This South Shore Orthodontist says retainers are for life

That's right. Retainers need to be worn FOR-EV-ER. Why? Let's talk about equilibriums.

Before you start orthodontic treatment your teeth, jaws, lips, cheeks, tongue, gums, and virtually every part of your mouth are working together in their own equilibrium. Your teeth are in that position because all those acting forces ended up with balancing them there. It would be nice if our natural equilibrium led to naturally straight and properly aligned teeth and jaws. For some people, that's exactly what happens. Unfortunately, the majority end up with some sort of misalignment or malocclusion due to varying differences in development and discrepancies.

A little more pressure than usual from the lips over time will crowd the teeth a bit. A little less bony support will allow the teeth to move a bit as well. Wear the teeth down, get a cavity, or take one (or a few) out, and you again have a shifted bite waiting to express itself over time. Have your child use the pacifier too much, suck on their thumb, or even breath with their mouths open all the time, and they squeezed the cheek muscles more than what's typical and altered their tongue posture - resulting in a narrow palate.

Orthodontic treatment is another change in equilibrium. We moved the teeth and jaws into improved alignment and function, so the teeth are now pressing against the lips and cheeks and gums and bone differently than before. As a result, the mouth is trying to establish a new balance with the various forces (from the cheeks, lips, teeth, gums, bone, tongue, ligaments, etc.), and while things most likely don't go back to the original arrangement they will shift away from the nice new position we worked so hard to achieve. We call this relapse, and everyone's relaspe potential is different.

Like a forcefield around the teeth, retainers shield them from a lot of the external forces trying to reset their position from nice and straight to somewhat crooked. While this post will focus on thermoplastic full coverage retainers, we need to understand the other types as well. Hawley retainers (the acrylic with wire ones) are available, and they may be utilized instead. Then, there's the bonded retainer. It's the wire that is glued to the palatal or tongue surface of your upper and lower teeth. These are not removable but can fail due to normal function and material wear and tear.

Now, retainers aren't just something people can benefit from only after finishing their orthodontic treatment. Those with already nicely aligned teeth and bites will undergo aging changes as well, so while the shifting won't be as drastic or quick it will still happen over time. As we get older our muscles get weaker, bones become less dense, gums recede, and teeth wear and break down. It's the same reason our eyesight gets worse with age, we have wrinkles, get shorter or stand smaller, among all the other things that happen to our body over the years. These intraoral events change the balance in our mouths - the equilibrium. So, even if you never needed orthodontic treatment, you will likely need a retainer at some point in the future if you want to maintain that smile.

"Well, my teeth are straight and I haven't ever worn a retainer my entire life".

Fair enough. You're one of the small percentage of people who are fortunate enough to have very little signifiant change in your dental equilibrium throughout most of your life. That said, we cannot predict who will go through the next 10, 20, 40, 50 years with this luxury, so we play it safe and recommend everyone wear a retainer to really help preserve that beautiful smile. Remember, most people experience drastic shifting of their teeth over the years without retainers regardless of having orthodontic treatment or not. There's a reason I see plenty of adults who have never had braces as a child but are surprised to see their smiles change drastically as they get older. You don't know if the aging proces will alter your smile equilibrium until it's too late.

So, if retainers are forever, then how are we supposed to care for the retainer for years to come? Afterall, they are made of thermoplastic or a combination of acrylic, plastic, and metal, so they aren't going to last forever. However, they should last you a long time and look clean if you take very good care of them. Also, if you're ever getting dental work done, you might need a new retainer if the new restorations don't fit within the existing one. To help minimize this issue, bring your retainers to those appointments with your dentist to see if they can make the new dental work fit. It's often not possible, but sometimes things work out in your favor. Otherwise, call us immediately after this dental work completed for a purchase a replacement retainer.

This is my personal retainer.

It's coming up on 4 years old as of this post, and it looks about as clear as the day I made it. They've stayed this clean simply with regular brushing using soap and water (sometimes only water). I've never needed to use retainer cleaner or anything other than soap and water.

A major key is to make sure your teeth are impeccably clean before wearing your retainers. Clean teeth = clean retainers. If you look closely at unsightly (what are supposed to be clear) retainers, you will notice they're discolored and most likely have a sort of film on them. That discoloration is the transfer of dyes from the foods you ate all day, and that film is plaque (or tartar if it's hardened) that transferred from your teeth to the retainer. Multiple nights of this attack on the retainers will result in them being permanently stained. If your teeth are clean to start, then there is very little to transfer to the retainer. The only thing from that moment would be whatever is in your saliva overnight in addition to the small amount of waste produced by the bacteria that are always present.

Since you're doing such a great job brushing your teeth at night, then your morning routine would include a quick retainer cleaning. Simply brush them with soap and COOL water with a toothbrush. Don’t be afraid to use your regular toothbrush. If you can use soap to wash the dishes and eat with those, then you can do the same with your toothbrush. Just rinse the brush clean to remove all the soap suds. NEVER boil your retainer. Don’t even use warm water. Everyone's definition of warm is different, and water that is too warm can distort and damage the retainer. If things have gotten out of hand and you haven't been able to keep up with the oral hygiene routine, then you can utilize retainer cleaning tablets (follow the manufacturer's directions) or even a quick soak in a 50/50 water/hydrogen peroxide mixture. Just remember that tartar will persist. Tartar on your teeth is like a barnacle on a whale. It's stuck on there and can't be removed with simple brushing. The same goes for tartar on the retainers. If the tartar is too abundant, then you might need to replace your retainers.

Why not use toothpaste? Most toothpastes have aluminum oxide in them, or some sort of "whitening" polishing agent to remove surface stains. These are abrasive and will dull the surface of the retainer with regular use over time. While a soft brush can potentially act as an abrasive, its use is far gentler than adding the abrasives from toothpaste.

So, remember that you need to wear your retainers religiously and brush well regularly if you want to keep maintain that beautiful smile. If you have a bonded retainer, then monitor the glue and its integrity.

Just imagine, if I created the most hideous, uncomfortable pajamas ever known to mankind that allowed you to wake up every day with perfect health, immense wealth, and all the happiness in the world as long they were clean and worn every night, I know you'd find a way to deal with wearing them about 8 hours every night and ensuring they're clean! Retainers are special pajamas for your teeth that help to keep your smile where we want it. Wear them every night; keep them clean; replace them when they break, grow legs and disappear, fit funny, look funny, smell funny; come in for a retainer check from time to time if you're unsure; and as long as they fit securely and completely, then your bite and smile should last you a lifetime - allowing you to express yourself through your best smile.