Tips for Cleaning and Maintaining Lingual Retainers

Lingual retainers play a critical role in maintaining the integrity of the oral arch following orthodontic treatment. These devices, discreetly positioned behind the teeth, require careful cleaning and maintenance to ensure ongoing effectiveness and prevent complications. Here are some best practices for cleaning and maintaining lingual retainers based on current evidence.

Daily Oral Hygiene Practices

Daily oral hygiene practices are fundamental in preserving the health of lingual retainers and the surrounding oral structures. Effective cleaning helps to prevent the buildup of plaque, reduces the risk of dental cavities or halitosis, and contributes to the overall health and well-being of the patient. The Cleveland Clinic has a comprehensive overview of the impact of poor oral health on a range of conditions, including cardiovascular disease and pneumonia, and the importance of maintaining good oral hygiene. (1)

Patients of any age with lingual retainers should maintain a rigorous daily oral hygiene routine. This includes brushing their teeth after each meal using fluoride toothpaste and a soft-bristled toothbrush. Emphasize the importance of reaching all surfaces, including behind the retainer, to ensure thorough cleaning.

Flossing Techniques

Lingual retainers can create challenging spaces to reach with traditional flossing methods, but proper flossing is essential to remove debris and plaque from between the teeth and around the retainer. There is a wealth of guidance and videos available online to help patients with flossing their retainers. 

Dental professionals can instruct patients on the use of floss threaders or interdental brushes. Floss threaders are small plastic needles that can be used to direct floss between the teeth and under the retainer wire. When the floss is beneath the wire, it can be moved around the adjacent teeth in the usual way to remove debris and plaque. 

Other options include using a water jet flosser, which can be easier for some patients to use. Some electric toothbrushes now include a water floss function. Encourage patients to floss daily, in addition to cleaning both the front and back surfaces of the teeth for comprehensive plaque removal.

Antimicrobial Rinses

Antimicrobial rinses can be a helpful addition to brushing and flossing, enhancing the patient’s oral hygiene routine and cleaning of the lingual retainer. The American Dental Association (ADA) has produced guidance on the appropriateness and use of mouthwashes, including over-the-counter preparations and those available by prescription. 

Dental professionals can recommend specific products that are safe to use with orthodontic appliances to help reduce bacteria and plaque. In all cases, patients should be advised to follow the manufacturers’ instructions and the prescriber’s guidance where appropriate. (2) 

Regular Professional Checkups

Regular professional checkups are essential for monitoring the condition of lingual retainers and addressing any emerging issues promptly. Professional assessments can help prevent complications and ensure the long-term success of orthodontic treatment. 

During these visits, dental professionals can assess the condition of the lingual retainer, identify any signs of wear or damage, and provide necessary adjustments. This proactive approach helps maintain the retainer’s effectiveness and addresses potential issues before they escalate.

Avoiding Harmful Habits

Some habits can compromise the integrity of lingual retainers. Patients need guidance on avoiding activities that may lead to damaging or dislodging the retainer. It is important to educate patients about the potential risks of activities such as nail-biting, chewing on objects like pencils or pens, and playing with the retainer using their tongue. This should be highlighted when the retainer is fitted rather than once damage is evident, so it is worth asking about these habits early on in the treatment program. The key is to avoid any unnecessary stress on the lingual retainer so it will last longer.

Retainer Inspection

Regular inspection of the lingual retainer is essential for identifying wear and tear or signs of malfunction. Timely detection allows for prompt intervention and can prevent future damage and complications. Patients can be encouraged to perform their own regular inspection, either visually or by feeling with their tongue. They should also be given advice on what to look out for and to contact their orthodontist immediately if they notice any changes. This proactive approach empowers patients to take an active role in the maintenance of their orthodontic appliances.

Effectively cleaning and maintaining lingual retainers is integral to the success of orthodontic treatment and the overall oral health of patients. Drawing guidance from authoritative sources such as the AAO and ADA ensures that dental professionals provide evidence-based recommendations to their patients. 

By emphasizing daily oral hygiene practices, instructing patients on flossing techniques, incorporating antimicrobial rinses, scheduling regular professional checkups, advising against harmful habits, and promoting retainer inspections, dental professionals can empower patients to actively participate in the preservation of their lingual retainers. This approach contributes to the long-term success of orthodontic treatment and the maintenance of a healthy, functional, and aesthetically pleasing smile.