How do you keep your teeth straight following orthodontic treatment?

Teeth alignment is maintained using retainers.

There are 2 types of retainers:

1. Fixed retainers

Fixed retainers are small lengths of wire glued to the back of the upper and lower front teeth separately to prevent them from moving.

These can be custom made (for better access for cleaning) or made directly in the mouth. Fixed retainers are meant to stay on the teeth as long as the patient desires straight teeth. Fixed retainers should be inspected regularly for signs of damage.

Issues with fixed retainers include fracture of the wire itself or fracture of the glue that holds the retainer on to the tooth surface. Retainer fractures tend to happen when a patient bites into something hard (like a nut) that gets wedged between the retainer wire and the tooth.

When a fixed retainer is damaged, it may need to be repaired or replaced. This should be done as soon as possible to prevent the unretained tooth from moving from its position.

2. Removable retainers

Removable retainers can be made out of clear plastic that covers all the teeth (Essix style) or with a wire loop and plastic backing (Hawley style). These are usually worn at night and the patient removes them during the day.

Removable retainers can be combined with fixed retainers for extra security. Removable retainers depend greatly on patient cooperation and compliance for success. Most patients stop wearing removable retainers within a year of completing orthodontic treatment due to a variety of reasons (forgetting to wear it, losing the retainer etc).

If no fixed retainer has been provided to complement the removable retainer, then relapse (where the teeth start to move) will occur. Removable retainers can also be used as bite guards for patients who grind their teeth in their sleep.

After treatment whether you are doing braces or Invisalign, you have to wear retainers. Basically I consider braces and Invisalign as an active phase of treatment, but because our mouth is a dynamic environment, as every day we talk, we eat, our tongue in cheek are always moving, so there is always pressure on the teeth, so after the braces or Invisalign is off, there is nothing holding on to the teeth anymore so there is a chance the teeth will move back to the original position especially during the first 6 to 8 months because that is the amount of time the gum takes to reorganize itself to let the teeth stabilize to the new position. So that's why retainers are very important once you finish your braces or Invisalign treatment, you need to be wearing this retainer to maintain this position, I always tell my patient the first 3 months try to wear it as much as you can, so that allows for this reorganisation of the gum and bone and things like that during this period of time, after that, you should wear the retainers before you go to sleep just for long term maintenance.

Now I continue to see my patients 6 monthly after they are done with their active phase for a few things because sometimes maybe the patient thinks they are wearing the retainers well but they are not or maybe it requires some adjustment and at the same time monitor their condition because if you catch these problems early, we can actually reverse these problems with very minimal work. But if you don't get your followup sometimes it gets very complicated and you have to redo the whole treatment again, which is what we want to avoid.

So after you have done your treatment, wear your retainers and continue to see your orthodontist regularly and that is the interval to get your regular cleaning done as well so I think you can plan all these with your dentists so you get your regular maintenance and at the same time monitor the alignment.