Retainer and Retention After Bracket Removal

This an extremely critical time if the long-term benefits of orthodontic correction are to be fully realized.

1. Orthodontics is a field in which improvement, not perfection, is the expected result. In all fields of medicine and dentistry – indeed, any field dealing with improvement in nature’s plan for the individual – cannot yield ideal corrections. There may be some slippage or relapse in spite of all our efforts. This consists typically of slight lower incisor crowding which occurs in a large percentage of both treated and non-treated dentition in the late teens, early adulthood, and throughout life to a degree.
2. Retainers must be worn according to the needs of the individual and these vary tremendously. Some people have short-term retention requirements, while others may require life-time retention. A schedule will be required for each patient’s wearing time for the first year after removal of orthodontic brackets. Thereafter, it becomes entirely your responsibility to wear it as much as your teeth require to hold them in right position.
3. If the retainer is not worn correctly and our instructions are not followed, the retainer may not fit or the teeth may slip or relapse. Very comprehensive instructions are given during the retention period and if carelessness or failure to follow instructions for any reason result in the necessity of a new retainer and/or re-treatment, then the appropriate charges shall be made.
4. There are many types of retainers, and the most appropriate for each case is used.

Rules for Wearing Your Removable Retainer

1. To assist you in becoming accustomed to your retainer, we recommend that you read aloud to yourself at home for perhaps an hour to allow your tongue to adapt to the retainer while speaking.
2. For a retainer with a wire, when brushing your teeth, remove the retainer, hold it in the palm of your hand and scrub it thoroughly with your toothbrush or preferably a stiffer type brush. Be certain also to brush the roof of your mouth lightly with your toothbrush. About once a week, you should soak your retainer in a bubbly denture cleaner to keep it disinfected. Be sure to keep your case clean also.
3. For an Essex, or clear, wireless retainer, you should soak it in mouthwash for ½-1 hour per day to give it a fresh clean taste. It may be soaked in a bubbly denture cleaner to keep it fresh. You may use a cotton tipped applicator such as “Q-Tips” instead of your toothbrush on this type to prevent small scratches in the retainer which may fill with plaque. You may also soak your retainer in an over the counter 3% hydrogen peroxide solution. Use about 1/3 hydrogen peroxide and 2/3 water.
4. Your retainer should be worn at all times except during meals unless specifically directed otherwise. You have a small retainer case in which your retainer must be kept anytime it is not in your mouth. Be sure to keep the case clean also.
5. Keep your retainers away from any heat source (dash of car, top of stove, boiling water, etc.) and do not let your pets or anyone else’s animals get to it.
6. Remember your retainer is an expensive orthodontic appliance. Take good care of it. If it ever gives you any problem or is lost or broken, call the office immediately. If you have a problem with your retainer DO NOT attempt to adjust it on your own. Call our office as soon as possible for an appointment. Otherwise, your teeth may slip back a little and that could mean treatment all over again and money spent for no good reason.
7. There is a charge to replace any lost or broken retainer.

You have been a good patient during your active appliance wearing time or you would not be receiving your retainer today. To assist you in obtaining the best possible orthodontic treatment, we must have your continued cooperation. Your tooth relationships and frequently your entire facial appearance will continue to improve for the next eighteen months to two years as nature assists us by adjusting to these corrected tooth positions.

Sample Schedule for Wearing Removable Retainers*

• First 6 months - Wear retainer continually.
• Next 6 months - Leave off 2 hours each day or more if directed.
• Next 6 months - Leave off 6 hours a day.
• Next 6 months - Leave off 12 hours a day.
• Next 6 months - Leave off 1 night a week or more if so directed.

The fixed retainer is often used for the lower teeth. This is usually worn a minimum of two years and in some cases for many years. This schedule is subject to change. Many patients ask for a fixed (glued to the teeth) upper retainer. In some cases the fixed upper retainer does not work well behind the upper front teeth because it interferes with chewing.

You should not experience great changes in the teeth if you follow this schedule, but you may have a collapse if you fail to follow the above outline. Some cases are instructed to wear retainers until the wisdom teeth are erupted or removed and others even after that.

If at any time the retainer seems to go on with difficulty or feels tight after leaving it off, increase the wearing time and drop back to the former schedule for a time. After three years of wearing the retainer the teeth are usually as permanent as can be expected. Any relapse after that time is due to natural causes, but minor shifts are expected and occur in patients even without orthodontic treatment. Therefore, slight irregularity, particularly of the lower front teeth may sometimes be accepted as the best for the particular circumstances and for normal development irrespective of orthodontic treatment. IF YOU WANT TO MINIMIZE THIS SHIFTING THEN IT IS IMPORTANT TO WEAR RETAINERS LONG TERM.

This schedule is subject to change. In case of loss or breakage of the retainer, a charge will be made.

After 12 months following active treatment completion, then a separate per visit charge will be made for visits about 6 months apart to evaluate the third molars, etc.

* This is a sample wearing schedule. It is not necessarily your wearing schedule.