Retention is one of the most easily discarded, yet equally important aspect of orthodontic treatment. Now that you have your new beautiful smile you want to keep it looking straight and attractive.
Why is retention so important
Initially after orthodontic tooth movement your teeth are in a state of tension, much like a stretched out rubber band, and they will want to return to their pre-orthodontic position. Retainer wear prevents this relapse.
How long do I have to wear my retainer?
Our prescription for retention is full time retainer wear for 6 months, night time wear for the next 6 months, and every other night for the rest of your life. If, during that every other night it becomes tight return to every night.
Why do I have to wear my retainer for life?
We all grow, and we continue to grow throughout life, albeit at a much slower rate then when we were kids. Females tend to get longer/taller faces while males tend to have the lower jaw come more forward. When this growth occurs there is pressure from the lower lip pressing backwards. This lip pressure causes the lower teeth to crowd up.
What about bonded retainers?
Many offices will bond a wire to the lingual (tongue side) of the lower teeth. Some offices even bond the upper teeth as well. We prefer to use a lingual bonded retainer on the lower arch. This offers a low-profile, non-compliant, permanent retention for your orthodontic result.
My hygienist told me bonded retainers are bad.
In patients with poor home care bonded lingual retainers can act as plaque and calculus traps. If a patient is unable to adequately keep their lingual retainer clean the risk of periodontal disease trumps that of orthodontic retention. If a patient is able to keep their teeth clean a bonded lingual retainer is a useful tool to maintain their orthodontic result.
What about clear retainers?
Many orthodontists will use a vacu-form clear retainer. It looks much like a bleaching tray. These are easily fabricated and initially look good. With time, however, they discolor, distort, and wear out faster. Also, the teeth are never in actual contact which does not allow for natural tooth settling, and long term can result in posterior (back) open-bite.
What type of retainer do you use?
On the upper, our office generally likes to use a wrap-around retainer. The wrap-around retainer is a more rigid design which enables the teeth to erupt and settle into a functional occlusion. Also, since we advocate retention for life, the wrap around retainer is more durable for long-term use. On the lower we usually do a bonded lingual retainer. We can do a lower removable retainer at the patient's request, or if the patient is unable to keep their lower retainer clean.
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