3 Types of Retainers: Which is the best one for me?

When my patients think about retainers, they commonly think of the colourful plastic ones with metal wires that are worn after they their braces are removed. However, do you know that there 3 uniquely different types of retainers on the market right now, all with different pros and cons? Let’s go through each of them in turn so that you can find the best retainer for your personal oral health and wellbeing.

Hawley retainers

Hawley retainers are usually made with either plastic or acrylic with bendable metal wires and come in a variety of different colours. The wire usually goes in front of your teeth while the acrylic is made to fit snugly in your mouth. These are usually fitted tightly to your teeth and can be very durable, lasting up to 10 years for some patients!

Pros

• Adjustable so your dentist can tweak it to continue realignment of your teeth
• Helps to correct your bite and allow upper and lower teeth to touch naturally
• Can last for years with the proper maintenance
• Repairable if it’s broken by accident 
• More durable than clear retainers
• Easily removable

Cons

• Causes a very distinct lisp when speaking
• Far more noticeable in public due to the metal wire at the front
• Considerably more uncomfortable to wear and may irritate your inner lips and cheeks initially
• If not cleaned properly, bacteria may build up on it

Clear retainers 

These retainers have become much more popular in recent years, especially with the rising popularity of clear aligner brands such as Invisalign and Zenyum. Common brands for clear retainers include Essix, Zendura and Vivera. They are commonly made using plastic or polyurethane and are designed specifically for your mouth through the use of 3D imaging technology. 

Pros

• Fitted to your teeth and are comfortable to wear
• Thinner than traditional Hawley retainers
• Can have multiple copies of them made
• Almost invisible to the naked eye when worn
• Easily removable when its mealtime 

Cons

• Not adjustable and you may require new ones if your teeth shift
• Need to be replaced on a yearly basis
• Easy to misplace due to the size and lack of colour
• Can’t be repaired if broken or cracked
• Your teeth don’t touch naturally with this sort of retainer, so your natural bite could be affected
• Might become discoloured if the patient smokes or drinks coffee
• Can lose its shape if exposed to heat

Permanent retainers

These retainers are made with a metal wire and is attached to your teeth with adhesive. They are sometimes known as bonded or fixed retainers. In general, these wires are made with a braided texture and aren’t easily removed. Orthodontists will sometimes elect to prescribe permanent retainers to individuals who have a tough time being compliant with the use of removable retainers. They are more commonly used on the lower teeth as it is easier to safely attach them to the lower shelf of teeth rather than the upper.

Pros

• They don’t need to be removed before meals
• Can’t be seen as they are bonded behind your teeth
• Doesn’t cause a lisp
• Can’t be misplaced
• Can’t be damaged easily
• Complicance with instructions no longer an issue

Cons

• Harder to maintain oral hygiene as it can’t be removed
• Makes flossing very difficult
• Metal wire can sometimes irritate the inside of the mouth or tongue
• Many patients do not like the fact that they cannot remove it completely

Permanent retainers should be cleaned daily and special techniques may be needed to remove trapped food and plaque from underneath the wire. If plaque build-up is too severe, it might need to be removed and cleaned at the orthodontist occasionally. Otherwise, they are generally left in your mouth indefinitely.

So, which retainer is best for me?

Every individual has a different oral anatomy and it is best to consult with your orthodontist as to which retainer is the best one for you. Each style of retainer comes with their own unique strengths and weaknesses, so it’s advisable to take your personal habits and lifestyle when deciding on which retainer you choose to maintain a beautiful smile. The type of retainer you pick will be a constant in your life over many years, so it’s important to find the one that you find most comfortable to use properly on a long-term basis.

References

1. Clear retainer
   Chaimongkol et al.
   https://apospublications.com/clear-retainer/
2. Occlusal Contact Changes with Removable and Bonded Retainers in a 1-Year Retention Period
   Sari, Uysal, Başçiftçi, & Inan
   https://meridian.allenpress.com/angle-orthodontist/article/79/5/867/57634/Occlusal-Contact-Changes-with-Removable-and-Bonded
3. A Polysaccharide-Based Antibacterial Coating with Improved Durability for Clear Overlay Appliances
   https://pubs.acs.org/doi/abs/10.1021/acsami.8b04433
4. The effects of fixed and removable orthodontic retainers: a systematic review
   Horowitz et al.
   https://link.springer.com/article/10.1186/s40510-016-0137-x
5. Retention in orthodontics
   Johnston & Littlewood
   https://www.nature.com/articles/sj.bdj.2015.47