Orthodontists prescribe many types of lower retainers for their patients. Selection of a retainer depends upon the initial problems, the age of the patient, and the desired balance of cleansability, control, and cooperation. There is no perfect retainer. Retainers that allow the best oral hygiene (those that can be removed by the patient) are also the ones that depend most upon patient cooperation. Those that require the least cooperation (those glued to every tooth) are the hardest to clean. Since there are compromises with every retainer, we strive to find the best mix of features that will best minimize changes after treatment.

Retainers glued to every tooth offer control but are hard to clean
For our adolescent and adult patients, there are three types of lower retainers. The one with the most control is the bonded retainer. It is constructed from a braided gold wire that is glued to every tooth. It provides the most control but it is the hardest to keep clean requiring a threader every time a patient wants to floss. Floss threaders aren’t that expensive, they are just inconvenient.

Removable retainer allow best hygiene but require compliance
At the other end of the spectrum are removable retainers. Conventional retainers (sometimes called wrap-around or Hawley retainers – named for the inventor) are constructed of wire on the outside of the teeth and plastic on the inside. These do a good job of keeping spaces closed but are bulky and somewhat uncomfortable. The other removable retainer is a clear snap-on type that tightly encases the teeth to be retained. These are also known as Essix retainers. Not only do these retainers keep the teeth straight, they also cover the chewing surfaces providing some protection against clenching and grinding. They are not quite as effective at keeping spaces closed, but they are more comfortable to wear. Both of these retainers are removable and therefore rely completely upon patient cooperation.

Fixed retainers bonded only to the end teeth offer both cleansability and require little cooperation
My favorite retainer for the lower teeth is the bonded canine-to-canine retainer (lower 3-to-3) for three reasons. First, it is invisible (hidden behind the lower front teeth). Second, it is cleansable. Constructed of a wire that spans from canine to canine (attached only at the ends) it can be flossed without a floss threader. Our staff can show you how to do this. Third, because it is glued in place, it requires no patient cooperation beyond keeping it clean. While there is the potential for more movement than with a retainer bonded to every tooth, it is effective in over 95% of our patients. It is the best balance of appearance, cleansability, and cooperation.

To see a great way to floss your lower fixed retainer without a floss threader, take a look at my blog post here: https://www.jorgensenorthodontics.com/blog/how-to-floss-your-permanent-retainer

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.