Answering big orthodontic questions: Do retainers work?

Here’s a scene I see every day.

My lovely patient has just completed braces treatment and they’re smiling into the mirror, realising they’re finally free. Yay!

Then I remind them: they need a retainer to keep those gorgeous teeth they’ve worked so hard for straight and in place.

A question I’m commonly asked at this point is: Do retainers work?

I’m asked even more reluctantly: What do retainers do?

And then there’s the hopeful: Do I really need retainers after orthodontic treatment?

Because I’m all about clearing up the confusion around orthodontic treatment, let’s answer these questions about retainers.

What are retainers?

Let’s start with the basics.

Retainer wear is the last phase of orthodontic treatment. It occurs after the active treatment phase is finished.

After braces have been removed, or Invisalign treatment is complete, a readjustment needs to occur in the mouth and it’s possible for teeth to shift or relapse if retainers aren’t worn. Essentially, retainers are worn to help maintain the position of teeth

Teeth move at all stages of life, including as we age, which is why it’s recommended that you wear a retainer indefinitely if you’re happy with the way your teeth look immediately after braces treatment is finished.

Are there different types of retainers?

The ideal retainer for each person is based on individual needs. What the patient wants and how likely they are to be diligent with their oral hygiene and maintaining their retainer are also factors. They can greatly influence the answer to the question Do retainers work?

Retainers are usually fabricated by the orthodontist, who will take a mould or impression at the same appointment you finish orthodontic treatment.

Different types of removable retainers can be made from this mould. The simplest form is a Trutain retainer, which looks like a thin clear plastic mouthguard. Some orthodontists also use a thin acrylic plate-like retainer that has a thin wire across the front teeth.

The retainer is inserted during a separate appointment once it is made. In most cases, it’s recommended that retainers are worn indefinitely. (More on this below)

What are the different types of retainers?

There are two types of retainers: fixed and removable.

Fixed retainers are usually made with a thin wire worn across the back of the lower and/or upper front teeth. The wire is bonded in place with a cement that is similar to the one used on the brackets of braces. Because this wire stretches across several teeth, a floss threader or similar cleaning device is essential for accessing the spaces between teeth, just like you do with braces.

I recommend carefully weighing up your decision around a fixed retainer. They are prone to breakage if you’re not conscientious with care. Just as with braces, biting into hard foods can break wires. This type of retainer also takes more work to keep clean. Keep in mind that unless the wearer (your child) already has solid oral hygiene habits in place, a Trutain retainer is probably the way to go.

Removable retainers can either be the Trutain type (as described above), which is my preferred retainer for my patients or made using wire that is placed across the front of the lower or upper front teeth, connected by an acrylic plate, attached to teeth through clasps and hooks.

Being removable, this type of retainer makes it easier to clean teeth. The downside? The patient must remember to wear it daily.

Immediately after completing braces treatment, it’s necessary to wear the retainer 24 hours every day for between 6 and 12 weeks. I tell patients they only need to wear the retainer at night after this period. However, beyond this the retainer needs to be worn indefinitely.

The obvious disadvantage of a removable retainer after braces is it can be lost or damaged. It can even melt or change shape if it is exposed to heat, such as warm or hot water. I’ve had more than the odd patient whose dog has taken a liking to their retainer too, so it pays to set up a routine for safe-keeping right from the start.

What do retainers do?

This is a great question and one I’m asked a lot. Some patients find it confusing, particularly as they’ve just invested time, effort and money in braces treatment.

I like to explain it this way: If braces create a beautiful smile, a retainer maintains it.

Although retainers for teeth are most commonly used to hold straight teeth in place after orthodontic treatment, the advantages of wearing retainers correctly go beyond that.

Another way to answer the most pressing retain questions like Do retainers work is to consider what happens when you don’t follow through with retainer.

Johnno’s retainer story

Johnno* had completed a course of braces and had been fitted with a retainer.

When he came to see me he brought a container that looked as though it had been eaten by a shark.

Unfortunately, he didn’t come back as soon as he noticed his dog had eaten the retainer. When he did eventually make it back – about a short month later – his teeth had moved.

Although he’d only been without the retainer for around four weeks, his lower teeth had moved noticeably. Although in some people, the movement is not as pronounced, but for this teenage boy, it wasn’t the case.

It isn’t possible to predict whose teeth will move and whose won’t. For a patient whose teeth move it can be very disappointing, especially when there is a need for additional costs to be outlaid for further treatment.

My big tip here? If you want to keep the smile you’ve worked so hard for without incurring unnecessary additional costs, wear your retainer!

As a mum myself, I totally understand it can be hard for kids to wear a retainer consistently, correctly, and for long periods of time. But after a while, it will be a part of daily life, just like braces and ultimately, the compliments they receive for a beautiful (well-maintained) smile.

Do you want to understand more about retainers and whether they work? Why not discover the answers to all your orthodontic treatment questions in Dr Sarah Dan’s book So Smile: A guide to straightening out the confusion, concern and catastrophes around orthodontic treatment. Sarah is a specialist orthodontist and mum. She truly understands the challenges of kids, teens and orthodontic treatment – and is equally across the joys, especially knowing the benefits of retention after braces. Dr Sarah Dan is available for consultations at Menai Orthodontics, Sydney and can be contacted through her website www.drsarahdan.com.au, where copies of her orthodontic treatment book, SO Smile can be purchased.