MIAMI, CORAL GABLES AND BRICKELL, FLORIDA – Orthodontists once prescribed retainers to patients for a certain length of time after completing their treatment with braces, and slowly tapered down their use until the patient would not wear them any longer.
That school of thought has changed, and these days when it comes to orthodontics Miami braces expert Dr. Stephen Grussmark says retainers should be a perpetual part of life for patients who want to hold onto a good thing- their proper alignment achieved through orthodontic treatment.
Types of Retainers
There are many different types of retainers used after braces. Miami Orthodontist Dr. Grussmark says patients may be prescribed the traditional retainer with a wire that runs across the front teeth and is connected to an acrylic piece that fits in the roof of the mouth. Another type of retainer, according to orthodontists – Miami, FL orthodontist Dr. Grussmark included- is the clear retainer option, often mistakenly called an Invisalign retainer.
“Both the traditional and the clear retainers have specific indications of when they are the preferred retainer of choice,” he says.
Retainers are used primarily to hold (retain) the teeth in the position that the impression was taken, Grussmark says. Slight adjustments in the position of certain teeth can be incorporated in the retainer, however.
Clear retainers, along with the feature of holding the teeth in their final position, also provide an added benefit of protecting the teeth from parafunctional habits. Since the retainer covers the occlusal surfaces of the teeth, those patients who grind or clench their teeth, often while sleeping, according to Grussmark, will benefit from this added occlusal coverage.
Why must retainers be worn for life? Because the teeth shift throughout a person’s life.
“Teeth are not set in concrete,” Grussmark says.
There are many factors that contribute to this continual movement of teeth throughout life. One of the main factors is the physiologic process of “mesial migration.” This is the term applied to describe the movement of teeth toward the midline (the central point between the two front upper and lower teeth) throughout life.
This is a normal process and is usually most often manifested in the lower front teeth, according to Grussmark.
“One of the most common occurrences that orthodontists see is lower teeth crowding in adults, primarily a result of mesial migration,” he says.
Other factors that do play a role in tooth crowding are:
- Teeth not having completely set after the completion of orthodontic treatment
- Continued changes associated with growth in a patient who has not yet reached adulthood
- Failure to wear the retainer appropriately after treatment
- The action of erupting wisdom teeth
Wisdom teeth typically are often cited as the reason. However, this is one of the least significant factors in the manifestation of lower anterior crowding.
“Wisdom teeth create a very passive eruptive force,” Grussmark says. “Patients often say their wisdom teeth are pushing their lower teeth, but we’ve had patients complain of this and upon X-ray, we’ve determined they don’t even have lower wisdom teeth.”
A Beautiful Smile for a Lifetime
For those who want to make their orthodontic treatment last and don’t want to have any significant change in the position of their teeth, it is necessary to have some time of retention- at least for a minimum amount of time, however, for a lifetime, he says.
“This doesn’t mean having to wear a retainer every day or every night for the rest of your life,” Grussmark says. “But it may mean that placing your retainer in just several times a month may be adequate to hold the teeth in place.”
Retainers After Invisalign
Contrary to what many people believe, after patients complete treatment with Invisalign, Miami Invisalign specialist Dr. Grussmark and other Invisalign providers throughout the world do not simply send a patient out with their final Invisalign aligner to wear as a retainer. Instead, most patients will get a clear retainer after their active Invisalign treatment is completed. This retainer is similar to the aligners used in their active treatment; however, it is more durable and made of a stiffer material.
“All retainers must be checked periodically by your orthodontist to be either adjusted, or tightened,” Grussmark says, adding that if it’s a clear retainer and it “stretches,” a new one may need to be made.
The average time for observation during the retention phase of treatment is initially three months, then every six months, and then possibly yearly, depending on many factors including growth, wisdom teeth, etc.
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