Dental Retainers: Types, Cost, How Long to Wear, and How to Clean

Ah, retainers...those pesky devices that come after braces. Do you really need one? (The answer is YES!) Let’s look at how long you should wear yours, how to care for them, and the difference between the types of retainers.

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retainers

One of the most frequent questions I get from patients after they have braces removed is how long to wear their retainers.

Any dentist worth his or her degree will answer this question the same way: you should wear your retainer for an eternity, of course!

The real question is: How long do you want to wear your retainers? It all depends on how long you want your teeth to stay that way. If you stopped wearing your retainer today, you probably wouldn’t notice major changes right away.

In a few years, though…your teeth might start to shift back to their original position.

To know “how long,” you should know “why”! Let’s look at the purpose of retainers, why you need them in the first place, how long to wear your retainer, and the best retainer cleaner.

What are Retainers and What Do They Do?

In simple terms, a dental retainer is an appliance custom-made to fit your teeth that keeps teeth in place. Some retainers are also designed to correct small orthodontic issues.

There are two basic purposes for retainers your dentist or orthodontist may recommend, depending on your needs.

1. Passive Retainer

A passive retainer is what you wear after braces. Your orthodontist will fit you for a passive retainer exactly the shape of your new dental structure when the braces come off. Passive retainers hold teeth in place and prevent shifting of teeth over time.

2. Active Retainer

An active retainer is a retainer for teeth straightening. It might be prescribed if you have minor orthodontic issues to correct that don’t need invasive treatment (braces).

Active retainers aren’t exactly the shape of your teeth. Instead, they’re designed to incrementally move a tooth (or teeth) to a more desirable position.

Sometimes, active retainers are prescribed if you’ve had braces but failed to wear your passive retainer. When your dentist notices new shifting, you may not need another full set of braces, just a retainer to move teeth to the right place.

Here’s a brief overview of the types of retainers and the major pros and cons to each:

Type of RetainerMaterialCostLifetimeProsCons
Permanent (wired, bonded, or fixed)Metal wiresUp to $500 for an arch (bottom or top)Forever, if cared for– You don’t have to remember to put it in at night

– Shouldn’t be visible when you talk

– Difficult to damage or lose

– Long-lasting

– Makes flossing difficult

– Subject to additional plaque/tartar buildup

– Some patients report discomfort of the tongue

– Not guaranteed to prevent teeth shifting

Removable clear plastic (Invisalign, Essix, and Zendura)Polyurethane or a type of plastic$400-800 for both arches (not including Invisalign braces)Up to 2 years– Fitted to your exact bite

– Clear

– Easy to remove for brushing, flossing, etc.

– More comfortable than other options

– Simple to order replacements

– Don’t last as long as other options

– New impressions required after other major dental work

– More susceptible to bacteria

– Can cause more salivation

– Easy to lose or damage

– Plastics may disrupt hormones in some people

Removable HawleyMetal wires with acrylic or plastic$150-600 for both archesUp to 20 years– Simple to adjust

– Personalizable color

– Durable

– Easy to remove for brushing, flossing, etc.

– Very cost-effective

– Metal brackets visible while you speak

– More susceptible to bacteria

– Can cause more salivation

– Easy to lose or damage

– Plastics may disrupt hormones in some people

Who Needs to Wear a Retainer?

If you’ve ever had braces, you need to wear a retainer at night.

As much as it may feel inconvenient, wearing your retainer every night will prevent your teeth from moving.

Left without structure too long, your teeth could go back to their original positions.

If a patient has shown minor movement or shifting in a tooth (or teeth), it may be fixed by using an active retainer.

In a perfect world, you would see your dentist every six months on the dot and s/he would immediately notice any change in where your teeth sit. However, this isn’t always realistic. For one, your dentist may not see miniscule movements in your teeth when several months (or even a year) separates your visits.

Unlike your dentist, you get to look at your teeth every day! So, f you notice something changes in your tooth structure, it’s a great idea to be proactive and ask your dentist about it on your next visit.

If a patient in my office is curious about a gap or movement of his or her teeth, I measure it using thin metal spacers. Each visit after that, I can use the spacers to track shifting.

Once we notice the teeth becoming further or closer apart, it’s time to look into prescribing and fitting an active retainer.

Not sure how to tell if your teeth might be moving? Often, you’ll notice that your bite feels a little different or that food gets caught between teeth where it didn’t before.

It takes a long time to notice visible gaps between teeth. Not all of your teeth sit in a place where you would be able to see it, so these symptoms are typically the first signs.

To keep an eye on any possible changes after your braces come off, your orthodontist will likely request checkups at months 1, 3, 6, 12, and 24.

How Long Do I Have to Wear a Retainer?

Before I explain the answer to this question, let’s cover the basics:

Retainers should be worn 22+ hours each day for the first year, then every night from then on.

Teeth are not static. They are dynamic, always moving, and they will continue to move and shift even though you’ve had braces. They’ll try to move forward, up and outwards, and they will continually crowd.

This process is called “mesial drift.”

If you chew your nails or smoke cigarettes, teeth will move. As we age, our bite (and hence, our face) collapses. This is part of the normal aging process.

It’s why straightening your teeth and correcting drift is one way your dentist can make you look younger.

How do braces work? Dental braces correct the position of your teeth by reversing mesial drift and stretching your ligaments in order to get your teeth where you want them to be.

Right after your braces came off, you had (or have) a high probability of seeing those teeth relapse into their original position.

The teeth actually have a “memory” of the position they were in before braces. There are ligaments that connect the teeth to the bone which stretch as teeth are moved to their new position.

This is where retainers come into play. They lock the teeth into place and, over time, the memory of these ligaments will fade.

However, teeth are continually moving and shifting—not always to our advantage. It’s wise, once you’ve attained a functional and aesthetic bite with braces or Invisalign, to maintain this position as long as you can.

In fact, Invisalign was first introduced as a product designed to correct adult relapse (for adults who didn’t wear their retainers).

This brings us back to the question, how long should I wear my retainers? Ultimately, the answer is, as long as you want them to be in the right position. (Sorry!)

I still wear my Invisalign aligners, ten years after orthodontic correction. I wear them while I sleep, mountain bike, jog, and ski. Not only are my teeth not relapsing, but I am protecting them during activities.

The retainers, then, have become just more than about keeping my teeth in place. They protect my teeth from wear and tear, too. So they’ve become lifelong friends, and good friends are meant for life!

On the flipside, I’ve heard many people share the story of their cousin or sister-in-law who stopped wearing his or her retainer after 4-5 years. Years later, they discover their teeth remained firmly in place.

And it’s true—some people can stop wearing their retainer and never experience a relapse of teeth.

Do you want to know why I never recommend this to my patients?

For one, you would be testing a theory. There is no hard and fast rule about how long it takes your ligaments to stretch and your oral “memory” to set into its new position.

At best, you would be acting on blind hope that your theory is correct and your teeth won’t relapse or begin to shift back.

Second, it takes years to figure out if your theory is right. By the time you know if it’s “worked,” (meaning 2+ years in the future), your teeth may have shifted far enough to require an entirely new set of braces.

The risk, in this case, isn’t worth the reward.

People who are decades away from their braces may be able to get away with, for instance, not wearing their retainer every single night.

The longer it’s been since you’ve had braces, the less likely your teeth will relapse.

But there’s no harm in wearing your retainer during sleep or strenuous physical activity. Plus, maintaining a habit is typically the best way to maintain a habit (yes, that’s redundant on purpose).

When you start to become lax with your retainer use, your habits will only get less and less consistent. Stick to using the retainer every night.

Plus, there’s a major added benefit: Keeping your teeth in line isn’t just good for your teeth to make brushing and flossing easier. It’s associated with an improvement in overall health!

How to Care for Your Retainer

Retainers are meant to last a very long time, but the way you care for them will make a big difference. I wrote an article about how to clean retainers, but here are the basics:

Most things you may use to clean your retainer are actually toxic or abrasive. Persulfate, in retainer/denture cleansers like Polident and Efferdent, is actually an allergen the FDA warns never to use in the mouth. Unfortunately, retainers are porous and absorb whatever they are exposed to.

Mouthwash usually contains sodium lauryl sulfate and/or alcohol. These substances dry out retainer material (and your mouth). Brushing your retainer isn’t a great idea, either. It can gouge the material and leave microscopic space for food particles and bacteria to live.

Keep your retainer in a stainless steel container filled with distilled water and baking soda. When it’s not in your mouth, your retainer needs to stay moist. Distilled water is best, as the minerals in tap water can seed the formation of plaque and calculus.

Once a week, soak your retainer in white vinegar for 15 minutes. This helps to remove any stubborn bacteria. After you soak it for just 15 minutes, be sure to thoroughly rinse the retainer and then put it back in the baking soda solution (or your mouth).

If you feel like your retainer is hanging onto gunk or needs a more thorough cleaning, take it to your dentist. He/she can use an ultrasonic cleaner to give it a deep clean without abrasive chemicals.

Retainer FAQs

Q:

Why does my retainer hurt my teeth?

A: At first, you may notice your teeth are sore after using your retainer while sleeping. This is totally normal—your teeth, freed from braces, want to head back to their original positions.

Remember the ligaments stretching? That’s probably where the sore feeling is coming from.

If you were prescribed an active retainer for orthodontic correction, you may also experience this same soreness as teeth begin to move.

But you shouldn’t notice sharp pain related to your retainer.

If you’re concerned that your retainer was not properly fitted because it causes acute pain, contact your orthodontist right away.

Q:

What will happen if I stop wearing my retainer?

A: As we’ve seen above, failing to use your retainer can lead to relapse of the teeth back to their original position.

If you’ve just had your braces taken off, missing even a few days is a poor choice and could lead to the retainer making your teeth more sore.

But after a few years have passed, it’s likely that missing a day or two will result in no lasting or noticeable changes.

After 4-5 years, some people are able to wear their retainers less. As I explained, you wouldn’t know for sure if it “worked” until several months or even years had passed. That’s why it’s not a good idea to stop wearing it altogether.

Remember, teeth move slowly. Most changes, both positive and negative, happen over a long span of time.

Don’t get in the habit of leaving your retainer out, even if you won’t be able to see the effects of it right away.

Q:

What is a bonded retainer?

A: Some permanent retainers are bonded behind the teeth so you don’t have to take them in or out.

I don’t recommend these bonded retainers, but many orthodontists love them. They’re often used for young children who may have a hard time remembering to wear their retainer.

Most patients given bonded retainers will have their dentists remove them after 10 years or so. I personally removed two just last month!

Unfortunately, bonded retainers collect tartar and calculus. They also make it much harder to floss.

If your orthodontist recommends a bonded retainer for your child, keep these risks in mind. You may opt for a standard retainer instead and choose to keep a close eye on your child’s retainer habits.

Q:

What are the best types of retainers?

A: The simple answer for “what is the best retainer?” is whatever works best for your bite!

You can typically get one of two types of retainers: a hawley retainer or clear retainer like Vivera (for use after Invisalign).

Hawley retainers are more common and the old-fashioned variety you’ve probably seen before. These use metal wire around your six anterior teeth on both sides to hold teeth in place.

Clear retainers are made from flexible thermoplastic. They use no metal and are shaped to apply exactly the pressure each section of your mouth and teeth need.

An opposing retainer affects the other side of teeth (a retainer on the bottom for top teeth, for example). For these, it’s probably best to have a hawley retainer.

Sometimes, clear retainers don’t function well when you bite down and hits back teeth too soon. In these cases, your dentist may opt for prescribing you a hawley retainer instead.

Orthodontists may also use a combination retainer with a hawley on top and a clear retainer on the bottom (or vice versa).

There are pros and cons to both types of retainers.

Hawley retainers may interfere with speech and cause a slight lisp at first. It can also be seen while talking if you’re wearing it throughout the day. Some people report the metal wire can irritate gums more frequently.

Clear retainers are more aesthetically pleasing for many people. But using a clear braces/retainer system like Invisalign is significantly more expensive than other options. They also must be worn for longer periods of time each day.

Q:

How much do retainers cost?

A: Traditional hawley retainers cost anywhere from $150-600.

You’ll pay more to be fitted for and purchase your hawley retainer through your orthodontist than your dentist.

If you carry dental insurance that offers two-step orthodontic coverage, a portion of your hawley retainer is probably covered. It’s a good idea to check with your insurance company ahead of time to be sure.

Invisalign and other clear retainers are part of the entire realignment process. There aren’t separate braces and retainers. The cost of these long-term retainers is built-in to what you pay from the start.

One benefit of using Invisalign is that you can order replacement retainers without even visiting your dentist—all you have to do is call.

Replacement retainers are typically not covered by insurance. If you lose or damage your retainer, you’ll probably have to pay for it out-of-pocket.

Q:

Can retainers straighten teeth?

A: Active retainers are designed to straighten and realign teeth that have moved slightly but may not require full braces. Your orthodontist will figure out the amount of time and correction you can achieve at your consultation.

Hawley retainers can straighten teeth using wires. Clear retainers use bubbles and other attachments to straighten teeth as needed.

Passive retainers given after braces aren’t used to straighten teeth, but rather to keep them in their optimal position.

Final Thoughts on Retainers

Retainers are an often necessary but somewhat inconvenient part of orthodontic health.

If you’ve needed braces in the past, passive retainers are a lifelong commitment you make. They ensure your teeth don’t relapse back to their original position.

You may also need a retainer if you have teeth that have shifted slightly, but not enough to require a full set of braces.

If you notice food getting stuck in new places or a change in your bite, ask your dentist to measure the movement. An active retainer might be a good idea to correct slight shift.

The longer it’s been since you’ve had braces, the more lax you can technically become without fear of your teeth moving. That means several years, not just a few months.

However, I still wear my retainer every night and during strenuous physical activity to maintain the habit.

The best way to care for your retainer is to soak it in distilled water and baking soda when it’s not in your mouth. Soak it for 15 minutes once a week in white vinegar. Avoid brushing your retainer or soaking it in mouthwash or effervescent tablets.

I know it’s not the most fun thing to do. But keeping up with maintenance and wearing it regularly can help those tiny shifts of your teeth from becoming more serious.

I hope you feel confident in the “why” behind your retainer, as well as the answer to, “How long should I wear my retainer?”

Read Next: How to Clean Retainers Without Harsh Chemicals

References

References

  1. Andriekute, A., Vasiliauskas, A., & Sidlauskas, A. (2017). A survey of protocols and trends in orthodontic retention. Progress in orthodontics, 18(1), 31. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5632597/
  2. Alfuriji, S., Alhazmi, N., Alhamlan, N., Al-Ehaideb, A., Alruwaithi, M., Alkatheeri, N., & Geevarghese, A. (2014). The effect of orthodontic therapy on periodontal health: A review of the literature. International journal of dentistry, 2014. Full text: https://www.hindawi.com/journals/ijd/2014/585048/?_ga=2.78540116.1982780395.1544415086-864268254.1544415086

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