Retainers: Removeable vs Fixed

After completion of orthodontic treatment, retainers are used to hold the teeth in place and prevent them from moving.  There are two different types of retainers used to do this, removeable or fixed retainers.  Fixed retainers usually consist of an orthodontic wire bonded onto the back of the anterior teeth and do not extend to the posterior teeth.  Removeable retainers are made of acrylic and wires and usually extend from second molar to second molar, or are made out of a clear plastic that fit over all the teeth.  There are advantages and disadvantages to both type of retainers.

The biggest problem with fixed retainers is that they make it more difficult to maintain a good oral hygiene regiment.  In other words, it is more difficult to floss the anterior teeth.  If you want to floss the anterior teeth, you need to use a floss threader to get underneath the retention wire to floss the teeth and this needs to be used and threaded between each of the individual anterior teeth.  Most individuals that I have talked to do not do this because it takes too much time.   Not flossing under the retention wire can lead to increased incidences of gingivitis, gum disease, and/or cavities.  The advantage of fixed retainers is that they are always present on the teeth; holding them in place.

The biggest problem that I have seen with removeable is that they are sometimes lost or broken.  The advantages to removeable retainers are 1)  after the initial time period of full time wear, they usually only need to be worn at night while the patient is sleeping, 2)  they allow the patient to maintain a good oral hygiene regiment.  In our office, we use the removeable retainers to allow for good oral hygiene.

We have had many patients who have had the bonding on their fixed retainers come off that have opted to have them completely removed instead or repaired, and replaced with a removeable retainer.  If you have any questions or comments, please let me know at drmax@drmaxwood.com.


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