The One Year Retention Phase
The retention phase is one of the most challenging aspects of orthodontics. The purpose of retention is to keep your or your child’s teeth in place after braces have been removed. Teeth tend to want to shift back into their original positions once braces are removed. Retainers are used to keep teeth in their new positions until the new bite is more stable and less likely to relapse.
In the early 1900s, orthodontic treatment was accomplished without removing teeth. In the mid-1900s, orthodontists began to believe that this non-extraction approach was affecting relapse. They began removing some permanent teeth as part of orthodontic treatment, hoping that this would minimize their patients’ tendencies toward relapse. However, recent studies have shown that significant orthodontic relapse occurs whether teeth are saved or extracted as part of treatment. Dr. Ingraham has chosen to do everything possible to avoid extracting permanent teeth, for three reasons:
- Relapse potential is the same, whether teeth are extracted or not.
- Full, wide smiles are judged more pleasing and beautiful by most people.
- Dr. Ingraham knows that nothing works better than your natural teeth.
Importance of Your Retainer
As a team, we have worked hard to get your teeth into the best possible position. However, when your braces are removed, your teeth will want to return to their original positions. Recent relapse studies show that 20 to 30 years after treatment, over half of orthodontic patients experience significant tooth movement.
Our main problem is that we can’t predict which of our patients will have this tooth movement. For this reason, we recommend that you wear your retainers full time for at least one year after your braces are removed, and after that, to a lesser degree while sleeping. For some patients, this might be three or four times a week. For others, it might be once a month, just to check whether any tooth movement has occurred.
The fee for your orthodontic treatment includes a retention fee that covers the initial set of retainers and one year of retention follow-up appointments. After the one year, you should call us if your retainer needs adjustment. If you lose or break your retainer or it doesn’t fit properly, we urge you to protect the time and investment you’ve made in your orthodontic health and call us for a consultation. Any additional retainer services will be subject to our fees at that time.
Types of Retainers
Traditional retainers are removable and made of colored acrylic and wire. You can customize your retainer colors. You are given a special case for your retainer; please make sure you keep them in this case when not wearing it! To clean these retainers, brush them with toothpaste (sometimes with denture cleaner) using warm water. Your retainers should be worn at all times with the exception of eating and brushing your teeth. Your retainer should also be removed when participating in sports that require a mouthguard or while swimming.
The invisible retainer is a transparent removable retainer that fits over the entire arch of teeth. Clear retainers are made of a clear thermoplastic material and have no wires. Clear overlay retainers are small and easy to wear. They also protect the surfaces of your teeth if you have a grinding (bruxism) or clenching habit.
Bonded lingual retainers are cemented directly to the inside surface of your lower canines (eye teeth). This is one of the best ways to prevent your lower teeth from shifting as it is permanently attached! Patients with bonded lingual retainers must be careful with their bite as the bonding material may break due to incorrect biting and cause teeth to shift quickly. As with removable retainers, it is important to keep them clean. When brushing, make sure to carefully clean the inside of your lower teeth as well as the wire.
Care of Your Retainer
In many cases, retainers will need to be worn only at night. Your wear instructions will depend on the relationship of your teeth and the tendency to relapse. We’ll make this determination at the appropriate time during your treatment, and we urge you to follow our instructions carefully.
Retainers, just like braces and teeth, tend to attract plaque and food particles. When you remove them, brush them carefully with your toothbrush, toothpaste or soap as directed. There is also a retainer cleaner, made by Efferdent, that is available at most stores. You should soak your retainers in a glass of room temperature tap water with a denture cleaning tablet, such as Polident or Efferdent, once a day. Keeping your retainers clean will make them taste better and will help keep your breath sweet and fresh.
When you’re not wearing your retainers, store them in the case that was provided. (It’s not necessary to keep a retainer moist.) Your retainers and their case don’t mix well with heat. Never use hot water to clean your retainers, and never put them or the case in direct sunlight. Never wrap them in a tissue, where you might forget and throw them away. Never leave them where your dog can get them. Dogs love the smell of retainers and will chew them up. Don’t chew on the retainer yourself. If you chew on your retainer, you will damage the fit and it will have to be remade.
If you lose or damage your retainers, they will have to be replaced. There is an extra charge to replace for this.
If your retainers don’t fit correctly or you’re unable to wear them for any reason, call our office immediately. Failing to wear your retainer for even a small amount of time may require a new retainer or re-banding of the teeth at an additional cost.
Keep your retainer appointments! These short checks of your retainers and teeth are important. Bring your retainers to all appointments.
Following treatment, we will evaluate your treatment and the status of your wisdom teeth with a series of X-rays. These X-rays can be sent to your dentist. We’d like you to see your dentist as soon as possible for a post-treatment checkup.
We’d like you to think of your retainers as insurance for your new smile! Take proper care of them and follow our instructions so that your new smile will stay straight and healthy.