The Whys and Hows of Teeth Retention

If you are considering having orthodontic work or are in the process of having it, the most important thing for you to know is as follows. Teeth move throughout life and the rate of natural tooth movement slows down as we get older, however teeth will never remain in exactly the same position.

Do not have orthodontic treatment without accepting a commitment to long term retention. This means holding the teeth with retainers in their new position following treatment.

So how much change will occur once retention is stopped? As soon as you stop wearing retainers your teeth will move, they may not go back to where they started but they will not remain in the corrected position. Teeth rest in a position of balance between the different forces applied to them. These forces come from the face and mouth, including the lips, tongue, biting forces, swallowing, and the gum elasticity. It is the balance of these forces that will determine where the teeth end up. As the balance of forces change throughout life so the teeth move.

The risk factors encouraging relapse are varied. They include not wearing your retainers, poor mouth care leading to gum disease and tooth loss, hormonal changes, smoking, drugs, excess alcohol, and some medical conditions.

There are a number of different retainer types to choose from.

Fixed retainers are a thin short strip of gold braid, multi-flex stainless steel, or glass fiber, and is stuck to the inner surface of the teeth of the anterior teeth and cannot be seen. If it breaks or comes detached it will need urgent replacement. Good cleaning and occasional maintenance is essential.

Removable retainers (also known as Essix retainers) are the see-through plastic clear type. Though attractive, they are fairly weak and harbor bacteria and do not offer a long term answer. They will need regular replacement each year or so.

Acrylic and stainless steel retainers (commonly called Hawleys retainers) are stronger than the clear retainers but are fairly bulky and will require replacement at 2-3 year intervals. They also will harbor bacteria and deteriorate with time.

Cast chrome cobalt retainers (Somnowell Retainers) are a relatively new retainer type which are long lasting, robust, and easy to clean. However they are more expensive to make than the other retainers.

So how often do you need to wear the retainer? The fixed retainer is worn all the time. It is permanent and becomes part of the mouth. Removable retainers are normally worn full time to begin with and then gradually reduced to night time wear. Each patient varies but often after a year or so the removable retainer can be worn less frequently at night. But the more you wear the retainers the better the chance of keeping your beautiful result.

It will be your responsibility to look after the retainers and to ask your dentist to do repairs and replacements. But always remember, once you stop retention your teeth will move.