Once the active period of treatment is completed, your braces are removed. The next step is called retention. Retainers are utilized to hold your teeth in their new positions until your bone, gums and muscles adapt to your orthodontic correction. You must wear your retainers as instructed, otherwise your teeth may move back toward their original positions.
There are two basic kinds of upper retainers. The retainer that we most commonly use has colored acrylic in the roof of your mouth and a wire in front of your teeth; it is called a Hawley retainer.
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Hawley retainers are our most common choice to hold the upper teeth, as they are more durable, more versatile and more adjustable than any other retainer design. After the braces are removed, facial growth and the development of “wisdom teeth” can affect the tooth positions and the bite. The Hawley retainer design allows the upper and lower teeth to lock together, which enhances tooth stability and function.
The other type of upper retainer is called an ESSIX retainer. This is a clear plastic tray that looks like an Invisalign aligner. The main advantage of an ESSIX retainer is that it is more aesthetic, but unfortunately this retainer design has some major limitations that limit its usefulness.
Because the ESSIX retainer covers the biting surfaces of the teeth, it does not allow the teeth to lock together. Its flexible plastic design also limits how much we can adjust the retainers and makes it less durable.
A fixed lower retainer is usually bonded behind the lower front teeth. It is called a permanent retainer and will be left in place for several years. Lower front teeth are most likely to move over time, so the permanent retainer is typically left in place until the “wisdom teeth” have been removed and facial growth is complete.
Patients often ask us about permanent retainers for the upper teeth, but the fit of the teeth in an ideal bite often precludes placement of a wire behind the upper front teeth. Upper permanent retainers are far more likely to break over time, and are more difficult to keep clean.
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