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The Clear Choice for Reliable Retention Joanna N. Farber


by Joanna N. Farber

Effective retention is a critical factor in maintaining treatment results. Because traditional thermoplastic retainers begin to deform in as little as two months of wear, you need something that will really work.

Vivera retainers, a retainer program suitable for any orthodontic patient, offers four sets of fresh retainers over a period of time. The exact amount of wear time for each set of retainers is determined by the doctor and based on the usage he or she prescribes for the patient. Vivera's proprietary thermoplastic material is 30 percent stronger than other leading clear retainer materials, and the retainer is made from a PVS impression or final Invisalign ClinCheck stage. Images of the patient's dentition are captured digitally, and these findings are kept on file for future use.

To understand the clinician's perspective on this retention product, we spoke with Drs. Linda Crawford and Jeff Haskins, orthodontists who have chosen to use Vivera in their practices.

How long have you been using Vivera retainers?
Crawford: Since they were first introduced in 2007.
Haskins: We started recommending Vivera in the spring of 2008. I was looking for a retention solution for my patients, both traditional and Invisalign, to continue wearing clear retainers long term.

Do you prescribe Vivera for all of your retention patients? What determines your decision to use this or another retention product?
Crawford: Yes, I do. I generally don't offer other options.
Haskins: We prescribe Vivera to 100 percent of our patients. We manufacture two in-house clear retainers for each patient after their braces are removed. Gingival tissue needs to heal and the cost of Vivera is not included in our braces fee.

How many Vivera cases have you treated?
Crawford: More than 100 patients, which equates to more than 400 Vivera retainers that have been delivered.
Haskins: We currently have more than 80 patients in Vivera retainers. We have had an overwhelmingly positive response from our patients and parents, especially as patients enter their college years. In fact, we market Vivera as "the college four-pack" of retainers. Parents are relieved knowing their kids have spare sets of retainers if they are lost or misplaced while they are away at school.

What are your strongest reasons for using Vivera?
Crawford: If patients forget to wear their retainers and their teeth relapse, the Vivera retainers are strong enough to self correct certain types of relapse back to the original retained position, up to .25 mm. They control all of the teeth rather than just the anteriors. They are a good night guard for those patients who clench and/or grind. They can be used as bleaching trays and even as sports guards, to a limited degree. Finally, they are aesthetically pleasing. Because they are clear, this greatly improves compliance. When you consider the office time it takes to make a traditional retainer, including impressions, preparation, trimming, polishing, finishing, and delivery, the Vivera system is more efficient from a business standpoint.
Haskins: The biggest advantages are the strength of the material used to fabricate the retainers, the fact that there are four sets instead of one, and that the patient's cost is less than if they purchased four individual sets of in-house clear retainers.

How has Vivera allowed you to attain successful, long-term retention?
Crawford: There have always been and always will be several different philosophies about retention. But what I have observed is that retention appliances are essential to maintain the teeth. Not only the position, but they physically protect our restored teeth and our restorations when the patients sleep. My patients also swear they sleep better with their Vivera retainers. Mostly they feel it is because their jaws are more comfortable. This system will adapt to doctors' individual retention philosophies, making this four-retainer approach a true benefit compared to the life of a single retainer.
Haskins: First, I have always advocated long-term sleep-hours-only retention to all of our patients. We started using clear retainers in 1985 with better success than we experienced with Hawley or fixed retainers. Vivera enables my practice to endorse "long-term" retention with a viable product option when patients graduate from the practice and move on with their lives. And, depending on the patient circumstances (i.e., TMD symptoms), we might recommend alternating wearing the maxillary retainer one night and the mandibular retainer the next night.

What are the main differences in patient responses between Vivera and traditional retainers?
Crawford: In the last year, out of hundreds of treated patients who have needed re-treatment from their childhood orthodontic therapies, only one wanted a traditional retention appliance at the end of treatment. There were a few occasions in which I offered them as an option in the very beginning, but that was because I was perfecting my impression technique for the best reproducible fit. Patients want convenience, and that is exactly what Vivera gives them. Patients love the fact that they can have their next sets of retainers shipped directly to them without having to come in for impressions and then come back for the retainer. Often, patients want to replace their retainers more frequently, but they don't have time for the necessary appointment. With the Vivera system, they can have a new, fresh retainer every three months.
Haskins: Patients appreciate the quality in the fabrication resulting in a more accurate, comfortable fit. And their parents are relieved that a lost or broken retainer is no longer a crisis.
Do you see a difference in preference between your adult patients versus non-adult?
Haskins: Adults have been more receptive to Vivera than any other sector of my practice, especially with former Invisalign patients. I assume this finding is because they realize the higher quality Align Technology delivers in its Vivera retainers, versus in-house clear retainers.

Is the price difference between these and traditional retainers an issue for you or your patients?
Crawford: The cost is much better for the Vivera appliance because you receive multiple sets of retainers over a one-year period with very little difference in the initial investment. And with night-time-only wear, the Vivera retainers can last much longer than one year.
Haskins: The cost-effectiveness of Vivera is a big selling point. Each patient receives four sets of retainers for considerably less than the cost they would pay for four individual "in-house" replacements. Not only do my patients receive four sets, but thanks to the plastic material they are made of being 30 percent stronger than that in other retainer products, they also last longer than traditional clear retainers.

What have your patients said about their experience using these retainers?
Crawford: They love them. They bring their children back in who were treated before Vivera was available and have their retainers replaced. Many times, they want to get their own set to use as bleaching trays and night guards. Parents like Vivera for their children, because with multiple sets of Vivera retainers, they can keep one set at college and the rest at home. For adults, they can keep a set in their gym bag or travel kit, and in the office or at home. They don't have to worry about carrying them around or forgetting them at home when they travel.
Haskins: Vivera is easy and worry free. Parents are very appreciative of the multiple-set aspect of the Vivera program.
Doctors' Bios
Linda Crawford, DDS, MS, has been an orthodontic and dentofacial orthopedic specialist since 1993, when she graduated from Baylor College of Dentistry. Dr. Crawford was inducted into Omicron Kappa Upsilon, the dental field's honor society in May 2005; and is a member of the American Board of Orthodontics (since 2003) and the American Association of Orthodontists.
Jeff Haskins, DDS, MS, is a Diplomate of the American Board of Orthodontics. He established Village Orthodontics in Colorado in 1983 after having earned his masters degree in orthodontics from Washington University in St. Louis, Missouri. He was featured as a "Top Doc" in 5280 Magazine in 2004 and 2008, after having been nominated by his peers; he is also involved in several civic and professional organizations.
Do patients see a difference in fit and/or comfort between Vivera and traditional retainers?
Crawford: Vivera fits much better than traditional appliances unless the impression was not taken properly. Patients notice that the Vivera retainers are much more comfortable and less bulky. Oftentimes, traditional retainers are too thick or cut too high on the gingiva, which can be irritating to the gums and difficult for a patient with a gag reflex. The compliance with a clear, comfortable appliance that doesn't cover the roof of their mouth is much better.
Haskins: Patients report excellent fit due to the gingival contouring of each Vivera retainer. The durability of the material is far superior to that of the traditional clear-retainer material. Traditional retainers tend to be bulkier and looser fitting. My adults and teens really notice the difference between our in-house aligners and the Vivera retainers. The gingival contouring along with the exact fit are much improved over traditional clear retainers. The .04 thickness is also well-received, especially in our patients who have a history of evening bruxism.

How do you and your patients like the multi-set delivery program?
Crawford: They like it. We like it too. Old retainers become unpleasant, and patients lose their enthusiasm to wear them. Patients need constant reminders about retention, and they like having a new, fresh retainer to use.
Haskins: Patients appreciate that they only have to come in to pick up their first set of retainers, and that sets two, three, and four are mailed directly to them. It means they have fewer appointments to worry about fitting into their busy schedules.

Do you find your patients are more compliant about using Vivera?
Haskins: Long-term data is not available yet; however, our hypothesis should be confirmed that with multiple sets of quality clear retainers, long-term compliance will increase dramatically.

What should other doctors know about using Vivera to its fullest potential?
Crawford: I think other doctors should consider the multiple advantages of the Vivera appliance. The investment made by the doctor compared to the satisfaction received by the patient is quite valuable. Doctors are comfortable with the PVS impression- taking process and the outcome with an excellent impression is so very predictable. It requires very little chair time, and most doctors want their patients to have bruxism guards to help protect their teeth anyway. I offer it as an option whenever there is evidence of enamel loss, whether or not patients want their teeth aligned.
Haskins: Practicing orthodontists should not let the manufacturing costs be a roadblock to using Vivera. The material quality is superior, and the long-term potential cost is much less than that of traditional retainers. It is also very patient- and parent-friendly, and it is also the most accepted retention method by the hygienists who see my patients
Author's Bio
Joanna N. Farber has been in the publishing field since graduating with a B.A. in journalism and public relations more than 10 years ago. She has held editor positions for dental/orthodontic newspapers, and has also worked as a freelance writer. Currently, she freelance writes for Align Technology. Joanna lives in New Jersey with her husband, Golan, and their son, David.
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September 2025
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