The Best Orthodontic Retainer for Your Top Teeth
Which of all the available retainers is the best for your top teeth? Unfortunately there is not one retainer that is best in all situations. Since there are compromises that must be accepted with any retainer, we try to find the mix of features that will best maintain correction that has been achieved. Ideally we look for the best balance between control of the teeth, cleansability, and the cooperation required by the patient.
Bonded retainers have good control but hard to clean
For our adolescent and adult patients, there are three types of upper retainers. The one with the most control is the bonded retainer. This is typically a thin braided gold wire that is bonded or glued to the back of every tooth. It provides the most control but is also the hardest to keep clean requiring a floss threader every time you want to floss. Threaders aren’t that expensive, they are just inconvenient.
Hawley retainers keep spaces closed but don't prevent all movement
At the other end of the spectrum are two types of removable retainers. The first is the timeless acrylic and wire retainer sometimes called a wrap-around or Hawley (pictured above). These do a good job of keeping spaces closed but are somewhat bulky and offer the least control of movement.
Clear aligner-style retainers control movement but not as effective holding spaces closed
The second option is a clear snap-on or Essix retainer (pictured to the left) that tightly encases the teeth to be retained. Not only do these retainers keep the teeth straight, they also cover the chewing surfaces providing some protection against wear due to clenching and grinding. They are not quite as effective at keeping spaces closed as wrap-arounds, but are more comfortable. Both of these retainers are removable and therefore rely completely upon patient cooperation.
The choice of which retainer to use is determined by the initial orthodontic problem. If a patient starts out with severe rotations, spaces, or excessive mobility, we use a bonded retainer. I let patients know right up front that these retainers will eventually come unglued from the backs of the upper teeth due to normal wear and that repair or replacement is inevitable. I prefer removable retainers in the upper arch if possible. If a patient had expansion of the upper arch or started with spaces between the teeth, a wrap-around retainer is prescribed. For most of our patients however my favorite upper retainer is the clear Essix snap-on. Studies show that patients continue wearing these retainers longer that the other two types to boot!
NOTE: The author, Dr. Greg Jorgensen, is a board-certified orthodontist who is in the private practice of orthodontics in Rio Rancho, New Mexico (a suburb on the Westside of Albuquerque). He was trained at BYU, Washington University in St. Louis, and the University of Iowa in the United States. Dr. Jorgensen’s 25 years of specialty practice and nearly 10,000 finished cases qualify him an expert in two-phase treatment, extraction and non-extraction therapy, functional orthodontics, clear aligners (Invisalign), and multiple bracket systems (including conventional braces, Damon and other self-ligating brackets, Suresmile, and lingual braces). This blog is for informational purposes only and is designed to help consumers understand currently accepted orthodontic concepts. It is not a venue for debating alternative treatment theories. Dr. Jorgensen is licensed to diagnose and treat patients only in the state of New Mexico. He cannot diagnose cases described in comments nor can he select treatment plans for readers. Please understand that because he has tens of thousands of readers each month, IT IS IMPOSSIBLE FOR HIM TO RESPOND TO EVERY QUESTION. Please read all of the comments associated with each article as most of the questions he receives each week have been asked and answered previously. The opinions expressed here are protected by copyright laws and can only be used with written permission from the author.