Congratulations! You’ve completed your orthodontic treatment and now have a beautifully aligned smile. But before you celebrate too much, there’s one important thing to understand—your teeth are not locked in place forever.
Retention is a crucial phase of orthodontic treatment. Without retainers, your teeth can shift over time, leading to unwanted changes. In this blog, we’ll explain why retention matters, the different types of retainers, and what you should know to keep your smile stable for life.
1. Teeth Move Throughout Life—With or Without Braces
It’s a common misconception that teeth stay in place once orthodontic treatment is complete. The truth is that teeth are always moving, whether you’ve had braces or not. This happens due to natural aging, changes in muscle activity, and the forces applied during chewing and speaking.
However, there’s a difference between orthodontic relapse and natural aging changes:
• Orthodontic relapse occurs when teeth move back toward their original, pre-treatment positions due to a lack of proper retention.
• Natural aging changes refer to gradual shifts in tooth position that happen to everyone, even those who have never had braces.
Because teeth have a tendency to move, wearing retainers is the best way to keep your smile as close to its final position as possible.
2. The Key to Stability: Finishing in a Naturally Stable Position
One of the most overlooked factors in long-term orthodontic stability is how the teeth are positioned at the end of treatment.
Placing the teeth in a naturally stable position—where the bite and bone support are optimized—makes it much easier to maintain results with retainers. If teeth are left in an unstable position, they will naturally try to move over time, and even a retainer may struggle to keep them in place.
A key aspect of this is ensuring that the roots are well-positioned in the bone. When the roots are in a balanced, supportive position, the forces acting on the teeth are more evenly distributed, reducing the risk of unwanted movement.
This doesn’t mean retainers are unnecessary—but it does mean that when the teeth are set up properly, keeping them in place with retainers becomes much easier.
3. No One-Size-Fits-All Retention Protocol
There is no universal retention plan that all orthodontists follow. Different specialists have their own preferences based on their training, technical skills, and how their practice is structured.
Some orthodontists prefer only removable retainers, while others recommend fixed (bonded) retainers. Many use a combination of both.
Regardless of the approach, the goal is the same—to ensure your teeth stay aligned long-term.
4. Types of Retainers: Fixed vs. Removable
Orthodontic retention generally falls into three categories:
1. Fixed (Bonded) Retainers – A thin wire that is glued behind the teeth, usually in the front.
2. Removable Retainers – Clear plastic retainers or traditional acrylic-and-wire retainers.
3. Combination of Both – A fixed retainer for continuous support plus a removable retainer for nighttime wear.
Each type has its advantages and may be recommended based on your unique case.
5. Removable Retainers: Types and Benefits
Removable retainers come in different styles, but the most commonly used are:
1. Vacuum-Formed Retainers (Essix Retainers)
• Made of clear plastic that fits snugly over the teeth.
• Most comfortable and effective for maintaining alignment.
• Nearly invisible when worn.
2. Hawley Retainers
• Made of an acrylic base with a metal wire in front.
• More rigid, making them better at maintaining arch width after expansion.
• Slightly bulkier but very durable.
For most patients, Essix retainers are the best choice because they are comfortable, effective, and easy to wear at night. However, in cases where a patient has had significant arch expansion, a Hawley retainer may be preferred to help maintain the new width of the dental arch.
6. Fixed (Bonded) Retainers: Pros and Cons
Fixed retainers are thin wires glued to the back of the upper and/or lower front teeth. These provide long-term stability without needing daily compliance.
The most common types include:
1. Twist-Flex Wire (Three Twisted Strands)
• Not recommended due to the risk of untwisting over time, which can lead to unintended tooth movement.
• Studies have shown this can actually cause relapse.
2. OrthoFlex (Dead-Chain Wire)
• My preferred choice for fixed retainers.
• It remains passive and does not exert unwanted forces, making it a safer long-term option.
3. Single Rigid Bar (Stainless Steel Wire on 2-3 Teeth)
• Attaches only to a few front teeth.
• Can still allow minor shifting of the unattached teeth, which is why I do not use this type.
Fixed retainers are especially useful for patients who are prone to relapse, but they should be monitored to ensure they stay intact.
7. How Often Should You Wear Your Retainers?
There has been a shift in retention recommendations in recent years. Research now shows that retainers do not need to be worn full-time to be effective—nighttime wear is sufficient, provided that the teeth were finished in a naturally stable position.
However, every patient is different, and some may need more frequent wear in the beginning.
8. My Retention Protocol for 95% of My Patients
For nearly all my patients, I recommend a combination approach:
✅ Fixed OrthoFlex wire bonded to the back of the upper and lower six front teeth.
✅ Essix removable retainer for night-time wear.
This provides the best of both worlds—constant support from the fixed wire and additional protection from the removable retainer.
9. What About Upper Fixed Retainers?
Some orthodontists avoid bonding upper fixed retainers because they can detach more easily. However, in my experience, the failure rate in my practice is less than 1%, making it a reliable option for my patients.
If the upper retainer is properly bonded, it can provide excellent long-term stability with minimal maintenance.
Final Thoughts: Retention is for Life
Your orthodontic journey doesn’t end the day your braces come off—it continues with lifetime retention. Teeth naturally shift over time, but with proper retainers and a well-planned retention strategy, you can maintain your beautiful smile for years to come.
The key takeaways:
✔ Teeth always move, so retainers are essential.
✔ Stability starts with finishing in a naturally stable position.
✔ There is no single retention protocol—different orthodontists have different preferences.
✔ Essix retainers are the most effective and comfortable option for most patients.
✔ OrthoFlex fixed wires provide long-term stability without active movement.
✔ Nighttime wear is generally enough for removable retainers.
By following your retention plan, you’ll ensure your smile stays as perfect as the day your braces came off!
If you have any questions about your retainers or need a replacement, feel free to contact us. Your smile deserves the best care!
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I recommend and prescribe orthodontic treatments to my patients as if they were my own family and I value meaningful relationships based on communication, confidence and trust.
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