So you’ve just got off your braces and now have a brand new set of beautiful teeth. But in order to keep your teeth straight for as long as possible and even in the years to come, the next step is to get a pair of dental retainers.

Dental retainers are custom made devices designed to hold your teeth in place after wearing braces to ensure no realignment occurs. Most dentists require patients to wear retainers for about 7-8 hours a day, or during sleep. While there are a few types of retainers out there including permanent and Hawley retainers, my patients will know that I prefer clear retainers. Aesthetic reasons aside, clear retainers are a lot comfortable compared to conventional and fixed retainers. Clear retainers may appear thin, but they are extremely strong.

But first, what are clear retainers made of?

Clear retainers are made of high-quality polypropylene or polyurethane material. They’re usually about 0.76mm in thickness and are designed to withstand any crack or stress resistance. To create a clear retainer, a mould of your teeth is created. A very thin plastic made from the materials mentioned above is then heated and sucked down the mould, creating a retainer that’s uniquely yours. Modern technology allows for greater accuracy now; intraoral scanners can virtually take a record of teeth shape and position and 3D printers can create dental models with 25-micron accuracy.

Advantages:

• Virtually invisible, so you’re more likely to wear it, which means a lesser chance of realignment or relapse
• Less bulky and more comfortable than some retainers like Hawley retainers
• Easy to take in and out
• Less likely to affect speech than Hawley retainers
• Inexpensive
• Provides better oral hygiene than fixed retainers
• Acts as a night guard for bruxism

Disadvantages:

• Should your teeth be realigned, you will need to get a new set of retainers as clear retainers are not adjustable
• They cannot be repaired if cracked or broken
• Can warp if exposed to heat
• May affect your speech more than permanent retainers
• Can become discoloured if you smoke or drink coffee
• Easily misplaced due to transparency

Can I eat with a clear retainer on?

You should always remove your retainer when eating or even drinking beverages that tend to leave stains, such as coffee. Eating with a retainer on may cause the retainer to break, and food can get stuck between the plastic and your teeth.

When food and drink gets stuck between your retainer and teeth, it can cause decay, bad breath and a stained retainer — I’m sure you don’t wish to look like you have extremely yellow teeth thanks to your stained retainer. This is also why I emphasise for my patients to try to clean their retainer daily.

How do I clean my clear retainer?

Here are a few tips I share with my patients on cleaning their clear retainers:

• Brush or rinse your retainer with warm water daily
• Use a very smooth toothbrush so you don’t scratch the clear plastic
• Avoid using toothpaste as this may too abrasive
• Use a cotton swab or Q-tip to clean the corners and edges
• Soak your clear retainer in a denture cleanser
• Avoid soaking your clear retainer in hot water as this may warp the plastic material

If the above sounds like too much effort for you, the easiest way to keep your clear retainer clean is to soak it in warm water whenever you have a chance. This will keep your clear retainer moist and loosen any lingering food pieces.

Clear retainer for lost teeth

Patients with missing teeth can also benefit from clear retainers. In fact, one useful application of clear retainers is that they can fabricate and construct a crown or denture teeth to replace missing anterior teeth. It can be challenging for orthodontists to provide both function and aesthetics for a patient who’s waiting for final tooth restoration, and a clear retainer can help act as a temporary prosthesis.

Who are clear retainers suitable for?

Clear retainers are suitable for anyone looking to maintain their straight teeth after braces. The invisibility of clear retainers is definitely a plus point for my younger patients who care about their looks.

However, I would not recommend clear retainers for patients who have undergone dental arch expansion as a clear retainer may not be rigid enough. A Hawley retainer might be better instead.

While all types of retainers are generally very effective when used properly, if appearance and comfort are your top priorities, then clear retainers might be your best bet.

When my patients think about retainers, they commonly think of the colourful plastic ones with metal wires that are worn after they their braces are removed. However, do you know that there 3 uniquely different types of retainers on the market right now, all with different pros and cons? Let’s go through each of them in turn so that you can find the best retainer for your personal oral health and wellbeing.

Hawley retainers

Hawley retainers are usually made with either plastic or acrylic with bendable metal wires and come in a variety of different colours. The wire usually goes in front of your teeth while the acrylic is made to fit snugly in your mouth. These are usually fitted tightly to your teeth and can be very durable, lasting up to 10 years for some patients!

Pros

• Adjustable so your dentist can tweak it to continue realignment of your teeth
• Helps to correct your bite and allow upper and lower teeth to touch naturally
• Can last for years with the proper maintenance
• Repairable if it’s broken by accident 
• More durable than clear retainers
• Easily removable

Cons

• Causes a very distinct lisp when speaking
• Far more noticeable in public due to the metal wire at the front
• Considerably more uncomfortable to wear and may irritate your inner lips and cheeks initially
• If not cleaned properly, bacteria may build up on it

Clear retainers 

These retainers have become much more popular in recent years, especially with the rising popularity of clear aligner brands such as Invisalign and Zenyum. Common brands for clear retainers include Essix, Zendura and Vivera. They are commonly made using plastic or polyurethane and are designed specifically for your mouth through the use of 3D imaging technology. 

Pros

• Fitted to your teeth and are comfortable to wear
• Thinner than traditional Hawley retainers
• Can have multiple copies of them made
• Almost invisible to the naked eye when worn
• Easily removable when its mealtime 

Cons

• Not adjustable and you may require new ones if your teeth shift
• Need to be replaced on a yearly basis
• Easy to misplace due to the size and lack of colour
• Can’t be repaired if broken or cracked
• Your teeth don’t touch naturally with this sort of retainer, so your natural bite could be affected
• Might become discoloured if the patient smokes or drinks coffee
• Can lose its shape if exposed to heat

Permanent retainers

These retainers are made with a metal wire and is attached to your teeth with adhesive. They are sometimes known as bonded or fixed retainers. In general, these wires are made with a braided texture and aren’t easily removed. Orthodontists will sometimes elect to prescribe permanent retainers to individuals who have a tough time being compliant with the use of removable retainers. They are more commonly used on the lower teeth as it is easier to safely attach them to the lower shelf of teeth rather than the upper.

Pros

• They don’t need to be removed before meals
• Can’t be seen as they are bonded behind your teeth
• Doesn’t cause a lisp
• Can’t be misplaced
• Can’t be damaged easily
• Complicance with instructions no longer an issue

Cons

• Harder to maintain oral hygiene as it can’t be removed
• Makes flossing very difficult
• Metal wire can sometimes irritate the inside of the mouth or tongue
• Many patients do not like the fact that they cannot remove it completely

Permanent retainers should be cleaned daily and special techniques may be needed to remove trapped food and plaque from underneath the wire. If plaque build-up is too severe, it might need to be removed and cleaned at the orthodontist occasionally. Otherwise, they are generally left in your mouth indefinitely.

So, which retainer is best for me?

Every individual has a different oral anatomy and it is best to consult with your orthodontist as to which retainer is the best one for you. Each style of retainer comes with their own unique strengths and weaknesses, so it’s advisable to take your personal habits and lifestyle when deciding on which retainer you choose to maintain a beautiful smile. The type of retainer you pick will be a constant in your life over many years, so it’s important to find the one that you find most comfortable to use properly on a long-term basis.

References

1. Clear retainer
   Chaimongkol et al.
   https://apospublications.com/clear-retainer/
2. Occlusal Contact Changes with Removable and Bonded Retainers in a 1-Year Retention Period
   Sari, Uysal, Başçiftçi, & Inan
   https://meridian.allenpress.com/angle-orthodontist/article/79/5/867/57634/Occlusal-Contact-Changes-with-Removable-and-Bonded
3. A Polysaccharide-Based Antibacterial Coating with Improved Durability for Clear Overlay Appliances
   https://pubs.acs.org/doi/abs/10.1021/acsami.8b04433
4. The effects of fixed and removable orthodontic retainers: a systematic review
   Horowitz et al.
   https://link.springer.com/article/10.1186/s40510-016-0137-x
5. Retention in orthodontics
   Johnston & Littlewood
   https://www.nature.com/articles/sj.bdj.2015.47

Many younger patients who’ve gone through years of wearing braces often find their teeth regressing due to incorrect retainer usage. After all the effort spent in order to correct one’s teeth alignment, it’s a pity to see many adolescent patients lose their beautiful smiles due to either losing one’s retainer, forgetting to wear them, or simply not understanding the importance of consistent retainer usage.

Modern retainers in 2020 are far more user-friendly than the types from the past; using 3D scanning and 3D printing technologies, these retainers fit precisely onto the teeth which allows for maximum comfort and helps teeth stay in position for longer. Let’s take a closer look as to why proper retainer usage can greatly improve our children’s quality of life and oral health.

First, why wear retainers?

Simply put, retainers for teeth are commonly worn after a patient fully corrects their teeth by wearing braces. They can be seen as the final phase of a braces treatment, and often patients will be needed to wear retainers for the rest of their lives to maintain their teeth’s alignment. 

Most dentists will require patients to wear retainers during sleep (7-8 hours a day). In some cases, the patient might need to wear retainers during the day for around a year after completing braces treatment.

Why straighten teeth in the first place?

Leaving aside aesthetic concerns, there are actually many functional reasons why having straight teeth is good for our oral and overall health and well being. Straighter teeth are much easier to clean and are less susceptible to cavities or plaque build-up. A correct bite, which retainers can correct, is also very important in chewing food properly (especially crucial for younger kids). Having straight teeth and a correct bite may allow more saliva production, which reduces plaque build-up & the chance of developing cavities.

What other benefits does wearing retainers have?

Retainers can be used as an early form of tooth grinding (bruxism) detection. If you find that the retainers constantly have perforations or holes in them, it could be a sign that your child might be grinding your teeth at night. As such, a nightguard is might be a better option as it protects the teeth and is more durable to breakages.

How do I get my kids into the habit of wearing a retainer?

Retainers are often thought to be a hassle and I see many of my younger patients unhappy that they need to wear them on a daily basis. Many kids who wear retainers throughout the day find that they are easy to misplace and find that removing them before meals can be a gross experience. However, wearing retainers doesn’t need to feel like a chore for your kids. Here are some tips & tricks to help your kids build up good retainer habits in their lives:

• If the retainer case is too small and easy to misplace, consider finding a better container for your child to carry along. It can be something like a pouch with their favourite cartoon emblazoned on it or a case in their favourite colour. Giving your child something larger and more colourful makes it much less likely for them to carelessly misplace their container.
• You can try leaving a personalized, handwritten note in your child’s retainer box. Little things like these can make the experience fun and will serve as a reminder for your child to remember to place the retainer back into the box when they’re not wearing it.
• Help your child build up the habit of keeping the box into their school bag or pockets when he or she needs to remove their retainers before meals. Also, keeping the retainer box at the same spot in their bedrooms will make it much harder to misplace.
• For the younger children, giving them little incentives like small gifts for wearing their retainers properly at night can be really encouraging and helps them see the entire process of wearing retainers in a more positive light.

At the end of the day, it may take a while for your children to become accustomed to wearing their retainers and settling into good retainer habits, but be patient and they will get there eventually. As with all good habits we try to inculcate into our children, they will be the ones thanking us in the future and it’ll be very rewarding to see their glowing, beautiful smiles when that day comes.

References

1. US4413978A - Orthodontic retainer
   https://patents.google.com/patent/US4413978A/en
2. Retainer wear and compliance in the first 2 years after active orthodontic treatment
   Kacer, Valiathan, Narendran, & Hans
   https://www.sciencedirect.com/science/article/abs/pii/S0889540610005391
3. The quality of information on the Internet on orthodontic retainer wear: a cross-sectional study
   https://www.tandfonline.com/doi/abs/10.1080/14653125.2015.1114711
4. Mechanical and geometric properties of thermoformed and 3D printed clear dental aligners
   Jindal, Juneja, Siena, Bajaj, & Breedon
   https://www.sciencedirect.com/science/article/abs/pii/S0889540619306262
5. Evaluation of fit for 3D-printed retainers compared with thermoform retainers
   Cole, Bencharit, Carrico, Arias, & Tüfekçi
   https://www.sciencedirect.com/science/article/abs/pii/S088954061831117X