Orthodontic retainers are often used before or after braces in order to hold teeth in a certain position while allowing surrounding gums and bone to adjust. Often a patient will be required to wear the retainer at all times except when eating for a period determined by the orthodontist and then after this period it may only be necessary to wear it at night.

Both the top and bottom Hawley retainers.

The most common type is the Hawley retainer, which is made of a metal wire that surrounds the teeth and keeps them in place. It is anchored in a specially-molded, sometimes brightly colored acrylic form that sits in the palate or floor of the mouth. Top and bottom retainers are usually made as necessary.

Another type is the Essix. This clear or transparent retainer fits over the entire arch of teeth and can also be produced from a mold. It is similar in appearance to Invisalign trays. Essix retainers, if worn 24 hours per day, do not allow the upper and lower teeth to touch because plastic covers the chewing surfaces of the teeth. Some orthodontists feel that it is important for the top and bottom chewing surfaces to meet to allow for “favorable settling” to occur. Essix retainers are less expensive, more inconspicuous, and easier to wear than Hawley retainers. However, for patients with disorders such as Bruxism, Essix retainers are prone to rapid breakage and wear.

The bottom (as worn) of an upper Hawley retainer resting on top of a retainer case.

Most removable retainers come with a retainer case to protect them. During the first few days of retainer use, many people will have extra saliva in their mouth. This is natural and is due to the presence of a new object inside the mouth and consequent stimulation of the saliva glands. It may be difficult to speak for a while after getting a retainer, but this speech difficulty should go away over time as one gets used to wearing it.

An entirely different category of orthodontic retainers, by definition not removable, are fixed retainers. A fixed retainer typically consists of a passive wire bonded to the tongue-side of the lower incisors. Some doctors prescribe fixed retainers regularly, especially where active orthodontic treatment effected great changes in the bite and there is a high risk for reversal of these changes. Fixed retainers are usually the source of tartar build-up, due to the placement and difficulty with flossing, tartar build-up can occur causing severe gingivitis.

Retainer Tips from Lisa

You’ve probably seen a kid in the cafeteria take out his retainer before eating lunch. Carefully, he places it in a plastic container to make sure that it’s safe while he eats. You can tell that this small plastic and metal mouthpiece is important to him. You might wonder why. Let’s find out.

What’s a Retainer?

A retainer is a piece of plastic and metal that is custom-made for each individual kid who needs one. It fits the top of the teeth and mouth. No two retainers are alike, even though many look similar. Retainers are really common. In fact, most people (kids and adults) who have braces have to wear a retainer for at least a little while after getting their braces taken off. Other people wear them to close gaps in their teeth, to help with speech problems, or to solve certain medical problems.

Why Do I Need to Wear a Retainer?

There are different reasons why you might need a retainer. The most common reason is to help your teeth stay set in their new positions after wearing braces. It’s important to wear your retainer because as your body grows, your teeth do some shifting. The retainer helps to control this shifting, which occurs naturally.

After your braces are removed, your orthodontist (a special dentist who helps straighten teeth and correct jaw problems) will fit you for a retainer. He or she will tell you how long to wear it and when. For example, you might have to wear it all day for 3 months but then only at night after the 3 months is up. Some kids may wear their retainer only at night right from the start, but they may have to wear it for more than a year. The retainer keeps the teeth in line and you won’t even notice it while you’re sleeping!

Other kids may wear retainers to close a space between their teeth or just to move one tooth. In these cases, braces aren’t needed because retainers can do the job. Often, retainers will be worn for several years to close a space, for example, and then keep the gap closed by holding the teeth in place. When you wear a retainer for any reason, certain teeth may feel pressure and might even feel sore for the first few days. If you experience this, don’t worry – it’s completely normal.

Essix retainer in the foreground (used on upper); illustration of an early Hawley retainer in the background.

Retainers can help many mouth problems besides shifting teeth. Sometimes retainers are used to help a medical problem. For example, you may have a tongue thrust (a condition where your tongue sneaks through your teeth when you talk). There are some retainers, known as a crib or tongue cage retainers, that are designed with small metal bars which hang down from the roof of your mouth. These retainers keep your tongue from going forward in between your teeth when you speak. Your tongue is trained to go to the roof of your mouth instead of through your teeth. For each person, the length of time they have to wear a tongue cage varies.

Another use for retainers is to help people with temporomandibular disorder (TMD). This disorder is usually a result of a bite problem (the teeth don’t meet together properly when the jaws are closed) called malocclusion (say: ma-luh-kloo-zhun) or bruxism (say: bruk-sih-zum), which is grinding your teeth while you sleep. Grinding stretches the muscles and joints in your mouth and jaws and sometimes can cause jaw pain or headaches. Retainers can help you by preventing your mouth from closing completely at night, which keeps you from grinding your teeth.

Getting Fitted for and Wearing Your Retainer

This is the easy part. Your orthodontist will fit you for the retainer using a material known as alginate (say: al-juh-nate). It’s a chewy, chalky kind of thick liquid that makes a mold of your teeth when you sink them into it. The fitting process is fast, painless, and doesn’t even taste bad. There are different flavors you can choose from.

Your finished retainer can be designed to express your style and likes. Sometimes you can have a picture such as Batman, Christmas trees, or Halloween bats on the plastic part of the retainer. Once you’ve been fitted for the retainer, you usually have to wait less than a week to get the real thing.

You may think your retainer feels weird at first. That’s normal. But see your orthodontist for an adjustment if the retainer causes pain or cuts or rubs against your gums. At first, you’ll need to get used to talking with it in your mouth. Talking slowly at first is a good way to practice and eventually, you won’t even notice it’s there. Dentists advise reading aloud for several minutes each day. You may also notice an increased saliva flow (more fluid in your mouth) in the first few days of wearing your new retainer, which is normal.

How to Care for Your Retainer

Retainers live in your mouth along with bacteria, plaque, and leftover food particles. You’ll want to clean your retainer every day by taking it out and brushing it with your toothbrush and toothpaste. You can also soak it in mouthwash or a denture-cleaning agent to freshen it up and kill germs.

Because the plastic of your retainer can crack if it gets too dry, you should always soak it when it isn’t in your mouth. Plastic can warp easily, so don’t put it in hot water or leave it near a heat source – like on your radiator, for example. Finally, do not bend the wires. Flipping the retainer around in your mouth will cause the wires to bend.

One important way to take care of your retainer is not to lose it! They are expensive and your mom or dad might have to pay for lost or damaged retainers. Worse yet, they might ask you to help pay for a new one! So look before you dump your lunch tray and try to keep it in the same spot at home when you’re not wearing it. In other words, retain your retainer!

Reviewed by: Lisa A. Goss, RDH, BS

Galella Spring Retainer for severe movement or movement of cuspids
Anterior Spring Clip
Option: extend adapted wires along the lingual to the distal of the first molar to make the appliance to large to aspirate
Std. Spring retainer design four incisor teeth only minor movement

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