Dental News - Retainer usage under investigation

Dental Tribune International

Tue. 7 June 2011

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CLEVELAND, OH, USA: Little has been written about retainer usage and subsequent patient compliance. For this reason, Prof. Manish Valiathan, Assistant Professor of Orthodontics at Case Western Reserve University School of Dental Medicine and member of the American Board of Orthodontics, and colleagues investigated which types of retainers are prescribed, how patients are using them and what happens when they do not follow up orthodontic work with a retainer.

In an initial study, the researchers conducted a survey of 2,000 randomly selected orthodontists throughout the country to investigate the kinds of retainers they prescribed. The majority (58.2 %) of the 658 respondents prescribed removable retainers, about 40 % opted for fixed lingual retainers. Post-braces, the majority of orthodontists said they required their patients to wear removable retainers full-time for the first nine months and then part-time after that. They also encouraged part-time retainer use throughout life.

According to the researchers, specific prior conditions may return without retainers. However, no definitive research has been conducted on the conditions that require ongoing retainer use.

In another study focused on patient compliance, Prof. Valiathan and colleagues found that 60 % of the 1,200 surveyed patients wore retainers more than ten hours a day in the first three months and 69 % wore them every night. By the time retainer users reached 19 to 24 months, 19 % had stopped wearing their retainers, while 81 % were still wearing their retainers, even if it was only one night a week. About 4 % never wore their retainers at all. Furthermore, the study indicated that age, gender and the type of retainer did not affect compliance.

A third study examined the ramifications of no retainer use within the first four weeks after braces removal. Researchers measured patients’ teeth before and after for spacing issues, overbites, underbites and tooth crowding. Thirty patients had the wires removed from their braces, but the appliances were kept affixed to the teeth to monitor any changes without a retainer. Nearly half of the participants showed no movement, and many showed positive settling of the posterior teeth, including the molars. Some however required additional orthodontic treatment at the end of the four weeks.

Further studies on a larger study population are necessary, Prof. Valiathan concluded.

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