Dear Dr. Mady:
I just got my braces off after wearing them for two and a half years. My orthodontist said that I need to wear retainers now but they are not ready yet. What exactly are retainers and why are they so important? Jo Ann in St. Clair Beach
Dear Jo Ann,
Almost always after orthodontic treatment, the teeth need a way to be maintained in their new correct position. Teeth naturally have the tendency to want to rotate and drift back to the position they were in prior to orthodontic treatment, especially the lower front teeth.
The teeth need to maintain where they are while the muscles of the oral cavity adapt to their new positions. Also the supporting ligaments, fibres and bone surrounding the roots of the teeth will mature more over time and decrease the chance of future tooth movements.
Retainers are removable or fixed oral appliances that hold the teeth where your orthodontist engineered them to be for health, function and aesthetics. If you desire good results and don’t want to feel that you wasted two and a half years and a lot of money, then it is vitally essential that you follow the recommended directions with respect to your retainers and wear them for the prescribed time or longer.
There are many kinds of retainers, but the three most common are the removable clear retainer, the removable Hawley and the bonded wire type. A clear retainer is a clear plastic overlay that covers the entire surface of the teeth in the upper or lower arch. It is a semi-rigid clear plastic that is not noticeable when you wear it. The clear retainer can be worn at night or twenty-four hours a day if you wish.
The Hawley type is made of a coloured plastic that covers the gums behind the teeth with a wire that goes along the fronts of the teeth. There are usually two cribs that help stabilize the retainers around the molar teeth. There are many fun colours that you can choose from for the plastic/acrylic portion and this removable kind has no special hygiene requirements and no real restrictions related to eating. After each meal, these removable appliances must be taken out and cleaned but remember not to use water that is too hot because the acrylic could get distorted. Many people take them out when they eat. Your orthodontist will instruct you as to what is best for you. Always remove it during sports and take note that dogs love to chew Hawley retainers. When you first start to wear this type of retainer you may get a plastic taste that usually disappears within a few days and your speech will be different initially but will return to normal quickly. The removable types are often used for minor tooth movements and for fine tuning the alignment of your teeth, even if you have never had orthodontic treatment.
The third one is the Bonded Wire type. It is custom shaped on a model of your upper or lower teeth (or both) to fit the inside of the front teeth after they have been straightened. It does not show because of it’s location on the tongue side and is permanently bonded in place. It usually fits behind two to six front teeth and can be either bonded at the two ends only or to all the teeth that it lies against. I feel it is better if it is bonded on every tooth adjacent to it. This type is most often used on lower front teeth because these teeth are more prone to crowding and movement again. The wire can be left on for the rest of your life if you want to be sure that the teeth maintain proper position. The only negative side of this bonded wire is that it does not allow floss to slide in between the teeth where it is and a floss threader or super-floss must be used in order to maintain good preventive oral hygiene. Your dentist or orthodontist can remove this wire very quickly at any time.
Although your braces are removed, the retainer is the most important part of your treatment. If you choose a removable appliance and do not wear it as directed, your teeth will move. As a result, re-treatment may be required and this will involve additional time and costs.
Any questions for Dr. Mady can be e-mailed to drmady@drmady.com and also visit his blog at www.dentalden.com (dental education network)
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This column is reprinted with the permission of the author and The Windsor Star. “Ask the Dentist” is written by Windsor dentist (and ECDS member), Dr. David Mady Jr.. The column appears the first Thursday of each month in the Windsor Star. Readers with questions can write to “Ask The Dentist”, c/o The Windsor Star, 167 Ferry St., Windsor Ontario, N9A 4M5