WHAT YOU SHOULD KNOW ABOUT ORTHODONTIC RETAINERS
Most people who have orthodontic bands to straighten their teeth, will need to wear a retainer when the bands are removed. Retainers hold the teeth in their new positions while bone around them consolidates to ensure the teeth are stable.
There are many different types of retainer. Most are removable and are worn daily for a specific period of time. Each patient is prescribed a retainer that is most suitable to retain their teeth, depending on their original positions.
Some people are prescribed a ‘bonded retainer’ – a wire which can be attached permanently to the inside surfaces of front teeth.
Bonded wires have a long history in dentistry, being used to stabilize teeth that are loose due to bone loss caused by periodontal disease. They may also be used to splint teeth which have been re-implanted after being knocked out.
Orthodontists use bonded wires to retain teeth which have a high tendency to return to their original position. Large diastemas (especially gaps between upper central incisor teeth) and severely rotated front teeth are two examples. This is because the elastic fibres that connect teeth to bone must be stretched to move the teeth and, sometimes, they relax back from the stretched position.
Bonded retainers may also be advised for patients when there is a high risk of non-compliance with wearing removable retainers.
There are both advantages and disadvantages with bonded retainers and these factors are also taken into consideration when prescribing their use. Advantages
- Bonded retainers hold teeth when there is increased likelihood for relapse.
- Bonded retainers require no compliance by the patient to remember to wear them.
- Bonded retainers are ‘invisible’ because they are fixed to the inside surfaces.
Disadvantages
- Similar food restrictions apply to bonded retainers as to bands/braces. They are fixed to teeth in the same way and will not withstand biting into hard foods.
- Bonded retainers may present problems with oral hygiene. Dental floss cannot be passed between the teeth, and so must be guided under the wire using special threaders. Plaque will grow easily between teeth and in the undercuts around the wire so that excellent toothbrushing and flossing are essential. Patients with bonded wires should see their dentist regularly for a scale and clean.
- If the adhesive breaks on any part of the bonded wire, teeth are free to move. If breakages are not detected and the teeth move unacceptably, you may need some more braces or a plate to reposition them.
- Some patients may find bonded retainers feel uncomfortably bulky or rough.
- Bonded retainers are contraindicated:
- for small teeth where adhesive will cover most of the tooth surface, thus making cleaning impossible.
- for upper front teeth when the shape of the tooth surface does not allow the wire to be placed away from the gum margin.
- when wire placed on upper front teeth might unavoidably interfere with the occlusion (bite).
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