Retainers after braces: what are they and how long to wear them

Information on this page was updated on September 09, 2021.

Orthodontic treatment does not end with the removal of braces, because immediately after removal, the bone tissue and ligaments will begin to return to their original position and move the teeth. To consolidate the result after removing braces, it is necessary to install retention structures that will hold the teeth in the correct position until the bone tissue is finally formed around the roots of the teeth.

• What are retainers?
• Fixed retainers
• Removable retainers and mouthguards
• Combined
• How do retainers work?
• How long should retainers be worn?
• The process of installing permanent retainers
• How to care for retainers?
• Which is better: mouthguards or retainers?
• Frequently asked questions about retainers
• What problems can arise with a retainer?
• Reviews about retainers

Fixed retainers

A permanent retainer is a wire arch made of medical steel, which is attached to the inside of the teeth with a special compound. This type of retainer is used most often, as they are completely invisible, cannot be felt in the mouth and do not oxidize. Fixed retainers can come off due to mechanical stress, such as chewing hard food. In this case, you should immediately visit the orthodontist and return the retainer to its place to prevent the teeth from moving.

Fixed retainers have many advantages: you can’t forget to put them on - they are always on your teeth, and they are absolutely invisible and do not interfere. The main feature of wearing a fixed structure is the need for careful home hygiene and professional cleaning every six months at the dentist, since plaque in hard-to-reach places around the retainer is more difficult to clean.

Dental prosthetics

Dental prosthetics will not only make the front teeth beautiful, as the patient originally wanted, but will also create physiological contacts between the teeth, securing the correct bite achieved by the orthodontist and neuromuscular dentist.

The dentist records the initial state after correcting the bite using photographs. Photographs are needed to model dental crowns so that the restorations look organic from any angle.

Wax modeling of dental crowns

Impressions were taken of the patient’s teeth to model future restorations in wax. First, dental crowns are designed using computer modeling programs. The doctor takes into account the proportions of the face, the natural contour of the lips, the position of the lips when smiling and many other parameters. Based on the results of computer modeling, wax models are made in a dental laboratory.

Diagnostic wax-up forms are transferred to the teeth using temporary composite restorations without grinding the teeth!

Temporary composite restorations without grinding teeth

The photographs show the process of transferring the shape obtained as a result of a diagnostic wax-up onto the teeth using a composite material. First, the working area is isolated, that is, the tooth on which the fixation will be made, and then a composite restoration is fixed to the tooth, exactly repeating the shape of the wax model:

Temporary composite restorations without grinding the teeth are needed so that the patient can evaluate the appearance of the dental restorations and make the necessary comments.

Temporary composite restorations are evaluated from all angles.

The patient walked with temporary composite restorations for about a week. Since the patient had no comments, permanent ceramic crowns began to be made based on the results of wax modeling.

Temporary dental crowns

The preparation of teeth for crowns in Dial-Dent is performed on living teeth (not pulpless). For this, the orthopedic dentist used a special preparation technology that prevented overheating of the teeth. The prepared teeth are covered with temporary crowns. Temporary crowns were installed on dental implants.

The period of wearing temporary crowns is necessary for the patient to get used to dental restorations and check the convenience of the design. There's no need to rush here. It is better to understand everything with temporary crowns, so as not to redo permanent ones later. The girl wore temporary crowns for about a month.

Permanent ceramic crowns

The temporary crowns did not cause any complaints, the girl was completely satisfied with everything, so impressions were taken for permanent restorations, and after 2 months ceramic crowns made of E.max ceramics were fixed to the teeth. Ceramic teeth do not differ from natural teeth due to the excellent quality of this material. E.max ceramics has the translucent property of natural tooth enamel, it is durable and hypoallergenic.

The orthopedic stage (the stage of dental prosthetics) took approximately 4 months - from the start of modeling to the installation of permanent restorations. The cost of dental prosthetics is 1,500,000 rubles.

The result of dental prosthetics in the correct bite is not only beautiful from all sides, but also preserves health.

Photos before and after ceramic dental prosthetics clearly show the difference in the appearance of a smile:

Removable retainers and mouthguards

Removable retention structures come in two types:

1. Plastic plates with a metal arch that encircles the dentition;
2. Transparent mouth guards made of silicone.

After braces are removed, mouthguards or plates must be worn constantly, removed only during meals, brushing teeth, or public speaking. In the future, on the recommendation of a doctor, the time of wearing retention structures is reduced: they are removed at night and worn less during the day. Removable structures can be noticeable to others, and at first they affect diction and cause increased salivation. Typically, removable retainers are prescribed at the end of the retention period after fixed structures, but they can also be used independently throughout the entire retention period.

Plastic plates with metal arc

Silicone transparent mouth guard

Conclusions. Expert advice

The retention period is a very important part of correcting dental pathologies. If the patient behaves incorrectly at this time, the effect may well come to naught. The problem can be prevented using special removable or non-removable devices. They are called retainers.

Main features of orthodontic appliances:

• Requires regular wear for several years.
• They can be removed or attached to the teeth for life - it depends on the patient and the characteristics of his body.
• They require special attention to oral hygiene, the use of an irrigator and brushes.
• They must be worn under the supervision of a specialist.

Doctors know that it is the dental retainer that keeps the bite in the correct state until the muscles get used to the new position of the molars, incisors and canines. It is mandatory to wear the device. If problems arise with any type of orthodontic design, you can always choose another option that will better suit the patient.

How do retainers work?

Braces or aligners actively move teeth in the desired direction due to the traction of the arch and pressure on the dentition. A non-removable wire retainer does not put pressure on the teeth, but only holds them in the desired position, preventing them from moving apart. Removable aligners differ from aligners in that they are not used with attachments (activators of tooth movement), but exactly repeat the shape of the dentition and fit tightly to the teeth, fixing the dentition. Any retention structure does not move the teeth, but at the same time it should prevent the ligaments from relaxing and returning to their previous position until the bone tissue around is completely strengthened.

General comprehensive treatment plan

The joint treatment plan is drawn up based on the results of consultations and diagnostics.

1. Pre-orthodontic preparation - treatment by a neuromuscular dentist (A.V. Galeev). Relieving muscle tension through electrical myostimulation (TENS). Determination of the correct position of the lower jaw using a computer examination that analyzes the trajectory of the lower jaw, muscle function and the correct functioning of the temporomandibular joints. Manufacturing and installation of a permanent orthotic (a special overlay on the teeth that fixes the correct bite height).
2. Removal of a tooth in the upper jaw that cannot be treated.
3. Treatment with internal braces Incognito (braces invisible from the outside - the patient’s wish). During treatment with braces, wearing a Herbst apparatus to secure the correct position of the lower jaw (the use of a Herbst apparatus rebuilds the work of the muscles that hold the lower jaw in a position in which the joints work without disturbances).
4. Osteopathic correction throughout the entire orthodontic treatment to relieve tension in the muscles, joints and facilitate the body’s adaptation to the ongoing restructuring in the head-spine system. (T.Z. An)
5. At the end of orthodontic treatment (during the period of consolidation of the result), an Astra Tech dental implant is installed to replace the extracted tooth.
6. Dental prosthetics with ceramic crowns in the correct bite, creating the aesthetics of the front teeth.

How long should retainers be worn?

The duration of the retention period is on average 2 times longer than wearing braces, and patients who corrected their bite in adulthood - after 25-30 years, can wear retainers all their lives.

The length of time you wear retainers usually varies from person to person and depends on the following factors:

1. Age of the orthodontic patient. The younger a person is, the faster his ligaments and muscles are rebuilt, thereby fixing the teeth and bite in the correct position. For patients who received braces as teenagers, wearing retainers for 6 months to 2 years is sometimes sufficient.
2. Bad habits. People who smoke have poor blood supply and reduced immunity, so all processes of restructuring the position of teeth and healing are slower than in non-smokers.
3. Oral health. If the teeth and periodontal tissues are healthy, the fixation of the ligamentous apparatus occurs faster.
4. Complexity of the clinical case. The stronger the initial curvature of the teeth, the longer you need to wear a retainer.

The retention period must be carried out under the supervision of an orthodontist so that he monitors the condition of the bite. In any case, you should not stop wearing retainers without your doctor's approval, otherwise your teeth may become crooked again.

Manufacturing

Orthodontic structures are made from individual impressions taken from patients. The process of creating a model takes from 2 to 7 days.

Stages of manufacturing an orthodontic product:

• taking an impression;
• production and 3D scanning of the model;
• 3d printing of jaw;
• creation of a transparent mouthguard on a press former.

There are also standard retainers in the form of plates, which, when fixed, are adjusted to the patient’s jaw. But this method is inferior in effectiveness to the individual approach.

The process of installing permanent retainers

Retainers are installed after braces are removed on completely healthy teeth after professional hygiene. The patient may need to undergo oral sanitation after orthodontic treatment. While wearing braces, it is difficult to clean your teeth perfectly, and accumulated plaque can cause caries and tartar. Retainers cannot be installed on affected teeth, since another design in the mouth will again complicate hygiene and lead to a deterioration in the condition of the oral cavity. Also, during orthodontic treatment, the enamel may become thinner, so in addition to hygienic cleaning, teeth need fluoridation and mineralization.

After carrying out therapeutic and preventive measures, the orthodontist begins the laboratory stage of manufacturing retainers. An impression is taken from healthy teeth, according to which the retainer is given the necessary shape of the dentition.

Before the actual installation of the retainer, the teeth are etched with a special solution so that their surface becomes slightly rougher for better adhesion. In some cases, instead of etching the teeth, the teeth are prepared: a microgroove is drilled on the inside to fix the retainer. Once the teeth are prepared, the retainer is placed in the desired position and secured with composite material. The procedure is completed by grinding the material for the patient’s convenience.

The installation procedure takes 15-20 minutes and is absolutely painless. But in the first days of adaptation, the retainer can rub and reduce the clarity of diction.

Removal

Only the doctor who is observing the patient should remove orthodontic structures. He also decides to change the wearing regime of orthodontic splints. The procedure for removing structures from the oral cavity takes from 10 to 20 minutes. First, the doctor cuts the wire fastenings, and then carefully peels off the fixing parts.

There is a fee for removing fixed retainers.

The enamel coating needs to be thoroughly cleaned of the adhesive, so the doctor polishes it. If the enamel has been severely damaged, procedures are prescribed to restore the enamel coating. It is prohibited to remove fixed orthodontic mechanisms yourself: you can seriously damage the enamel layer.

How to care for retainers?

Retainers, like any structure in the mouth, without careful hygiene provoke the accumulation of bacteria, the appearance of plaque and caries.

1. You can brush your teeth with a regular toothbrush and toothpaste, but be careful when brushing the inside of your teeth if you have a permanent retainer;
2. If the retainer comes unstuck, you need to visit the orthodontist and return it to its place so that an orthodontic relapse does not occur;
3. For thorough hygiene when wearing fixed retainers, it is recommended to use a waterpik, brushes and dental floss to clean hard-to-reach places near the arch;
4. Removable retainers and mouth guards should be washed with disinfectants, soap, or brushed with toothpaste at least 2 times a day.
5. Mouthguards must be removed when eating and smoking and stored in special containers;
6. Mouthguards should not be washed with hot water because they will become deformed.
7. To strengthen the enamel, it is recommended to rinse the mouth with a fluoride solution.

After braces are removed and retainers are installed, you should periodically visit the orthodontist for follow-up examinations and the hygienist to maintain oral health. Only after the end of the retention period can orthodontic treatment be considered complete.

Signs

Most often, you can notice that the retainer has come unstuck by the following signs:

• Lack of pressure in the place where a certain element has come off. It is felt more clearly if it happened abruptly, for example, while biting into hard food or after a blow.
• The appearance of irritation on the mucous membrane of the tongue. You may not even feel tactilely that a slight peeling has appeared, but the mucous tissues are very delicate, so in most cases they react with irritation or even the appearance of ulcers.
• Changing the structure of the structure. The patient feels that the shape of the wire and its height have changed.
• The appearance of atypical sounds. Sometimes the fact that some part of the system has become unstuck is indicated by a quiet crunching sound that is not heard by others, but is felt by the patient while eating or talking.
• Having a piece of wire in the mouth. If the outermost piece has come off, it may come off. This often happens while chewing food.

Sometimes during a breakdown you can hear a specific crackling sound, but most often there is no sound effect.

Which is better: mouthguards or retainers?

Retention mouthguards and a non-removable retainer after orthodontic treatment are used in combination: a non-removable retainer from canine to fang is permanently placed on the teeth, the mouthguard is put on at night. After removing braces, we give patients 2 mouthguards: a night guard for all teeth in the upper dentition and a canine-to-canine safety mouthguard for the lower dentition, which is needed if the retainer breaks and there is no way to quickly make an appointment with an orthodontist. From the point of view of patient comfort, a non-removable retainer is more convenient than a mouth guard, since a week after installation, it is practically not felt in the mouth. And the mouth guards are quite bulky and it’s more difficult to get used to them.

Prices

Expert of the article you are reading: Yulia Andreevna Feodoridi Orthodontist, leading specialist of the NovaDent network

9 years
Clinical experience

Krasnogorsk

Moscow region, Krasnogorsk, Podmoskovny Boulevard, 5

+7

Free consultation with this specialist

Frequently asked questions about retainers:

Typically, patients who are thinking about installing braces learn about the need to wear a retainer during a consultation with an orthodontist. We have collected the most common questions that patients ask about the retention period.

How long to wear a retainer?

The minimum period for an adult patient is twice as long as the period of orthodontic treatment. Our recommended period is from 5 to 10 years, depending on the complexity of the case and the type of retention. Many patients do not feel the retainer on their teeth and quietly wear it all their lives.

Is it possible to do an MRI with a retainer?

Yes, an MRI can be done with a retainer, just like with braces, but due to the presence of metal in the mouth, there may be interference in the final image.

Do I need to change my permanent retainer?

If the retainer is not broken or unstuck, then there is no need to change it. To maintain good hygiene in the retainer area, use a single-tuft brush, brushes, dental floss, and regular professional hygiene.

Is there a warranty for the retainer?

In our clinic, the warranty on the retainer lasts 2 years. If during this time the retainer breaks or comes off, we will replace it absolutely free of charge.

Can teeth move apart if a retainer is installed?

If orthodontic treatment is completed correctly - the correct closure and position of the teeth is achieved, then with a permanent retainer, the teeth will remain in the correct position. If the retainer comes unstuck or breaks, you need to install it as quickly as possible, since even in a month your teeth can change position.

Consultation with an orthopedist before dental prosthetics

At the consultation, orthopedic dentist A.S. Ivankov listened to the patient’s complaints and conducted an examination. The patient complained about the unsightly appearance of her front teeth. Veneers installed on the front teeth several years ago have cracks and chips.

Often the reason for the fragility of dental restorations is an incorrect bite, strong clenching of the teeth (bruxism), so the orthopedic dentist asked if there were any other complaints in the area of ​​the temporal joints. The girl complained of dizziness, headaches, pain in the area of ​​the left temporomandibular joint, clicking on the left in the area of ​​the joint when opening her mouth, and a constant desire to find a comfortable position of the lower jaw when closing her teeth. She also noticed that she often clenched her teeth involuntarily.

The patient said that several years ago she had her bite corrected with braces, but the orthopedic dentist believed that the existing signs indicated a malocclusion. Dental prosthetics in malocclusion can lead to the fact that all articular symptoms will only intensify, and crowns and veneers will not last long, and damage to the restorations will occur. To resolve the need to re-correct the bite, the girl was referred to an orthodontist for consultation.

What problems can arise with a retainer?

The first thing a person who has a permanent retainer installed will face is getting used to it. At first, the retainer may rub your tongue, feel too big in your mouth, and interfere with clear diction. The retainer becomes invisible in the mouth after about a week.

The next task for a patient with a retainer is careful home hygiene, since food debris can get stuck in the spaces between the teeth and the retainer. For home cleaning, we recommend using a single-tuft brush, brushes, dental floss and irrigator.

The retainer may break or come off due to hard foods. In this case, you need to contact your doctor for a replacement.

If caries appears in the area of ​​the retainers on the teeth, then for treatment by a therapist, the retainer will need to be removed and then reinstalled.