Retainers After Braces: Why You Should Not Stop Wearing Them

Why do teeth move back after braces?

Each tooth is held in the bone by tiny fibres that work like ligaments. When braces move the teeth, these fibres and the surrounding bone need a long time to adapt, and some fibres around the neck of the tooth keep a kind of memory of the old position and pull towards it.

On top of that, teeth and jaws keep changing slightly as we age, even in people who never had braces. This explains the mild crowding of the lower front teeth that many adults notice. Factors that make relapse more likely include:

• Not wearing the retainer, or wearing it on and off, especially in the first months.
• How severe the problem was before treatment, such as heavy crowding or rotated teeth.
• Habits such as tongue thrusting or nail biting.
• Gum disease, which weakens the bone supporting the teeth.

What is the difference between fixed and removable retainers?

Your orthodontist chooses the type to suit your case, and sometimes combines them, for example a fixed retainer on the lower teeth and a removable one on the upper. Each has its advantages:

• Fixed retainer: a thin wire bonded behind the front teeth. It is invisible and works all the time without you having to remember it, but it needs careful cleaning because tartar builds up around it.
• Clear removable retainer: a transparent plastic tray similar to clear aligners. It is almost invisible and easy to clean, but it can crack or wear and needs replacing over time.
• Wire removable retainer (Hawley): made of wire and a plastic plate. It is durable and adjustable, but more noticeable when you speak and smile.
• With any removable type, the result depends on wearing it exactly as your orthodontist advises.

How long do you need to wear a retainer?

Instructions vary from case to case, but a common approach is to wear a removable retainer for most of the day in the first months after the braces come off, then move gradually to night-time only. Many orthodontists believe night-time wear should continue for many years, and possibly for life, if you want to keep the result.

A fixed retainer usually stays in place for years as long as it is intact and the gums around it are healthy. Do not stop wearing any retainer on your own. If it feels tight when you put it back after a few days off, that is a sign your teeth have already started to move.

How do you clean and look after a retainer?

A clean retainer protects your teeth and gums from bacteria and odour. The key steps are:

• Clean a removable retainer daily with a soft brush and lukewarm water or mild soap; avoid abrasive toothpaste, which scratches the plastic.
• Never rinse it in hot water or leave it in the car or in the sun; Eastern Province summer heat is enough to warp it.
• Take it out to eat and to drink sweetened coffee, tea or juice, then clean your teeth before putting it back, because sugar gets trapped against the teeth under the tray.
• Always keep it in its case and never wrap it in a tissue; many retainers are lost or thrown away by mistake this way.
• For a fixed retainer, use a floss threader or a small interdental brush under the wire, and have tartar removed by your dentist regularly.

What should you do if your retainer is lost or broken?

Contact your orthodontist as soon as possible, because teeth can start to move within days or a few weeks without a retainer. If you have an old retainer or your last aligner tray, your orthodontist may ask you to wear it temporarily if it still fits comfortably.

Do not try to repair a broken retainer yourself, and do not force in a retainer that no longer fits easily. If part of a fixed retainer comes loose, or the wire feels mobile or catches your tongue, book an appointment soon to have it rebonded before the teeth shift.