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

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Hi, I’m Dr. B, practicing functional dentist for 35 years. I graduated from the Dugoni School of Dentistry in San Francisco, CA in 1987 and am a member of the American Academy of Dental Sleep Medicine (AADSM), Academy of General Dentistry (Chicago, IL), American Academy for Oral Systemic Health (AAOSH), and Dental Board of California. I'm on a mission to empower people everywhere with the same evidence-based, easy-to-understand dental health advice that my patients get. Learn more about Dr. B

A retainer is an orthodontic appliance custom-made to fit your teeth to keep them in place after braces or shift them to a better position. Retainers for teeth are usually made from metal wires or a type of plastic.

Orthodontic retainers are used for one of two purposes: 

  1. Passive retainer: To retain the new position of your teeth after braces
  2. Active retainer: To correct small orthodontic issues that don’t require braces

If you are prescribed a retainer, you will probably need to wear it for the rest of your life. 

The cost of retainers is usually included in the cost of braces or Invisalign treatment. However, retainers may cost anywhere from $150-$1,000, depending on the type.

Passive retainers should be worn overnight, even many years after braces or other orthodontic treatment, so your teeth don’t move back to their old positions.

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Types of Retainers

There are 3 types of retainers: 

  1. Removable flexible plastic retainers (Invisalign, Vivera, Essix, and Zendura)
  2. Removable Hawley retainers (metal wires with acrylic or plastic)
  3. Permanent retainers, also known as lingual retainers (wired, bonded, or fixed)

Orthodontists and dentists prescribe either passive retainers, to maintain new tooth position after braces, or active retainers, to make minor orthodontic adjustments.

Fixed or bonded retainers tend to hang onto plaque and can cause problems with oral health.

However, orthodontists frequently prefer permanent retainers. Fixed retainers can’t be removed, which means patients can’t forget to wear them. They are more frequently prescribed to younger children but can be prescribed to patients of any age.

When retainers are needed for both upper and lower teeth, you may be prescribed a removable retainer for top teeth and a permanent retainer for bottom teeth.

Retainer Comparison Chart

Below is a chart comparing different retainer types by material, cost, expected lifetime, pros, and cons.

Type of RetainerMaterialCostHow long will it last?ProsCons
Permanent retainers
(wired, bonded, or fixed)
Metal wiresUp to $500 per arch (upper or lower teeth)Forever, if well cared for– Don’t have to remember to wear at night
– Not visible during speech
– Difficult to damage or lose
– Long-lasting
– Makes flossing difficult
– May cause plaque/tartar buildup
– May cause discomfort or soreness in the tongue
– Not guaranteed to prevent teeth shifting
– Bone loss over time (long term splinting of teeth together prevent teeth from moving individually)
Removable clear plastic retainers
(Invisalign, Essix, and Zendura)
Polyurethane or a type of plastic$400-800 for both arches (not including Invisalign treatment)Up to 2 years– Fitted to your exact bite
– Clear (not noticeable during speech)
– Easy to remove for brushing, flossing, etc.
– More comfortable than other options
– Easy to order replacements
– Short lifespan
– New impressions required after other major dental work
– May cause you to salivate more
– Easy to lose or damage
– Plastics may disrupt hormones in some people
– More expensive than other options
Removable Hawley retainersMetal wires with acrylic or plastic$150-600 for both archesUp to 20 years– Simple to adjust
– Personalizable color and/or designs
– Durable
– Easy to remove for brushing, flossing, etc.
– Very cost-effective
– Metal brackets visible while you speak
– Can irritate soft tissue in the mouth
– Easy to lose or damage
– Plastics may disrupt hormones in some people

Fitting Your New Retainer

When your dentist prescribes a retainer, he or she will custom-fit you for the orthodontic appliance using alginate or another impression material. Alginate is a thick, chalky substance used to make a mold of your teeth’s new position.

The fitting process for a new retainer should not hurt.

Adjusting to a New Retainer

It may take time to adjust to your new retainer, just as it will for your new smile.

Expect to adjust to speech issues. Hawley retainers, in particular, may cause a very slight lisp when you use them at first. 

Try reading out loud for 10-20 minutes every day for a few weeks to get used to your retainer. You may need to talk more slowly than usual for a short time.

Removable retainers will probably increase your saliva flow at first, which you’ll adjust to over time.

Q: Why does my retainer hurt my teeth?

A: Your retainer may hurt your teeth as your ligaments try to get back to their original position. If you have an active retainer for orthodontic correction, it may hurt your teeth as it moves them.

At first, you may notice your teeth are sore after using your retainer while sleeping. This is totally normal. Ligaments were stretched during your orthodontic treatment, and they may become sore.

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.

How many hours per day should you wear your retainer?

You should wear your retainer 22+ hours per day for the first 9-12 months. Then, you should wear your retainer every night during sleep.

Your orthodontist or general dentist will give you specific instructions for how many hours per day to wear your retainer. Always follow dentist’s orders for retainer wear.

How long after braces do you need to wear your retainer?

You should wear your retainer for the rest of your life after braces. 

Do you have to wear a retainer forever? Yes, you must wear a retainer forever overnight to protect your teeth from shifting.

Anecdotal stories tell of patients who stopped wearing a retainer a few years after braces and never experienced shifting teeth. Others have the opposite experience and teeth shift a decade after braces.

This is not a theory you want to test. By the time you know if your teeth will shift from their new position, you may require repeated orthodontic treatment.

I still wear my Invisalign aligners 10 years after orthodontic correction. I wear them while I sleep, mountain bike, jog, and ski. Not only are my teeth not relapsing, but my retainer acts as a protective mouthguard during activities.

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).

Plus, there’s a major added benefit: Proper orthodontic position is associated with a lower risk for gum disease, cavities, and even digestion.

What Happens If You Stop Wearing Your Retainer

If you stop wearing your retainer, your teeth may shift and require new orthodontic treatment to fix your bite.

The longer the amount of time since you’ve had braces, the less likely your teeth will relapse into their old position. The process of teeth shifting is called “mesial drift.”

As we age, our bite (and hence, our face) collapses. This is part of the normal aging process.

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

Right after your braces came off, your teeth are at 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).

How to Clean Your Retainer

To clean your removable retainer:

  1. Soak your retainer in distilled water and baking soda any time you’re not wearing it.
  2. Use a stainless steel container, not plastic. Stainless steel is less likely to allow bacteria to build up.
  3. Once a week, soak your retainer in a mixture with white vinegar for 15 minutes.
  4. If you feel your retainer is not coming clean, use an ultrasonic cleaner at home or your dentist’s office.
  5. Avoid persulfate cleansers, which the FDA warns may cause allergic reactions in the mouth.
  6. Do not use mouthwash, a toothbrush, or toothpaste to clean your retainer. These may dry out or scratch the retainer, shortening its lifespan and allowing space for bacteria to hide.

To clean your fixed retainer:

  1. Practice good oral hygiene, brushing your teeth at least twice every day.
  2. Using a floss threader, floss your bonded/fixed retainer and your front teeth at least once a day.
  3. Brush the area surrounding your fixed retainer vertically as well as horizontally to clear buildup from around the metal wires.
Learn More: DIY Retainer Cleaner

How much do retainers cost?

Traditional Hawley retainers cost between $150-600. 

Replacement clear retainers, like an Invisalign or an Essix retainer, cost between $400-$800. The first retainer you get is usually included in the cost of your total orthodontic treatment.

Permanent retainers cost between $150-$500 to place or replace. Usually, the placement of a fixed/bonded retainer is included in the cost of your braces.

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 — you don’t pay separately for braces and retainers. 

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 dental insurance. If you lose or damage your retainer, you’ll probably have to pay for it out-of-pocket. Some dental insurance may cover one post-treatment retainer in a lifetime.

Final Thoughts

Your orthodontist or general dentist may prescribe a retainer for small orthodontic adjustments or to prevent your teeth moving from their new position after braces or other orthodontic treatment.

There are 2 types of removable retainers: traditional Hawley and clear retainers. Fixed/bonded retainers are permanent retainers that are most often prescribed for lower teeth, especially for younger children.

For the first 9-12 months after beginning retainer wear, you should wear your retainer all day long unless you’re actively eating, brushing, or flossing your teeth. After that time, you should wear your retainer all night during sleep for the rest of your life.

If you stop wearing your retainer, your teeth may drift back to their original position.

Care for your retainer by keeping it in water and baking soda when not wearing it and soaking it in water, baking soda, and white vinegar once a week for 15 minutes. Do not brush your retainer or rinse it with mouthwash.

3 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. Pratt, M. C., Kluemper, G. T., Hartsfield Jr, J. K., Fardo, D., & Nash, D. A. (2011). Evaluation of retention protocols among members of the American Association of Orthodontists in the United States. American Journal of Orthodontics and Dentofacial Orthopedics, 140(4), 520-526. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5161457/
  3. 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