by Jeffrey Eberting, D.M.D., M.S.
You have gotten to the end of your orthodontic treatment. You have tolerated two years of metal brackets cemented to your teeth. You have endured the week’s discomfort after each appointment that your wires have been “tightened”. YOU HAVE NOT BEEN ALLOWED TO CHEW GUM THIS WHOLE TIME!!! You see the light at the end of tunnel and are happy to have these things off.
So what’s this nonsense about retainers?
Some patients and their families view this phase of treatment as the quintessential buzz kill. “We’re supposed to be done with treatment! Why do I have to wear retainers? Are you kidding me??!!” The idea of having to wear and take care of a piece of plastic for up to two additional years can seem like more treatment than one originally set out to have. As always, however, there is a rationale behind the madness…
Orthodontic treatment addresses not only the teeth, but the supporting structures as well – more specifically, the bone and the gingiva (or gums). As teeth are straightened and aligned, the gums and bone have to reshape or remodel themselves. This process takes place at a much slower rate than tooth movement. The analogy I like to make is that at the end of orthodontic treatment, the teeth are at the finish line, but the gums and bone are only halfway through the race.
“A patient’s retainers will hold the teeth at “the finish line” while the gums and bone continue reshaping themselves.”
Theoretically, if I were to remove a patient’s braces and tell them to “have a nice life,” then one could reasonably expect the teeth to relapse to the point where the bone and gums had reshaped themselves. This explains the need for retainers. A patient’s retainers will hold the teeth at “the finish line” while the gums and bone continue reshaping themselves. This reshaping process may take up to two years. Usually, at the end of the retention phase, there is a need to evaluate having the third molars (or wisdom teeth) extracted. I recommend having these teeth extracted as soon as possible. Trust me, you do not want wisdom teeth trying to erupt, pushing on the teeth in front of them, and messing up the beautiful orthodontic work for which you paid with a lot of time and money.
The big questions I get about retainers are “what type?” and “how long?” There are many types of retainers, and so long as they hold the teeth in their final positions, any type will do. Most orthodontists use the clear, plastic retainers which fit over the teeth (called an Essix retainer). People my age remember the type of retainer that has a wire coming across the upper front teeth and acrylic resting in the roof of the mouth (called a Hawley retainer). There also are cases where a wire may be bonded to tongue-side of the front teeth – either upper, lower or both – to prevent any relapse of the front teeth. We call these fixed retainers. How long does one wear these retainers? That varies by orthodontist and by patient. Most orthodontists have patients wear retainers for one or two years. I have noted that younger patients require a shorter retention phase while adult patients require a much longer retention phase.
A word of advice – please wear your retainers 24/7 and take good care of them. Clean them daily. And most importantly, please do not wrap them in a napkin and set them on your lunch tray. Hunting through the garbage bins behind the school cafeteria looking for your retainer is a not a fun way to spend your afternoon. I speak from personal experience.
Remember, now is the best time to have your orthodontic evaluation or begin orthodontic treatment. Call us at Hardin Valley Orthodontics at (865) 690-7115, and we will be more than happy to set an initial consultation to evaluate your orthodontic needs. We hope you have a happy and safe school year!!!
Dr. Eberting owns Hardin Valley Orthodontics and holds degrees from Duke University and Temple University in both General Dentistry and Orthodontics. He is a member of the American Dental Association, the TN Dental Association, the Second District Dental Society, the American Association of Orthodontists, the Southern Association of Orthodontists, and the TN Association of Orthodontists. He is a Fellow in the Academy of General Dentistry. Dr. Eberting enjoys theater, music running, politics, reading and movies. He has three children.