After braces are removed, patients will normally have to wear retainers for at least six months. Some patients will need to wear them all day, except when eating or brushing their teeth. Other patients will only need to wear them at night, while they sleep, but they must be worn at least eight hours a day. Increasingly, many adolescent patients wear them full time for the first year or two and then only at night after that. Many patients prefer a clear or overlay retainer for the aesthetic appeal.
A clear retainer is made of durable plastic. It molds to the teeth and is practically invisible when worn. The purpose of these retainers, also known as Essix retainers, is to prevent teeth from shifting back into incorrect positions so that the results of the straightening treatment with braces will have time to become permanent. They cover the teeth completely and do not depend on any metal clasps or wires to attach to the teeth. A clear retainer can serve as a mouth guard to prevent a patient with bruxism from grinding his teeth at the same time as it keeps the teeth in place.
Patients tend to find them more comfortable than other types of retainers. Because they tend to be thinner than other types, overlay retainers can also crack or break more easily over time, especially if the patient also grinds his teeth at night. They can become cloudy and stained, which might be a problem for patients who need to wear them all day. Finally, they can be lost more easily, since they are transparent and can be left inadvertently on a restaurant table. They are also more sensitive to any abnormalities such as swelling when trying to get a correct fit, so the fitting process can take longer.
Cleaning the retainer is important. It should always be washed with warm water after it is taken out and before it is put back in. It should also be cleaned in a product specially designed for it or in a denture cleaner. The products designed to clean retainers eliminate bacteria and can get into the smaller crevices that other types of cleaning cannot reach. Cleaners come in liquid solution, wipes and spray forms. Because the Essix retainer is clear, is should not be brushed with a toothbrush because it can get scratched.
The cost of retainers is usually included in the overall cost for braces, but if a replacement that is not covered needs to be made, it can run from $100 to $250 on average. Additionally, the patient needs a plastic carrying case. A clear retainer is similar looking to the aligners of the Invisalign treatment. But their functions are opposite. The retainer is designed to keep the teeth in their place and prevent movement, while the Invisalign aligners are designed to move the teeth into position for correct alignment. Retainers are also often used after the Invisalign treatment is completed to maintain teeth in the correct position.
Reddy RMS, Suma S, Chandrashekar BR, Chaukse A. Retention Appliances–A Review. Int J Dent Clin. 2010; 2(3): 31-36. http://intjdc.org/index.php/intjdc/article/download/2.3.6/pdf. Accessed February 4, 2018.