will need to attend regular checkups with their dentist to monitor progress. However, the duration can vary depending on the type of retainer used:  

- Fixed retainers: These are non-removable and must be worn 24/7. Specialists generally recommend keeping them in place until after the wisdom teeth are extracted, as they tend to deliver more reliable results.  

- Removable retainers: These are worn all day, except during meals and while performing oral hygiene. After three months, they are typically required only at night.  

The dentist will determine the appropriate course of action and the total duration of the retention phase for each individual case.  

It is important to note that if the treatment is unsuccessful and the teeth shift back to their original positions, fixed braces may be necessary again. Retainers cannot correct orthodontic relapse, making proper adherence to the retention phase essential.  

How to take care of a retainer

Both fixed and removable retainers come with protective cases. Fixed retainers require no special storage or maintenance, while removable retainers should only be taken out during meals and for oral hygiene routines. For maximum effectiveness, they should be worn at night.  

When not in use, the retainer should never be placed on surfaces that may harbor bacteria or viruses. Instead, it should be stored in its designated case and kept away from heat sources, as high temperatures can deform the resin, reducing its fit and making it less transparent.  

How to clean a retainer  

Fixed retainers require minimal maintenance, needing only regular brushing and rinsing with mouthwash. However, the metal wires can make flossing more challenging.  

Removable retainers, on the other hand, require careful cleaning with cold water and mild soap (or effervescent cleaning tablets). Avoid using regular toothpaste, as its abrasive properties can scratch the metal or damage the resin, making it less clear and less effective. Proper care ensures the retainer remains hygienic and functional.  

Maintaining proper hygiene for your retainer is essential not only for fresh breath but also to prevent the introduction of germs, food particles, and debris into the mouth, which can contribute to tartar buildup.