What Is the Best Orthodontic Retainer?
Hey guys! It’s Dr. Webster and I’m here to talk about retainers. I get this question all the time about what kind of retainer is best and the answer to that is there is no superior retainer. Every retainer has its pros and cons. There are three types – two are removable, and one is fixed or glued onto the person’s teeth.
I’m going to talk about the one I don’t like the most, which is the glued on one (or they’ve been called a fixed retainer, or a bonded retainer, or a permanent retainer). It’s basically a little wire that gets glued onto the backside of your teeth. I don’t like it as well as the removable kind for a couple reasons. One, you can’t take it out. I don’t have a permanent retainer in my mouth. The reason why I don’t is because I don’t want something glued onto my teeth. I don’t have to have something glued on my teeth for the long term.
The biggest problem is that you can’t take it out (it’s glued on), if you eat something hard or something breaks it, now you’ve got a broken retainer. Because it is a wire, it can poke your tongue, it can poke your cheek, it can poke your gums, just like having braces. A lot of times though, when it breaks, you don’t have any of those symptoms and you don’t even realize that it’s broken until you see teeth shift. The reason why you don’t see it’s broken is because it looks like it’s still intact with the teeth. But then over time, because you don’t notice that it’s broken, you don’t get it addressed. You don’t get it replaced or fixed and the teeth start to shift. At that point, we’re not talking about replacing the retainer, we’re talking about possibly doing some braces or Invisalign again to get those teeth straight.
The removable kind of retainer you can take out of your mouth. You can kind of see if it’s broken and you can get it replaced before the teeth start to shift. So that’s the first thing I don’t like – because it can break. And if it does break, you don’t know if it’s broken until teeth shift.
The other reason I don’t like the fixed retainers is hygiene. These are food traps just like braces so they’re going to trap food easier. It’s going to be harder to clean. Most people that have them have a hard time flossing. Some people don’t floss and because they don’t floss, they get gingival disease, gingivitis, sometimes bone loss in severe cases because they just don’t do it if it’s too hard for them. Another thing with hygiene is the hygienist and the dentist – when you go for your cleanings and exams, they don’t have access to clean those teeth as well. They’re either not going to clean them thoroughly, they’re going to possibly get too aggressive and maybe break them off, or they’re just not going to have access to clean everything so you’re not going to get as thorough of a cleaning.
The other thing is it’s only in the front part of your teeth. This permanent retainer does not go to your back teeth so you don’t have retention or any kind of stabilization in the back. Those are the main reasons why I don’t like it. Obviously, the advantage of having a permanent retainer is you don’t have to be responsible to take something in and out of your mouth. You don’t have to put it in your purse or carry it with you, take it out at a restaurant (it’s kind of embarrassing or what not). You don’t have to worry about it because they’re always glued on.
Let’s move onto the other types of retainers, the removable types. There are two types for that. I have both types. I think they’re both great, but they do have pros and cons. The first type is the type that people usually don’t use anymore, it’s called a Holly Retainer or we call it an “old school retainer.” The pink part is acrylic, and then there’s the metal part. These are really good, but they’re not as practical. People don’t have as much of a tendency to wear them and it’s because there’s metal on the outside. They’ve either had braces for a long time or Invisalign and they don’t want to still have something that shows a metal part in the front of their teeth, so they don’t wear them because of that.
The other thing is because it’s so rigid – this material is a lot more sturdy than the plastic retainer (that’s the other type of retainer). Because it goes into the roof of the mouth sometimes and around the tongue, they’re not as comfortable. People don’t wear them as much because they lisp or they gag so it’s just not as comfortable. They don’t tend to wear them as much or they have a harder time wearing them. These kinds are actually better clinically than the clear ones. Because they don’t have plastic that goes over the teeth, the teeth are allowed to kind of settle in, but they’re not very practical. Most of the time people have a hard time wearing them.
The best kind of retainer is the clear one that I use for most of my patients. It’s the modern type, it’s removable so you can take it out when you eat, and you don’t have to break it as much. It is plastic so it’s not as strong as the other type, but it’s clear so it’s very aesthetic. People don’t know that you have a retainer in when you’re wearing it. You can floss by taking it out. You get all the advantages of a removable retainer, plus you get the aesthetics and the comfort too, because the plastic is a lot less bulky than the other type. So hopefully that answers your questions. Leave any questions you have, and I will see you later for the next orthodontic topic.