You are here:

Orthodontics/bottom retainer

Advertisement


Question
QUESTION: I have a bottom retainer and it is not removable and i have noticed that it has started to get a lot of build up on it i brush my teeth that doesn't work i floss tried the water pick toothpicks and mouthwash nothing seems to work i go to the dentist every 6 months and that seems to work for a while but not for long i am due to go but a few family emergencies keep me from going what should i do

ANSWER:
Hi Rebekah,

This is a question which comes up a lot. I m a big fan of lingually bonded retainers, but will admit that they do require scrupulous hygiene, and may not be appropriate in all cases.

What I write here are only my opinions based on very limited information. My comments should not be viewed as any form of diagnosis, definitive or otherwise,  or any form of  treatment recommendation.  Indeed, in the ultimate analysis all final decisions, particularly clinical ones, should  only be made by qualified doctors who have had a chance to see you in person and who have had an opportunity to take and analyze proper diagnostic records.

Okay… having said  that…  your  questions focused on build up of "tartar" ( calculus ) and plaque on the inside of your lower incisors where a retainer has been placed. You  wrote:
" I have a bottom retainer and it is not removable and i have noticed that it has started to get a lot of build up on it  "


I understand your frustration at the hygiene challenge which you face. I have seen patients who seem to have a low salivary flow, and possibly high calcium levels in their saliva. They all had considerable build up of tartar in the insides of their lower teeth. There are several options.

1) Remove the lower lingually bonded retainer and instead wear a removable style retainer, either a clear style or a traditional Hawley type with a wire surrounding the outside of the lower front incisors. See the website http://www.braces.com for some photos.

2) Keep the lower retainer in place and consider buying a water pic or other oral irrigation device to help better maintain the lower incisor alignment. Twice a day use of a strong mouth wash like the yellow Listerine brand may significantly help to reduce the levels of plaque.

3) Consider seeing your dentist, dental hygienist, or dental health therapist three times a year rather than just twice.  By adding one extra tooth cleaning appointment every year the problem you have may disappear.

4) Modify your food or beverage intake in case things like sugary soft drinks or pastries with a lot of sugar and carbohydrates are part of your regular diet.

Rebekah, of all these options, I recommend that you carefully consider COMBINING # 2, 3, AND 4.

I hope that this has helped. Also you asked:  "  i am due to go but a few family emergencies keep me from going what should i do  "  At this point, keep judiciously brushing, and make an appointment for a professional cleaning whenever you can.

---------- FOLLOW-UP ----------

QUESTION: could fruit case the build up I don't eat pure sugar and no soft drinks but we eat a lot of fruit veggies I uses a water pick already and it doesn't work what else could I use

Answer

Hi Rebekah,

I am responding to your followup question, namely:  

---------- FOLLOW-UP ----------

QUESTION: could fruit case the build up I don't eat pure sugar and no soft drinks but we eat a lot of fruit veggies I uses a water pick already and it doesn't work what else could I use

-------------------------------

Fruits often can contain a lot of sugars which can be turned into plaque and calculus ("tartar"). I have a patient who likes to eat dates which are often packed in syrup, so you can imagine the carbohydrate/sugar challenge that this presents.

In answer to you specific question though, it is my opinion that eating fruits is not something you should go to extremes to minimize or eliminate just because of build up of deposits on your retainer. Judicious hygiene can help to address this problem. I think you are doing well to use a water irrigation device, along with flossing and brushing. Certain mouthwashes which have been shown to be clinically effective in addressing  gingivitis can also help to reduce the bacterial levels in the mouth. In so doing, the amount of build up on the retainer should also decrease.

So, what is the final summary here. Well Rebekah, I would perhaps slightly reduce the sugary fruit intake.More importantly though

1) Keep using the water irrigator.

2) Brush carefully along the inside and outside areas of the lower incisors, perhaps using an electric toothbrush.

3) Very carefully floss the lower incisors above and below the bonded retainer wire using a floss threader.

4) Finally, consider scheduling a professional cleaning appointment at the dental office perhaps three rather than two times a  year. That extra cleaning  session may be all that is needed to help prevent significant buildup

5) Rinse twice daily with a mouthwash such as Listerine (Yellow) to help further decrease oral bacteria levels.

Paul Supan, DDS, MA, MPH
Board Certified Orthodontist

Specialist in Orthodontics
Specialist in Dental Public Health
http://www.braces.com
http://www.leesburgbraces.com

Please allow a week for a reply. I am in full time Private Practice, lecture on occasion, and involved in many volunteer activities. I am therefore not always able to respond to questions straight away. Your understanding is appreciated.  

Orthodontics

All Answers


Answers by Expert:


Ask Experts

Volunteer


Paul Supan, DDS, MA, MPH

Expertise

First may I say please set your questions to Public so other readers can benefit from the response. Also, if you look at my comprehensive answers, they are not short 1 or 2 paragraph quickie replies that anyone can type out in < 5 minutes. Instead I often will ask other colleagues in other specialties for their advice in order to provide you the questioner with a more interdisciplinary perspective. This all takes time. I ask for readers to therefore allow 5-7 days. You will be rewarded with a very detailed response.

Because of the nature of Orthodontic questions, any pictures of the teeth and X-ray images would be very helpful. If you write to me and explain that you have crooked overlapping front teeth can be interpreted in many many ways, and my goal is to provide a specific response that meets your needs.

I hold double specialty credentials. I am Board Certified in Orthodontics and Board Eligible in Dental Public Health. I welcome questions regarding Braces, Invisible Braces, & Invisalign, as well as issues involving combination Cosmetic Dentistry and Orthodontic treatment. Orthodontics alone sometimes is not enough to achieve that perfect smile. Gingival (gum) re-contouring, tooth reshaping, bonding and other services are sometimes needed. I also have substantial experience in the areas of Infection Control and Sterilization in the Dental Environment. My personal websites braces.com and Leesburgbraces.com are non-commercial for information purposes only and may provide you with some background to more precisely frame your question for allexperts.com.

Please allow a week for a reply. I am in full time Private Practice, lecture on occasion, and am involved in many volunteer activities. I am therefore not always able to respond to questions straight away. Your understanding is appreciated.

Experience

Board Certified Orthodontist (ABO Diplomate) with over 25 years of Private Practice experience. Second Specialty Certificate in Dental Public Health with research experience at NIH, and Epidemiology Training & Research at Harvard, NIH, and the Centers for Disease Control (CDC) in Atlanta. Postgraduate Masters degree from the Harvard School of Public Health, as well as a Master of Arts Degree in Education.

Organizations
American Dental Association, American Association of Orthodontists, Academy of General Dentistry, College of Diplomates of the ABO, OSAP - Office Sterilization & Asepsis Procedures Organization, Others

Publications
Available upon Request.

Education/Credentials
BS College of William & Mary, DDS Medical College of Virginia, Masters of Public Health (MPH) Degree Harvard School of Public Health. Dental Public Health Specialty Certificate from NIH. Orthodontic Specialty Certificate from University of Rochester Eastman Dental Center. USPHS clinical research experience at NIH, and Epidemiology Training & Research at Harvard, NIH, and the Centers for Disease Control. Fellow of the Academy of General Dentistry (FAGD), and Fully Board Certified Diplomate of the American Board of Orthodontics. Board Eligible in Dental Public Health. Visiting Adjunct Associate Professor at the Meharry Medical College School of Dentistry, Nashville, Tennessee.

Awards and Honors
Available upon Request Please see my personal websites braces.com and Leesburgbraces.com for further personal background.

Past/Present Clients
Available upon Request

©2016 About.com. All rights reserved.