Short answer: A retainer is a retention appliance that keeps the teeth in their new positions after orthodontic treatment ends. Because the teeth and surrounding tissues tend to return to their old positions for a while, wearing a retainer is an integral part of treatment. A fixed wire bonded to the back of the front teeth, the Hawley appliance and clear tray retainers are the most common types; the wear time is determined by the orthodontist.
The last day of orthodontic treatment with braces or clear aligners is actually the start of a new phase. The short answer to what is a retainer is this: a retainer, also known as a retention appliance, is a device used to maintain the new positions the teeth have reached. No matter how successful the treatment, the teeth can shift if this stage is neglected. In this article we cover the types of retainers, how and for how long they are worn, and the rules for caring for them.
What is a retainer and why is it needed?
A retainer is a fixed or removable appliance used after orthodontic treatment to prevent the teeth from moving back to their old positions (relapse). Teeth are held in the bone by elastic fibers called the periodontal ligament. As teeth move during treatment, these fibers and the surrounding bone remodel; however, it takes months for these structures to fully adapt to the new position. Some fibers in the gums in particular “remember” the old position for longer and tend to pull the teeth back.
In addition, teeth do not stay still throughout life. Natural changes in the jaws with age, lip and tongue pressure, chewing forces and gum changes can lead to mild crowding of the front teeth over time, even in people who have never had orthodontic treatment. A retainer helps preserve the alignment of the teeth against these natural tendencies. That is why orthodontists see retainer wear not as an optional add-on but as a stage of treatment.
What kind of appliance is a fixed (wire) retainer?
A fixed retainer is a thin wire bonded to the tongue-side or palate-side surfaces of the front teeth and cannot be removed by the patient. It is usually placed on the six front teeth between the canines in the upper and lower jaws; it is not visible from the outside. During placement, the back surfaces of the teeth are prepared, the wire is shaped to fit the teeth and fixed with tooth-colored filling material. The procedure usually does not require anesthesia.
The biggest advantage of a fixed retainer is that it does not depend on patient compliance; there is no risk of forgetting to put it in. On the other hand, cleaning requires more care. Plaque and tartar tend to build up around the wire; that is why using a floss threader or interdental brush and going to regular dental check-ups are important. It is also possible for the wire to come loose at one point or break. In such a case, the teeth can shift without being noticed, so you should see your orthodontist without delay.
What are removable (Hawley and clear) retainers?
Removable retainers are appliances the patient can put in and take out, and the two most common types are the Hawley appliance and clear tray retainers. The Hawley appliance consists of an acrylic body that sits against the palate or tongue side and a thin wire that runs across the front of the front teeth. It is durable, the orthodontist can make small adjustments when needed, and it interferes less with how the upper and lower teeth contact when biting. Getting used to speaking with it may take a few days.
A clear retainer is a thin, transparent tray made from an impression or digital scan of the teeth. It is almost unnoticeable and covers all the teeth, which helps limit both forward-backward and rotational movements of the teeth. Patients who have had clear aligner treatment are already used to this form, so the transition is usually easy. Clear retainers may be more prone to wear and cracking than the Hawley appliance; they may need to be replaced at certain intervals.
Some patients use both types together; for example, a fixed wire on the lower jaw and a clear retainer worn at night on the upper jaw may be chosen. The choice depends on the type of problem before treatment, gum condition, the patient's habits and the orthodontist's assessment.
How long and how should a retainer be worn?
Retainer wear time varies from person to person; however, the current orthodontic approach recommends long-term wear, often lasting years. A common schedule for removable retainers is to wear the appliance all day (except while eating and brushing) in the first period after treatment ends, then switch to nighttime wear only when the orthodontist considers it appropriate. The timing of this transition depends on the difficulty of the treatment and the stability of the teeth.
As for how long nighttime wear should continue, many orthodontists recommend wearing the retainer for as long as you want to keep your teeth aligned. This may sound daunting at first, but once it becomes a habit, wearing a retainer at night becomes as ordinary a routine as brushing your teeth. Fixed retainers, meanwhile, can stay in the mouth for many years as long as they are checked regularly.
You can find details about the retention process after clear aligner treatment in our article retainers after clear aligners. Some practical points to keep in mind during wear are:
- Do not eat while wearing a removable retainer; take the appliance out before drinking anything other than water.
- Brush your teeth before putting the appliance in, so food debris is not trapped between the appliance and the teeth.
- If you forgot to wear it one night, you may feel slight tightness when you put it in the next night; this is a sign that the teeth have started to shift and shows the importance of consistent wear.
- If the appliance is noticeably tight or does not seat at all, do not force it; consult your orthodontist.
How do you care for a retainer, and what should you do if you lose it?
Removable retainers should be cleaned every day with a soft brush and lukewarm or cold water. Hot water should not be used, as it can distort the acrylic and tray material. Abrasive toothpastes can scratch and dull the surface of a clear retainer; so it is good to stick to the cleaning methods your orthodontist recommends. When not in use, the appliance should always be kept in its own case. Retainers wrapped in a napkin and accidentally thrown away, and pets chewing the appliance, are among the most common causes of loss.
If your retainer is lost or broken, the first thing to do is contact your orthodontist. Even a few weeks without the appliance can be enough for the teeth to shift noticeably in some patients. If you have an old retainer that still fits comfortably, you can ask your orthodontist whether it can be used temporarily until a new one is made. For patients with digital scan records, a new appliance can usually be made more quickly.
For people with fixed retainers, cleaning the spaces between the teeth around the wire is especially important in addition to brushing. To keep tartar buildup under control, dental check-ups at regular intervals and, if deemed necessary, professional cleaning are recommended. For questions about terminology, see our clear aligner glossary.
When should you see your orthodontist?
If you notice your fixed wire has come loose, your removable appliance is cracked or does not fit, or a new gap has opened between your teeth, booking a check-up without waiting prevents a small problem from growing. At our clinic in Park Oran Ofis in Oran, Çankaya, retainer check-ups, repairs and replacements are evaluated by our orthodontist; appointment details are on our contact page.
Frequently asked questions
What happens if I don't wear my retainer?
If a retainer is not worn consistently, the teeth can gradually shift back toward their old positions. Sometimes the shifting is noticed within a few weeks; sometimes it develops slowly over years. When there is significant shifting, orthodontic treatment may be needed again.
Is a fixed retainer permanent?
A fixed retainer can stay in the mouth for many years, but the wire can come loose or break. Regular dental check-ups allow such problems to be noticed early. How long the wire stays in place is decided together with your orthodontist.
Does wearing a retainer affect speech?
With removable retainers, especially the Hawley appliance, a slight lisp may occur in the first few days. In most people the tongue quickly gets used to the appliance and speech returns to normal. Because a fixed retainer is very thin on the tongue side, it usually does not affect speech.
How often should a clear retainer be replaced?
Clear retainers can wear down, become cloudy or crack over time. How often they need to be replaced depends on wear habits and conditions such as clenching. The condition of the appliance is assessed at check-ups, and a new one is made if necessary.
