Retainer Wear: Nighttime for a Lifetime!
March 9, 2013
Question: How long do I have to wear retainers?
Answer: As long as you want your teeth to stay straight.
Finishing up with braces or Invisalign is very exciting! However, it can be a bit confusing as well. Patients and parents always have questions about what kind of retainers are needed, and how long they need to be worn. It is always good to follow your orthodontist’s recommendations, but a little insight about retainer types and the need to wear them can be helpful before the braces come off.
Teeth have a tendency to shift throughout life, and crowding has a tendency to relapse over time due gum fibers pulling teeth toward their original positions, and the natural narrowing of the arches as we age. Relapse of crowding is a significant problem even in well-treated cases, and is difficult to predict. A study conducted by Little et al at the University of Washington followed orthodontic patients 10-20 years after completing treatment showed that no matter what type of orthodontic treatment the patient had: extraction, non-extraction, expansion, crowding, retraction, spacing, surgery, headgear- you name it- all patients undergo orthodontic relapse.
In short, every patient will need orthodontic retention to keep their teeth in the same positions after treatment is completed.
According to multiple post-treatment orthodontic retention studies, adults experience almost 3mm of anterior crowding between the ages of 26 and 43. Everyone has seen instances of lower crowding in adults. Since the skeletal structure of the face remodels with age, and teeth change with wear and eruption, we provide a set of retainers for all of our patients. We ask that after patients finish active treatment, they return to our office for 4 retainer checks during their scheduled 24 months of supervised retention. Retainer wear is full-time for the first 6 months, then:
Nighttime for a Lifetime
What kind of retainers do we provide? Just about all of our patients are offered a fixed lower retainer, as it provides the best protection against relapse of crowding, even if removable retainers aren’t worn as consistently as we’d like.
Here’s a rundown on our retainers:
A wire that sits behind the lower incisors, bonded only to the lingual surface of the canines.
Pros: Allows for slip-ups in wear of removable retainers. Proven method to prevent relapse. Studies show no risk of gingivitis or caries with long-term use if trimmed correctly and hygiene is maintained.
Cons: Risk of breakage. Foods like carrots and apples must be avoided. Teeth can also move before the retainer can be fixed. We provide a clear retainer that fits over the top as well.
A pressure-formed clear plastic retainer, similar to Invisalign. Our Essix retainers are made with the Drufomat system, allowing higher precision and better fit over other methods.
Pros: Esthetically pleasing. Barely noticeable. Holds rotations very well. Covers chewing surfaces of teeth for some protection from nighttime grinding.
Cons: Not as rigid as traditional Hawley retainers. Not as effective in preventing relapse of crossbites or expansion. Full coverage of chewing surfaces slows down the “bite settling” that normally happens after orthodontic treatment. Wears out faster than Hawley retainers (usually 2-5 years)
The traditional retainer. Wire clasps attached to an acrylic baseplate.
Pros: Allows bite to settle in. Rigidity prevents relapse of expansion or crossbite correction. Can be adjusted.
Cons: Palatal coverage can affect speech for some people. Metal bar across front is not always popular.Does not protect against grinding during nighttime wear.
We predominantly use upper and lower Essix retainers combined with a fixed lower retainer unless we need the rigidity of a Hawley after expansion, correction of a crossbite, or occlusal settling.
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