Retention decisions and protocols among orthodontists practicing in Canada: A cross-sectional survey

Introduction: This study aimed to survey retention protocols and retainer characteristics among orthodontists practicing in Canada. Methods: An online questionnaire was distributed to 576 orthodontists registered with the Canadian Association of Orthodontists. It included respondents' demographic details, preferred orthodontic retainers and prescribed wear protocol, adjunctive retention procedures, the timing of retention follow-ups, retainer choice in specific situations, and retainer characteristics. Chi-square tests and Fisher's exact tests were used to test the associations between variables. Results: An 18% response rate was recorded (n = 101). Vacuum formed retainers were the most commonly used retainers in the maxilla (50.5%), whereas bonded retainers were preferred in the mandible (54.5%). An initial full-time removable retainer wear period was commonly prescribed (63.0%-67.0%). Retainer checks were carried out by 85.1%-89.1% of orthodontists for 1 or 2 years after the end of active orthodontic treatment. Only 44.6%-56.4% were comfortable with general dentists continuing retainer checks. Most (72.5%-84.1%) retainers were fabricated in the orthodontists' office laboratory. Indefinite retainer wear was commonly suggested and was significantly influenced by the number of years in practice. Conclusions: Most orthodontists' preferred retainer was the vacuum-formed retainers in the maxilla and the bonded retainers in the mandible. A variety of retention protocols and retainer characteristics was evident among orthodontists that reflect the considerable variation in malocclusion traits we face day-to-day. There seems to be a potential dichotomy between orthodontists being uncomfortable about allowing general dental practitioners to manage retention and orthodontists unwilling to provide retention care indefinitely.

Automated summary

This study surveyed retention protocols and retainer characteristics among orthodontists in Canada. The results showed that vacuum formed retainers were commonly used in the maxilla, while bonded retainers were preferred in the mandible. There was a variety of retention protocols and retainer characteristics, reflecting the diverse malocclusion traits faced by orthodontists. There seemed to be a potential contradiction between orthodontists' discomfort with general dentists managing retention and their unwillingness to provide retention care indefinitely.