How long will I have to wear my retainers?

• As long as you like!
• We recommend that you wear the removable upper appliance at least one year and often longer part time. This can vary from one person to another depending on the type of malocclusion corrected.
• Fixed appliances (upper and lower wires) can be kept in the mouth “indefinitely” if oral hygiene is adequate.
• Some practitioners use lower retention wires that are bonded to the 6 anterior teeth. We do not use this kind of appliance because we find that it is harder to clean and, since the glue covers the wire, it tends to wear more rapidly, which ends up with more appliance breakings. If a tooth gets loose from the wire without the patient knowing, dental plaque can accumulate and cause caries (see pictures).
• The kind of lower wire that we prefer to use is very resistant and relatively easy to maintain. It is a very stiff wire that is only bonded to the canines with a little plate that covers the glue, making it less vulnerable to wearing (less susceptible to get loose).

• With a good hygiene and regular check-ups to the dentist, the lingual wire can stay in the mouth for a very long time, like this wire that never got loose in 25 years!

Am I obliged to wear my retainers?

This question is frequently asked to us so we present information allowing each patient to make an informed decision concerning the retention phase following their orthodontic treatment.

• Retention is an integral part of an orthodontic treatment. It allows maintaining the corrections obtained during the treatment as best and as long as possible. However, it is not guaranteed that the teeth will remain stable because too many uncontrollable factors influence stability of teeth.

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• Wearing retainers is not an “obligation” because we cannot demand it from patients, but it is a very strong recommendation made by the great majority of orthodontists for all patients having undergone significant corrections.

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• Fixed appliances or wires are easier to wear because they cannot be removed, but they have certain disadvantages; they must be cleaned thoroughly to avoid facilitating the accumulation of dental plaque and can be inconvenient for certain people. Their lifetime can be several years.

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• Removable appliances, like their name indicates, can be removed from the mouth, but they can be damaged and lost more easily. They also have a shorter lifetime depending on the model used.

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• Choosing to wear retainers or not is finally up to the patient who needs to decide in which measure he/she is ready to accept a certain relapse of the corrections. There are usually no problems in having slight dental displacement if the patient finds it acceptable esthetically and if function is not affected.

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• Certain types of malocclusions and dental corrections tend to relapse more so retention is more critical in these cases.

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• Some practitioners recommend wearing retainers “for life”. Although this can ensure some stability, it cannot guarantee it. Removable retainers having a shorter lifetime, they must be replaced regularly if someone accepts to wear them “for life”, which we find unrealistic. However, fixed appliances can stay in the mouth for decades if the patient wishes so and are easily replaceable if they break. If they become loose, they can often be rebonded.

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• Not wearing retainers is neither a certainty leading to teeth retrieving their initial position. It all depends on the corrections that were made and the type of malocclusion treated. Most of the time, orthodontic corrections do not only involve dental movements but dentoalveolar, skeletal (jaw) changes as well and influence perioral musculature. It is less likely that a relapse would allow all these changes to “undo” themselves and the occlusion to go back to square one, mostly if growth occurred.

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• Some consider that most patients would not need retention. However, the problem is that it is hard to identify for sure those who absolutely need it, so we do not take any chances and prescribe retainers to all patients.

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In conclusion, retention is not “mandatory”, but strongly recommended and is part of the protocols of any major orthodontic treatment. The orthodontist only recommends a retention protocol to patients and it is up to the patients to decide what they wish to do! It all depends on what they wish in the long term