Last Updated on April 27, 2023 by Dr Gustavo Assatourians DDS
People who have undergone orthodontic treatment know that to maintain the aesthetics and alignment of the teeth, as well as the bite, it is necessary to know the types of dental retainers and use a retainer to give continuity to the treatment and guarantee the results for a long time.
Orthodontists are the specialists who direct and determine this type of treatment; therefore, they determine the best type for maximum effect long term. We will now explain the different types of retainers, their costs, as well as the advantages and disadvantages of their respective use.
What are retainers?
After orthodontic treatment, the teeth may be a little loose and the gums sensitive, making it possible for them to move and return to the position they were in. So this does not happen, a device is required to prevent them from moving.
A dental retainer is custom-made for each person’s mouth and placed over the teeth, helping to maintain the alignment achieved by orthodontic treatment.
What is the function of retainers?
When we shed our baby teeth or as we get older, the teeth tend to move naturally. Therefore, some opt for orthodontic treatment. The pressure exerted by braces on the teeth causes the bite to be modified and the teeth to loosen a little from the bone.
So it is normal that at the end of the orthodontic process, the teeth are a bit loose and tend to return to their initial state. For this reason, it is necessary to put some kind of “brake” on them to avoid the failure of the applied orthodontic treatment. The periodontal and gingival tissues are affected by the orthodontic mobilization of the teeth and need time to reorganize when the brackets are removed.
The orthodontist will determine what type of retainer to wear, whether fixed or removable, how long to wear it, and what time of day. Sometimes, it must be 24 hours, while for others it is only at night. It can be a particular time of the day as well. Since the device is custom-made and unique, in the event of damage, you should go to the orthodontist as soon as possible so it can be adjusted quickly to prevent any movement of the teeth. It is likely that you will need to continue with orthodontic consultations as a control and to check the proper functioning of the retainer.
Different types of dental retainers
Retainers come in different shapes and are made from a variety of materials.
There are two main types:
- Fixed retainers that stay in the mouth (metal)
- Removable retainers can be transparent.
These types may be combined at the time of treatment, so the alignment of the teeth lasts over time. Selecting the best one will depend upon the patient’s risk of relapse, malocclusion (misalignment of teeth), and growth pattern.
Fixed retainers
Also called permanent retainers, these are fixed by means of a wire to the teeth. They are commonly used on the lower teeth as an option for those who forget to wear their retainer at risk of relapse (such as children). However, it makes cleaning the teeth more difficult. The only one who can remove it is the orthodontist. Of note it is possible that on the first day, the patient may produce more saliva. Permanent retainers are easily attached and not very visible.
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It is important that you follow the recommendations of the orthodontist. You must be very careful with cleaning since the accumulation of tartar and plaque could cause gum problems. For this, there are cleaning tips.
Removable retainers
These retainers can be made of plastic or metal, are usually worn at night, and can be removed at any time.
They can be easily cleaned with a toothbrush, toothpaste, or floss without a problem. It is likely that it will affect the way you speak. Usually used by orthodontists on upper teeth, they are easy to remove and fit.
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The most common problem with removable retainers is that relapse is common, which can be caused by losing it and not seeking a replacement immediately.
Ask your orthodontist about care since cleaning must be done daily. It must be soaked, so get advice on how to properly clean your retainer.
Within this group there two retainers are widely used by orthodontists:
Hawley retainers
These are the retainers that most people know made of foldable wire and acrylic or plastic. The wire is attached to the acrylic in front of the teeth, and the acrylic will fit on the palate. To have this effect and fit, a mold of the teeth must be taken and the retainer custom-made.
They are usually more comfortable and do not interfere with the natural contact of the teeth.
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Clear retainers
This type of retainer is made of clear plastic or polyurethane, does not have wires, and must be custom-made by taking a mold of your mouth. Within this group, we find such brands as Essix, Vivera, and Zendura. They are similar to aligners and many patients prefer them as they are less visible, but they tend to be annoying since the teeth do not touch naturally. Depending upon the treatment, one of the suggested brands may be used. For example, Vivera is made exclusively for Invisalign patients.
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Aligners
It is very common to see this type of retainer commercially on social networks, in shopping malls, and in chain stores. It is recommended to do it under the recommendation of an orthodontic specialist or dentist, so as not to increase or exacerbate a dental health problem.
It is important that these products have the approval of the FDA or the regulatory entities in the country, usually a group of authorized oral health experts. You could also check with your preferred dental insurance.
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These orthodontic appliances are suggested to be used by those who have a lower dental aesthetic expectation since it is likely to work best with crowding or a slight separation of the teeth, making the time of use and the results less effective. However, it should always be accompanied by a dental check-up.
Costs of the different types of retainers
Costs vary depending on the area of treatment and the type of specialist or dental clinic you choose. Also, it can reduce the cost if your insurance covers them.
The following shows an estimate of the cost within the treatment package or if you must purchase it individually. Remember that you can find packages of removable retainers.
| Retainer Type | Removable | Fixed or Permanent | Aligners (commercial) | |
| Hawley | Clear | |||
| Cost without insurance | $150 – 340 each or 600 for both | $100 – 300 per tray or 500 for a set. | $250 – 550 per piece (top or bottom) or up to $1,000 per set | Commercial cost or sometimes they have monthly plans |
| Cost with insurance | It depends upon the insurance providers and the benefits of each, generally included within orthodontic benefits. | |||
| Time | Up to 10 years | Up to 2 years | Up to 20 years | 3 – 6 months |
| Adjustable | Yes | No | Yes | No |
| Repairable | Yes | No | Yes | No |
| Characteristics | Wire and hard acrylic made with a mold. The wire passes in front of the teeth and fits over the molars. | Transparent plastic, made with a mold to keep the teeth fixed. Removable trays | With fixed wire on the inside of the teeth. | Transparent removable trays, for small corrections |
It is important to note that it will take four to six months for the bone around the teeth to harden after orthodontics, but teeth continue to change as we age and our bones and other tissues change.
With permanent retainers, it can be difficult to keep your teeth clean. However, floss threads can reach areas you cannot due to the wire. Oral irrigators are another option.
All retainers have their pros and cons, so consider their cost, maintenance, ease of use, durability, and visibility preference when discussing retainers with your orthodontist.
Conclusion
Retainers are an excellent option to complete orthodontic treatment, but it is recommended not to stop using them since you have probably invested time and money in getting your teeth aligned and your bite more functional. They have given you a nice smile, it is gratifying to see the results. So we invite you to evaluate together with your orthodontist the best option taking into account your treatment and personal habits, as well as the pros and cons of each retainer option.
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Bibliography
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