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Orthodontic retainers: now you have finished your orthodontic treatment how do you manage long-term post-orthodontic retention? Rupal Shah Joseph Noar Dental Update 2024 49:2, 707-709.
Retention is a key phase of orthodontic treatment that aims to maintain teeth in their corrected position following active orthodontic treatment. Although the evidence base is limited, there is now general consensus that orthodontic patients should wear their retainers life-long. This poses serious questions as to who is responsible for ensuring that the retainers are in good working order and fit for purpose. This article aims to set out some guidance for specialists, general dental practitioners and patients on the management of long-term retention, taking into consideration the best available knowledge. This article also aims to provide some guidance and rationale for retention wear and regimens. It is understood of course that these should be modified and individually assessed for each patient and their malocclusion.
CPD/Clinical Relevance: A knowledge of how to assess and maintain orthodontic retainers is essential for the practising dentist.
Article
Retention is a fundamental aspect of orthodontic treatment, and is defined by the British Standards Institute as ‘the use of an appliance or appliances to prevent relapse of tooth movements produced in treatment’.1 It is the crucial phase of orthodontic treatment which maintains teeth in their corrected position following active tooth movement.
Recently, focus on long-term retention has arisen from the British Orthodontic Society (BOS) campaign ‘Hold that Smile’2,3 and there has been considerable debate regarding the management of retention, and who takes responsibility for this.4,5
The stability of orthodontic correction has been the source of much discussion over the past 10 years, and there is now a general belief that retainers should be worn life-long if orthodontic patients want their teeth to remain in their post-treatment position, although the evidence base for this remains limited.6,7 This article discusses the current evidence for stability of tooth positions following orthodontic treatment, the physiological changes due to ageing, current evidence for retention appliances and regimens, difficulties with long-term retention management, and proposes a ‘best’ practice.
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