Retainers in Cologne – examples, images & frequently asked questions

Retainers hold the teeth in their new position after treatment and prevent them from moving back. There are two main types:

• Fixed (lingual) retainer: a thin wire on the back of the teeth – invisible, it does not interfere with speaking or eating and often stays in place for several years. If oral hygiene is inadequate, plaque and tartar can build up.
• Removable retainer: made of plastic (possibly with a wire), individually fitted and easy to take out. Two types: the Hawley retainer (wire plus palatal plate, durable and easy to adjust) and vacuum-formed retainers (VFR) made of thin, clear plastic (esthetic, but they wear down over time).

Wearing time and care: removable retainers are worn around the clock at first and later only at night; fixed ones usually stay in place for several years. Clean removable retainers daily under running water with a soft brush; for fixed ones, careful cleaning – ideally professional cleaning – helps. In a direct comparison, clear vacuum-formed retainers and Hawley retainers held the teeth in position almost equally well – the measured difference was 0.01 millimeters.

How long depends on the individual case, the type of correction and the recommendation of your practice. In the first months after the braces come off, the retainer is worn every day, after that often only at night – frequently over the long term, so that the teeth stay in position. Follow the wear instructions to secure the result permanently.

Without retention, teeth often shift again; studies recommend a long-term, often permanent retention phase.1

Yes, in most cases it is. After teeth have been corrected, they have to be held in their new position, otherwise they gradually move back and the original misalignment returns. The retainer prevents this. So follow the recommendations for retention. Even in people who have never had orthodontic treatment, the dental arches narrow by up to three millimeters in adulthood and the front teeth become more crowded over the years – a retainer counteracts this natural drifting.

What are retainers?
Retainers are special orthodontic appliances that are worn after braces are removed in order to hold the teeth in the corrected position. There are two types of retainers: fixed and removable. Fixed retainers consist of a thin wire that is permanently bonded to the back of the teeth (colloquially the “wire behind the teeth”), while removable retainers look similar to braces and are worn at night.

Why are retainers necessary?
After orthodontic treatment, the teeth need time to stabilize in their new position. Retainers help to hold the teeth in the correct position and prevent them from drifting back to where they were before.

How long should a retainer be worn?
The wear time for retainers varies depending on the individual situation, but usually they are worn all day directly after the braces are placed and then at night over a longer period. Your orthodontist will give you a plan tailored to your needs.

Caring for retainers
Removable retainers should be cleaned daily to prevent the buildup of bacteria and plaque. Fixed retainers require careful oral hygiene with regular tooth brushing and flossing in order to avoid gum inflammation and cavities.

Cost of retainers
The cost of retainers can vary depending on the type of retainer and the geographic location of the orthodontic practice. As a benchmark: only from about one millimeter of change in the position of the front teeth do experts speak of a meaningful difference – the differences between the individual types of retainer are smaller than that.

Costs depend on the type, the region and the provider. A removable retainer is usually less expensive (about 250–400 €), a fixed one somewhat more (about 400–600 €), because the wire is individually adapted. We are happy to tell you the exact costs for your case.

No – when professionally fitted and worn correctly, a retainer is harmless. Possible, usually harmless side effects:

• dry mouth with removable retainers
• temporary tooth sensitivity after a fixed retainer is placed
• slight irritation of the oral mucosa
• buildup of plaque and bacteria if cleaning is neglected

These points can be avoided with good care and by following the instructions. If you have any problems, talk to us. In an evaluation of 3,500 treatment cases, unwanted tooth movement under a fixed retainer in the lower jaw occurred in around one percent of patients.

A retainer is very safe. The main disadvantages are the somewhat greater cleaning effort (dental floss with a threader), an occasional wire that comes loose, and – if care is neglected – tartar. With correct placement and regular checks, there are essentially no health risks. With a fixed retainer, a bonding point often comes loose at some stage: in a summary of 31 studies this was the case in around 28 percent of those treated – which is why we check the retainer regularly, and in the long run the great majority of retainers stay in place.

Statutory health insurance usually does not cover the retainer, as it is not considered medically necessary. Private health insurance or supplementary dental insurance may reimburse part or all of it, depending on the plan. Check the terms directly with your insurer; we are happy to advise you on the costs. As a guide: removable retention splints usually cost about 250–400 €, fixed (bonded) retainers about 400–600 €.

If you do not wear the retainer, the teeth can gradually move back toward their old position – the correction deteriorates. How much varies from person to person: sometimes barely noticeable, sometimes so clearly that renewed treatment becomes necessary. Wear the retainer as recommended; if that is not possible for some reason, let us know and we will find a solution. The risk of relapse is highest in the first 6–12 months after treatment.

Yes, that is possible. The retainer stabilizes the teeth, but it cannot rule out movement entirely – for example if it is damaged by heavy biting, hard food or an injury, or if it wears down over time. Have it checked regularly and replaced soon if it is damaged, and wear and care for it as recommended. In a follow-up examination of 1,026 patients after two years of monitored retention, about four percent showed visible tooth movement in the lower jaw and about six percent in the upper jaw despite a fixed retainer – which is why we check it regularly.

Yes – flossing is in fact important to keep the teeth and the retainer free of plaque. Guide the floss carefully between the teeth and gently around the retainer, without rough movements, so that it is not damaged. Special floss for orthodontic appliances makes this easier – we are happy to show you the right technique. A review of 29 studies concluded that fixed retainers are generally compatible with healthy gums.

That depends on the purpose. A retainer stabilizes the teeth in their position after braces; it can be fixed or removable and – as a fixed retainer on the inside of the teeth – invisible. A splint is usually used to treat temporomandibular joint problems, is made of clear plastic and is easy to remove. Both have advantages and disadvantages – we will discuss what suits you in the consultation. In a direct comparison, the difference in tooth position between a clear splint worn around the clock and a fixed retainer was 0.6 millimeters, and thus below the threshold at which experts speak of a meaningful difference.

Some foods can damage or loosen the retainer – better to avoid:

• sticky or hard items such as chewing gum, caramel, candy or hard nuts
• crunchy items such as popcorn, crusty rolls or chips
• very sugary foods, which increase the risk of cavities when you wear a retainer

Brush and rinse thoroughly after eating. If the retainer is damaged or worn, have it replaced soon.

Usually not – a retainer is designed to be worn long term so that the result stays stable. It should only be removed in certain cases, for example if it is damaged or worn and needs to be replaced, if it causes pain, or if further treatment is coming up. If you have questions or discomfort, please talk to us. On follow-up care: the first check-up takes place about 4–6 weeks after the braces are removed, then every 6–12 months.

A general dentist can bond one as well – but having it done by an orthodontist is advisable: they have the experience in fitting and placing retainers, assess the case precisely and recommend the right option. For a result that stays stable long term, orthodontic care is the safer choice. In a survey among dentists, around 89 percent considered permanent retention justified – for fitting, checkups and repairs, however, the orthodontist is the more experienced address.