At the end of any course of orthodontic treatment, whether that be with braces or aligners, patients will be instructed to wear retainers to ensure their teeth do not relapse. Retainers can be bonded to the lingual surfaces of the teeth or can be removable or often will be a combination of both to ensure the best long term stable results.
A typical retention regime will often involve a period of full time wear immediately following the removal of your braces then reduced wear to nighttime only followed by intermittent wear a few times a week. Given the time and money adults invest in getting orthodontic treatment and the ease of fitting retainer wear schedules into a busy life, you would think that adult patients would be incredibly compliant but looking at some of the posts that regularly appear on various forums and on social media, this appears not to be the case.
So why do adult patients stop wearing their retainers? I guess this can come down to a combination of reasons and I have collated all that I could find. The first and most obvious one is simply losing their retainers. We all know that retainers should always be stored in their case when not being worn but how many times have retainers been taken out, put to one side then forgotten and lost? It’s easy to do, I remember taking my clear Essix retainers out at a hotel one morning, putting them on the white towel beside the basin, getting ready for a busy day of meetings and just as I was getting ready to leave the room and was doing my final check, realised my wash bag wasn’t rattling as it usually does (retainers in their case are really quite noisy!) so returned to the bathroom and hunted down the missing clear, bordering on invisible, retainers which were incredibly difficult to see on the white towel. An expensive mistake if I hadn’t realised before leaving the hotel.
Retainers are quite delicate and they can become damaged if not handled carefully. Chatting to a friend recently, they mentioned that they accidentally stepped on their retainers and broke them so care needs to be taken to ensure retainers are either being worn or kept in their case. Essix retainers do also start to crack after a period of time so although care may be taken to avoid inadvertent damage, just wearing them as instructed could also lead to them becoming damaged and unusable. My first upper Hawley retainer broke fairly soon after I received it and although impossible to tell what caused it, suspect this was due to something in the manufacture of the retainer as the labial bow (the wire that goes across the front of the teeth) snapped where it was bent to go around one of my teeth.
Getting out of the habit of wearing retainers is also fairly common according to some of the comments posted. You might intend to put them in before you head off to bed but you get tired, forget to wear them for one night which becomes a second and third night and quickly weeks and months pass by. When you do get motivated to wear them again, you have the added issue of now remembering where they were last seen and when you do manage to find them, could find them sore and uncomfortable as your teeth may have moved in the months since last worn. In the worst case, they may now no longer fit resulting in having to contemplate getting in touch with your orthodontist to look at what options are available to you.
To final reason I could find was comfort. For some patients, they have endured many years of treatment and have been looking forward to the day when there will be no more plastic, acrylic, wires or metal in their mouth. Whilst not uncomfortable, you are aware of wearing retainers, they feel unnatural and slightly awkward and for some people, this is something they struggle to tolerate. I have already written about the challenge I found with my fixed retainers but one night a few weeks ago I found my removable retainers difficult to wear and just wanted to take them out. If I had done, would it have been easy to put them in again the following night and the next night after? A little bit of self discipline is required and maybe this is where some patients fail? During treatment with fixed appliances, there isn’t much you can do other than to comply but once you finish treatment, you have full responsibility for keeping your teeth straight. By continuing to wear your retainers you are making a commitment to yourself to maintain the great result achieved from your treatment and if this is something you cannot do, maybe its worth thinking about this before embarking on orthodontic treatment.
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