Retainer (orthodontic device)

Orthodontic retainers are custom-made devices, made usually of wires or clear plastic, that hold teeth in position after surgery or any method of closing spaces between teeth. They are most often used before or after dental braces to hold teeth in position while assisting the adjustment of the surrounding gums to the changes in bone. Most patients are required to wear their retainer(s) every night at first, with many also having to wear them during the day. They should not be worn while eating any food or while drinking staining or acidic beverages (e.g., Cola products and coffee). There are three types of retainers typically prescribed by orthodontists and dentists: Hawley, Essix, and Bonded (Fixed) retainers.

The best-known type is the Hawley retainer, which is made of a metal wire that surrounds the teeth and keeps them in place. It is anchored in a specially-molded, sometimes brightly-colored acrylic arch that sits in the palate or floor of the mouth. The Hawley retainer is designed for treatment after use of products that close gaps. The advantage of this type of retainer is that the metal wires can be adjusted to finish treatment and continue moving teeth as needed. [cite web |first=Lynn |last=S. |url=http://www.archwired.com/6-_come_off.htm |title=Part Six: After the Braces Come Off |accessdate=2008-08-26 |work=Braces 101: a primer for adults new to braces]

Another common type is the Essix. This clear or transparent retainer fits over the entire arch of teeth and is produced from a mold. It is similar in appearance to Invisalign trays, though the latter are not considered "retainers". Essix retainers, if worn 24 hours per day, do not allow the upper and lower teeth to touch because plastic covers the chewing surfaces of the teeth. Some orthodontists feel that it is important for the top and bottom chewing surfaces to meet to allow for "favorable settling" to occur. Essix retainers are less expensive, more inconspicuous, and easier to wear than Hawley retainers. However, for patients with disorders such as Bruxism, Essix retainers are prone to rapid breakage and deterioration.

Most removable retainers are supplied with a retainer case for protection. During the first few days of retainer use, many people will have extra saliva in their mouth. This is natural and is due to the presence of a new object inside the mouth and consequent stimulation of the salivary glands. It may be difficult to speak for a while after getting a retainer, but this speech difficulty should go away over time as one gets used to wearing it. There is usually a slight change in speech in the first 1-2 weeks, usually in the form of a lisp, but speech eventually returns to normal.

An entirely different category of orthodontic retainers are fixed retainers. A fixed retainer typically consists of a passive wire "bonded" to the tongue-side of the lower incisors. Unlike the previously-mentioned retainer types, they can not be removed by the patient. Some doctors prescribe fixed retainers regularly, especially where active orthodontic treatment effected great changes in the bite and there is a high risk for reversal of these changes. Fixed retainers may lead to tartar build-up or gingivitis due to the difficulty of flossing while wearing these retainers.

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