Types of retainers compared: which is right for you?
Dr. Todd Ehrler
Table of Contents
- Retainer Basics
- Treatment Process
Braces and clear plastic aligners straighten your teeth for a beautiful smile, but a retainer helps to keep that great smile in place for longer.
Most retainers are removable, meaning you can take them out whenever you want, but you can also get a permanent retainer. If you get a temporary retainer, you are likely to wear it at night while you sleep, but you may also wear it for a specific number of hours per day. If you recently had braces removed or completed an aligner regime, it may be recommended that you wear your retainer most of the time for the next few months.
Permanent retainers remain in place until the orthodontist takes them out. No matter which kind you get, retainers stop your teeth from returning to their original misalignment.
Retainer basics: understanding the types of retainers.
Many people have misaligned, or crooked, teeth to some degree, and they want to fix this problem for aesthetic reasons. Others may have oral health issues that contribute to misalignment problems. In both cases, your orthodontic treatment may involve a retainer at some point.
In some cases, retainers may be used to correct very small misalignment issues, but they are most commonly used to keep teeth in place after they have been straightened with braces or aligners.
There are three basic types of retainers that may be recommended.
Also called a Hawley retainer, this device is made from acrylic with a metal wire. This type of retainer holds teeth in a specific position, and it’s usually worn overnight. The consistent pressure keeps your teeth from misaligning, which is especially important for adult teeth.
The combination of metal and acrylic can be adjustable, so an orthodontist will often change the shape of the retainer to keep your teeth in alignment. Retainers are not as visible as traditional braces, but there will still be a wire around the front of your teeth.
Removable retainers may be prescribed for full-day wear for several months, especially if you have just completed a course of braces. If your orthodontist prescribes this course, you can take the retainer out for eating and brushing your teeth, but otherwise, you will keep it in. After a few months have passed, you may switch to only wearing your retainer at night.
One retainer can cost between $150 and $350. With removable retainers, you may not need to get more than one or two during your full course of treatment. Your dental insurance should cover some of the cost too.
Clear Plastic Retainers
These types of retainers look much like aligners. They are clear plastic that fully surrounds the teeth. You can also get retainers made from plastic or polyurethane after you have other orthodontic treatment like braces.
These retainers are easy to clean and remove, just like metal and acrylic removable retainers. They are typically less visible, but they are more expensive than a Hawley retainer.
Plastic or polyurethane retainers are not as sturdy as metal/acrylic retainers, so you will probably replace them once a year if your course of treatment lasts longer than 12 months. It is convenient to have multiple copies made to fit your teeth. They are easy to clean and remove for hygiene or eating, and they may be more physically comfortable for your mouth.
If your teeth change alignment for any reason, you can easily have another imprint made to adjust for this change.
You must clean plastic retainers more thoroughly than Hawley retainers. While a plastic retainer may cost about the same as a standard removable retainer — between $100 and $300 — some options can cost up to $1,200 for a set.
Plastic retainers are easier to damage, as the material may be thinner than traditional retainers. They are not adjustable on their own, so an orthodontist can’t tighten them. Instead, a new retainer will need to be made.
If you need stronger dental treatment, your orthodontist will probably prescribe a metal and acrylic removable retainer. In some cases, you may have a permanent retainer instead.
This is a strong metal wire bonded to your teeth on the lingual side. This is the side closest to the tongue. Since it is on the inside of your teeth rather than facing out, no one can see your retainer when you smile. You will wear this wire indefinitely.
The benefits of a permanent retainer are numerous, especially for adults who need consistent orthodontic care to keep their teeth in place. These retainers are not visible to others; they cannot be misplaced or lost; they are difficult to break; and they are durable and will last for years. You also do not need to follow specific instructions on when to wear them.
While permanent retainers cost more than a Hawley retainer or a clear plastic retainer — around $250 to $550 per arch, either top or bottom — your dental insurance is likely to cover more of the cost of this preventative treatment.
Permanent retainers are harder to clean since they remain in your mouth. You will need to follow specific instructions from your orthodontist on maintaining oral health while you have this retainer in place, and that includes going to all your dentist appointments. It is still possible for your teeth to shift around this retainer, so orthodontist visits may involve adjustment, which can be uncomfortable for a few days or weeks afterward.
How your retainer treatment may work.
If you go through orthodontic treatment with traditional ceramic or metal braces, you are likely to get a retainer after that treatment ends. Your orthodontist may need to adjust your retainer or make a new plastic one for you every few months or years. Typically, the schedule will involve some kind of adjustment:
- Every month.
- Every three months.
- Every six months.
- Once per year.
- Every two years.
Each adjustment will be discussed and planned out with your orthodontist. You will only need to return for a visit more frequently than this if your retainer breaks or your teeth shift. If you have a good periodontist or general dentist, they may work with your orthodontist to adjust some parts of your retainer treatment to reduce the risk of gum disease and cavities.
One study into retainers and their effectiveness found that about 40 percent of respondents combined fixed and removable retainers over the long-term course of their orthodontic treatment. However, more than half of respondents stuck with a removable retainer for at least the majority of their treatment.
As plastic and polyurethane models become more popular, more people who want aesthetically pleasing smiles ask about clear aligners, rather than braces and metal/acrylic retainers. These are a great option for mild and moderate tooth adjustment.
Following aligner treatment, you’ll be given a retainer to wear at night to keep your teeth in place. Depending on the aligner company you choose, this retainer may be included in the total treatment price or come at an additional cost (usually about $250 to $300).
Some companies recommend that you wear the retainer around the clock for the first few weeks or months following treatment completion. This is usually the most vulnerable time when your teeth want to return to their original positioning, and regular retainer use helps them to stay in their new placement.
- Clean it by following the cleaning instructions provided.
- Keep it safe if it is removable, which means keeping it in its case in a safe location.
- Stick to scheduled orthodontic checkups if you have completed a course of braces. Follow the prescribed guidelines for wearing your retainer if you have completed an aligner course of treatment.
- Get in touch with your treatment team immediately if something does not feel right.
- Let your treatment team know if your retainer is damaged or isn’t fitting properly, so you can get a new one.
The type of retainer that is right for you will depend on the positioning of your teeth, your lifestyle, and the course of teeth straightening you completed. Talk to your orthodontist or treatment team about the best next step for you.
You Have to Wear Your Retainer! (December 2015). Medium.
What to Know Before You Get a Retainer. (May 2018). Healthline.
A Survey of Protocols and Trends in Orthodontic Retention. (October 2017). Progress in Orthodontics.
Evaluation of Retention Protocols Among Members of the American Association of Orthodontists in the United States. (December 2016). American Journal of Orthodontics and Dentofacial Orthopedics.
How to Retain a Brand New Smile. Orthodontics Australia.