Orthodontic retainers - Types (fixed, removable) / Pro's and con's.

Ortho Retainers.

Once your dentist has finished straightening your teeth, the retention phase of your treatment will begin. During this phase (which, at least in theory, will last the remainder of your life), you will be required to wear some type of dental retainers. This is true no matter what kind of braces or orthodontic system was used.

Types of orthodontic retainers.

There are generally two kinds of dental retainers, Removable and Fixed. And as their names imply, they differ by way of the fact that they are either permanently attached (bonded) to your teeth, or else just worn according to your dentist's instructions.

A) Permanent (fixed, bonded) retainers.
B) Removable retainers  -  Essix retainers (Vivera®),   Hawley retainers

You should thoroughly quiz your dentist about the different kinds of retainers that they offer because each one has its own distinct advantages and disadvantages. There is no single best type of retainer.

A) Fixed orthodontic retainers.

Fixed retainers are also referred to as "bonded" or "permanent" ones. And, as each of these names suggest, these types of appliances are attached (bonded) directly to your teeth. They cannot be removed.

The most common type of fixed dental retainer is a small wire that has been positioned on the backside of a patient's lower front teeth (it's sometimes called a "lingual wire").

While less common, fixed retainers are sometimes utilized with upper front teeth. The patient's "bite", however, may make this difficult or impossible.

Advantages and disadvantages of fixed retainers.

(See also: Removable retainers - Advantages / Disadvantages.)

1) Permanent retainers make it harder to clean your teeth.

The biggest disadvantage of bonded retainers is that they make it difficult for the patient to brush and floss.

If a person doesn't have the skills or motivation to perform effective oral home care, it's likely that dental plaque and tartar will accumulate. Especially when the long-term is considered, this debris can place a person at greater risk for complications such as gum disease.

Floss threaders.

Flossing around a bonded retainer typically requires the use of a floss "threader." This device helps the patient to position the floss in that area that's between their teeth and below the retainer wire.

2) Permanent retainers do their job well.

The great advantage of bonded retainers is that the dentist does not have to rely on patient cooperation. Unlike removable retainers that may be lost or simply not worn, fixed appliances are always in place to perform their duty. They may be left in for the remainder of the patient's life.

B) Removable orthodontic retainers.

There are two basic categories of removable dental retainers. They are the Essix and Hawley appliances. As discussed below, each type offers own specific advantages and disadvantages.

1) Essix retainers (Vivera®).

Essix retainers are clear plastic vacuum-formed appliances that are made on a cast of the patient's teeth.

They look very similar to Invisalign® aligners. However, since Essix retainers are just used to hold a patient's teeth in place (as opposed to realigning them), they are not switched every two weeks but instead are worn over a much longer time frame.

For Invisalign® patients, the use of Essix retainers may seem the logical choice since they are already familiar with wearing this type of appliance.

Vivera® = Essix.

Align Technology, Inc., the maker of the Invisalign® system, manufactures their own version of the Essix retainer. They call them Vivera® retainers.

Essix retainer advantages.

Essix retainer disadvantages.

  • Essix retainers are relatively fragile. They can develop cracks, breaks or holes, especially if the patient has a tooth-grinding habit. They can also become distorted if exposed to heat (wet or dry). An Essix retainer should be inspected regularly and replaced promptly once a problem has been identified.
  • While usually less than with a Hawley retainer, Essix appliances can interfere with speech. (In a similar way as with Invisalign® aligners.)
  • Essix retainers are non-adjustable. They can't be used to make further alignment refinements or corrections.

2) Hawley orthodontic retainers.

Hawley retainers have a design that consists of wires and clasps embedded in a relatively thick plastic body that covers over the roof of the patient's mouth or else lies along the tongue side of their lower teeth.

The clasps grasp selected teeth so the retainer is anchored securely. The retaining "bow" wire arches across the front side of the patient's teeth and holds and maintains their alignment.

Hawley retainer advantages.

  • A Hawley retainer is adjustable. That means it can be used to further refine the alignment of your teeth. Or, if you've failed to wear your retainer faithfully, it can be adjusted so to guide your teeth back into place.
  • Hawley's have a more rugged construction than Essix-style retainers. They are less likely to break or distort, and less likely to need to be replaced.

Hawley retainer disadvantages.

  • The appearance of a Hawley's bow wire makes it obvious that you're wearing your retainer.
  • The thickness of the retainer's plastic body (especially in the area behind your upper front teeth) can interfere with speech. Your dentist should be able to minimize this problem by trimming the plastic so it's as thin as possible.

General advantages and disadvantages of removable retainers.

Besides the specific factors outlined above for each individual type of appliance, there are some general issues associated with removable retainers that may need to be considered.

Their biggest advantage is also a disadvantage.

Just as their name implies, removable retainers can be taken out. You can remove them when you eat, brush and floss, or during those times when wearing them is not required. Of course, this also means that they can be lost or simply not worn. No retainer can perform its intended function if it is not in place.

Removable appliances can cause excessive salivation.

Wearing anything in your mouth may trick it into producing extra saliva. To our bodies, having something in our mouth usually means we are eating. And as a response, it will produce extra saliva. Over time, your body should figure things out and everything should return to normal. But at first, you may certainly notice this effect.

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