Why do I have to wear a retainer after braces?

• “When can I get my braces off?”
•  “Why do I need to wear a retainer after braces or Invisalign?”
• “How long do I have to wear my retainers after orthodontic treatment?”

These three questions are the most common questions I get asked at Feinstein 360 Orthodontics.

The answer to the first question is easy. Your braces or Invisalign will be taken off when your teeth and bite are in a stable, functional, and esthetic position.

The answers to the second and third questions are not as clear cut and before I answer directly, it is important to understand a few fundamentals.

How do teeth move?

Teeth are held in bone by periodontal ligaments connecting the root of teeth to their surrounding bone. These fibrous tissues are malleable, which means they can stretch and re-orient themselves. Periodontal ligaments are what allow teeth to move when pressure is applied to teeth. These flexible ligaments are also what allow teeth to relapse and move back to their original position after they are straight, and orthodontics is completed.

How do braces or Invisalign straighten teeth?

Teeth move once constant pressure is applied to them. It does not matter if these forces are applied by brackets and wires, with clear aligner systems such as Invisalign, or even rubber bands. I like to use the analogy of rolling a ball up a hill. If you roll a ball halfway up a hill and let go, it will simply roll back down, and all your hard work will be undone. Teeth react similarly. They need a certain amount of constant force applied to them and then, over time, they will move.

How do I stop my teeth from shifting back after braces or Invisalign?

After orthodontic treatment is completed, there are a few key protocols I ask my patients to follow.

• First, I will assess if a permanent retainer is necessary. I do not often recommend a permanent retainer, also known as a “fixed” retainer.  Patients will sometimes ask for them because they do not want to wear a removable retainer after their orthodontic treatment is completed. The reality of fixed retainers is that they are high maintenance because they are plaque traps, are difficult to floss and keep clean, and can debond from the teeth they are attached to, so I recommend a backup removable retainer that fits over the permanent retainer. Think of it like a belt and suspenders.
• There are two main types of removable retainers. One is called a Hawley retainer which is the classic retainer with a wire going across your front teeth.
• The other is a more modern version of a retainer is called an Essix retainer, which looks like Invisalign. I prefer the Essix retainer because it is more comfortable, esthetic, and protective from grinding since it covers the top and sides of your teeth.

To keep your teeth from shifting back after braces or Invisalign, it is important to wear your retainer consistently. I recommend a minimum of 16 hours of daily wear for approximately 6 months. I chose 16 hours so children do not have to bring their retainers to school, and adults can also enjoy a workday without having to wear their retainers. After this 6-month period, it is important to wear your retainers nightly if you want your teeth to stay in their current position. Over time your teeth will stabilize so you can reduce the number of nights you wear your retainers.  It is important to at least pop in your retainer once a week to see if it starts fitting tighter, which would mean your teeth are shifting!

Dr. Rachel Feinstein is a board-certified Orthodontist, and founder of Feinstein 360 Orthodontics, Richmond’s only Digital Orthodontic boutique. We specialize in Invisalign and braces in an esthetic and efficient way that will work with your lifestyle. Dr. Feinstein practices in Chesterfield, Virginia treating adults, teens, and young children from Chesterfield, Mosely, Midlothian, Richmond, Chester, and Henrico County.