Orthodontic Appliances - Orthodontic Retainers
Perhaps one of the most important parts of orthodontic treatment is determining how to keep the phenomenal smile that is accomplished at the end of active treatment. There are many different kinds of retainers that have been used by orthodontists and patients over the years. In this article I will present only a few of the most commonly used retainers and the pros and cons of using each.
The Hawley retainer is a wonderfully durable and widely used retainer. It is fabricated by taking an impression of the teeth and then pouring that impression in stone or plaster. A skilled technician then takes the plaster mold and fabricates a custom retainer. The Hawley retainer is designed to contact the tongue side of the teeth with acrylic (a type of plastic). The lips side of the teeth are also contacted by a wire in order to keep the teeth in the correct position.
The Pros: The Hawley tends to be a more durable retainer then the others that will be talked about today. It is worn for about 6 months full time then at nights only thereafter. It can also be used to slightly correct small movements that occur after orthodontic treatment. It can, on a very limited basis, be used to correct very mild tooth movements that occur from patients that do not use their retainers as directed.
The Cons: The Hawley is bulky. It feels like it takes up a lot of the tongue space in the mouth during the first weeks of wear. It is not extremely pleasing to the smile during its use as it has a wire that shows on the lips side of the teeth. Some patients experience a mild taste to the plastic. It can also cause some to have slight gag reflex.
Clear retainers are nearly invisible when they are in the mouth. They are excellent retainers and are fabricated very similar to the Hawley retainers except that the retainer is simply warmed and then formed over the patient’s teeth replication. At our office we also offer to have a digital impression of your mouth taken and then a high tech 3D printer creates a precision fit aligner that gives exceptional fit and comfort.
The Pros: Clear aligners seem to be very durable but not as durable as the Hawley retainer. They are very comfortable to wear and are extremely esthetic. These retainers sleek and take very little of the tongue space. The teeth are held not only on the tongue and lip side of the tooth but also the biting surface. The biting surface coverage gives one more dimension of retention to the teeth than the Hawley retainer. The coverage on the biting surface can also really help people who grind their teeth by wearing down the retainer rather than your teeth. These retainers can be used for professional tooth whitening as well.
The Cons: These aligners are not as durable. If you grind your teeth heavily the retainer can craze, crack, and then break.
Fixed retainers are an orthodontic wire that is custom fit to the tongue side of teeth. The teeth are then prepared and orthodontic glue is used to fix the wire into its position.
The Pros: Fixed retainers are extremely esthetic. These retainers can only be seen if you are really trying to show someone that you have a retainer in. They take up the very least amount of tongue space and are always in so you don’t have to worry about losing them.
The Cons: The retainers can break and when they do it can be difficult for the patient to know it. Usually the brake is not identified until the teeth have moved and then orthodontic treatment may be needed to correct the problem. Cleaning can be much more difficult as flossing takes much more dexterity. Hygienist will sometimes complain about cleaning around these during your regular cleaning visits.