Dr. Greg Jorgensen
(505) 891-9440
1401 Barbara Loop SE
Rio Rancho, NM 87124

The Jorgensen Orthodontics Blog

How many hours do I need to wear my orthodontic retainer?

Posted by Dr. Jorgensen on March 1st, 2011

TimeMy orthodontist told me to wear my retainer every night but my friend has to wear hers 24/7 for the first 6 months. Why the difference? Is there any research to support one approach over the other?

There is no happier day for an orthodontic patient than the day your braces come off. It is the culmination of months of difficult brushing, flossing, watching what you eat, and wearing those pesky rubber bands. The last thing in the world we want is for the teeth to move. So how much retainer wear is really needed?

As I’ve discussed in previous posts, there is no perfect retainer for all patients and no retainer exists that will keep the teeth exactly like they were when the braces came off. In summary, genetics, wear, tongue position, and regular use cause changes that cannot be completely prevented. The purpose of retainers is to minimize these changes.

In the spirit of doing the best we can, what is the optimum number of hours of retainer wear for the least amount of movement? According to an article in the European Journal of Orthodontics by Drs. Thickett and Power, there was NO SIGNIFICANT DIFFERENCE between the amount of tooth movement when full-time and part-time (10 hours per day) retainer wear were compared. That was really good news to me since I have always prescribed that my patients wear their upper retainers nights only after an initial break-in period of 48 hours. It is good to have some research that confirms what I’ve seen clinically over the years.

Is it possible to wear your retainer too much? In some patients who use the vacuum-formed clear retainers over the front teeth, full-time wear can lead to an anterior openbite (a space between the upper and lower front teeth). The openbite that develops is the same size as the plastic covering the teeth. Typically the teeth will settle back together after you are given a wrap-around retainer that does not cover the biting edges while it is worn.

Remember that all patients are individuals and nothing works for everyone. Be sure and follow the specific instructions that your orthodontist gives YOU! He or she is the best one to evaluate your specific needs.

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 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 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. Because he has over 25,000 readers each month, it is impossible for him respond to all questions. 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.

261 comments so far in response to “How many hours do I need to wear my orthodontic retainer?”

  1. Kara LeBlanc says:

    Hi,
    I’m 57 and I just finished 1.5 years of Invisalign (top and bottom) and 3 months of full-time retainers. This caused my bite to be off – the back top and bottom teeth no longer touch at all due to the Invisalign trays. My dentist (who did the treatment) wanted to file down my front teeth but I was wary of that. So I sought treatment from an orthodontist. He had me do extrusion with rubber bands on all of my teeth except the very back ones (and not the front ones, of course) for one month. I was very diligent and after a month, he took them off and bonded metal lingual retainers on my front top and bottom teeth and also gave me new Invisalign retainers to wear at night.
    The extrusion helped a bit but my very back teeth top and bottom do not touch at all (about 1/8 inch between them) and some of my side teeth touch but some don’t. He says to give it time and eventually they’ll move back together. Alternatively, he said that he could put the attachments back onto my teeth and I can wear the rubber bands for another month. I hate that idea because the clenching was giving me headaches and caused me to develop a “jowly” look in my jaw.
    I understand the need for the Invisalign retainers but it seems to me that wearing them will not only prevent the teeth from coming back together to close the bite, but that it will cause the same problem all over again by pushing the teeth back into the jaw (or wherever it is they get pushed into!), completely defeating the extrusion.
    So my questions are:
    1. Should I have the dentist file my front teeth to make the side/back teeth meet?
    2. Should I do another month of the rubber band extrusion?
    3. My concern about “just giving it some more time to adjust on its own” is that my bite is off and I don’t want to damage my front teeth which are taking most of the pressure now.
    4. How can I manage wearing the Invisalign retainers without them re-creating the bite problem that the trays caused to begin with?
    5. Are you a fan of the bonded lingual bars staying in permanently? I don’t mind them so much but flossing them becomes a time-consuming event and, in the long run, since I’m using the Invisalign retainers, too, I’m wondering how redundant they are?
    6. I’ve used the Invisalign Crystals all along to keep the trays clean. They’re great but they’re expensive. What do you think of Retainer-Brite or any other option? I’ve read mixed reviews.
    Thank you VERY much for your helpfulness on this web site. It’s a wonderful kindness that you do here! : )

    • This is a very complex question Kara, one that I can’t diagnose or treatment plan for you over the Internet. It sounds like the orthodontist you’re working with is headed in the right direction. Generally I’m against grinding down the teeth to make them fit. As for using rubber bands to extrude the teeth, refinement aligners can be used to adjust the final positions of the teeth with little or no rubber band wear. I would discuss additional treatment with your orthodontist if you are not satisfied with your results.

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