Orthodontic Retainers: Fixed vs Removable, Wearing Period, Care and What to Do If Lost
A retainer is an appliance that holds the teeth moved by orthodontics so they do not return to their original positions. The Korean Association of Orthodontists (KAO, 대한치과교정학회) says the tissue around the teeth needs time to settle again in the new position, and recommends wearing a removable retainer as many hours as possible for at least 1 year after orthodontics and then reducing the time as instructed. A fixed retainer bonded to the inside of the front teeth is recommended to be kept for a long time if there is no problem with care.
Key facts
| Why it is needed | Time is needed for the tissue around the teeth to reorganize in the new position (source: Korean Association of Orthodontists) |
|---|---|
| Fixed retainer | Thin wire bonded to the inside of the front teeth; keeping it long is recommended (source: Korean Association of Orthodontists) |
| If the fixed one comes off | Have it bonded again at the clinic as soon as possible (source: Korean Association of Orthodontists) |
| Removable retainer | Wear as many hours as possible for at least 1 year after orthodontics, then reduce as instructed (source: Korean Association of Orthodontists) |
| If not kept up | Teeth may return to their pre-treatment positions (relapse), and additional treatment may be needed (source: Korean Association of Orthodontists) |
Why is a retainer needed after orthodontics?
Orthodontics is a process of slowly moving teeth within the jawbone. Right after the appliance is removed, the tissue surrounding the teeth has not yet settled in the new position, so if left alone the teeth try to return to their original place.
The Korean Association of Orthodontists explains that if a retainer is not worn as instructed by the orthodontic specialist, relapse, in which the teeth move back to their pre-treatment positions, can occur and additional treatment may be needed. Which retainer to use is decided by the orthodontist based on the pre-treatment condition and how the teeth moved during orthodontics.
The retention period is the final stage of orthodontics. The day the appliance is removed is not the end of orthodontics; the result lasts long only if the period of using the retainer as instructed is also completed. During the retention period too, you visit the clinic at set intervals to check tooth positions and the condition of the retainer.
How is a fixed retainer cared for?
A fixed retainer is a method in which a thin wire is bonded to the inside of the front teeth to keep them from moving. There is no need to take it out and put it in, so you cannot forget to wear it, but calculus tends to form around the wire.
The Korean Association of Orthodontists recommends thorough hygiene care with regular check-ups, and advises that if the wire comes off a tooth you should see the dentist as soon as possible to have it bonded again. If it is left off, the teeth may move in the meantime.
For a fixed retainer, wearing it for a long time is recommended if there is no problem with care around the bonded teeth, and the orthodontist decides when to remove it. Pass floss under the wire using a floss threader or holder.
How long should a removable retainer be worn?
A removable retainer is an appliance the patient puts in and takes out, and it helps the upper-lower bite settle further while keeping the shape of the whole dental arch in a stable position. It comes in a clear plate form or a form made of wire and resin.
The Korean Association of Orthodontists recommends wearing it as many hours as possible for at least 1 year after orthodontics ends, and then reducing the wearing time as instructed by the orthodontic specialist. The wearing time may vary with the pre-treatment condition and the course of orthodontics.
If it feels tighter than usual or hurts when you put it in, it may be a sign that the teeth have already moved a little. In that case, do not cut down the wearing time on your own; tell the dentist.
What should I do if a retainer is lost or broken?
It is common for a removable retainer to be wrapped in tissue when taken out for a meal and then thrown away, or to be crushed and broken in a bag. When you take it out, always put it in its special case, and do not leave it where it can warp, such as in hot water or a car in strong sun.
If it is lost or broken, contact the dentist as soon as possible and have it remade. The teeth can move while you wait, and the longer the gap, the more likely it will not fit. The cost of remaking differs by clinic, so it is good to check in advance when starting orthodontics.
If a fixed wire has come partly off and dangles or has broken, it may injure the tongue or gums. Do not forcibly pull off or bend the loose part; if it bothers you, cover it with wax and visit the clinic.
What happens if the teeth move again after the retention period?
Teeth are not firmly fixed in the jawbone but are held in a supporting structure, so their positions can change depending on circumstances. The Korean Association of Orthodontists explains that when the dental arch shifts because of undesirable jawbone growth, trauma, gum disease or cavities, re-treatment can be considered.
If the extent of movement is not large, it is sometimes corrected again with a less noticeable appliance such as tooth-colored, lingual or clear appliances. To reduce the need for re-treatment, follow the retainer instructions, and even after reducing wearing time, have tooth positions checked at regular check-ups.
Common myths and facts
Myth: A retainer only needs to be worn for a few months.
According to the Association's guidance, a removable retainer should be worn as many hours as possible for more than 1 year after the appliance is removed, and the orthodontist decides when to reduce the time.
Myth: If the fixed wire comes off, you can just leave it.
If left off, the teeth can move, so the Association advises having it bonded again as soon as possible.
Frequently asked questions
Which is used, a fixed or a removable retainer?
The orthodontist decides based on the pre-treatment condition and how the teeth moved during orthodontics, and sometimes the upper and lower differ or the two types are used together. Ask for an explanation of the care method and the cost of remaking for each type. If it is hard to keep up wearing on your own, say so honestly and have it reflected in choosing the type.
Can I eat with a retainer in?
For a removable retainer, take it out to eat, brush your teeth and put it back. A fixed one stays attached while eating, but biting hard food hard with the front teeth can detach the wire, so be careful. If you drink sweet drinks with a removable retainer in, sugar collects inside the appliance, so take it out for anything other than water.
How do I clean a removable retainer?
Rinse it under running water and then clean it with a soft brush; avoid hot water, which can deform it. After cleaning, store it in its case, and if a white deposit forms on the appliance, ask the dentist how to care for it.
I did not wear it for a few days and now it fits tightly. Is that all right?
The teeth may have moved a little in the meantime. Do not force it in; if it stays tight or hurts, have the fit checked at the dentist. If it has not been worn for a long time, the appliance may have to be remade.
When is a fixed retainer removed?
The Korean Association of Orthodontists explains that wearing it for a long time is recommended if there is no problem with care in the surrounding mouth, and that the orthodontist decides on removal. If calculus keeps building up around the wire or gum inflammation recurs, discuss it at check-ups.