Free Orthodontic Retainer Delivery Note Template (D8680)
Retention is where a finished case stays finished, and the delivery note is the record of what the patient was given and told. This D8680 template documents the arch, the retainer type, any bonded retainer and the teeth it spans, fit, the wear schedule, and care instructions.
By Yasmin Byott, DDS, MS · Founder, ButterNote · Updated
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For a bonded lingual retainer.
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Replace each [bracketed field] with your specific clinical detail. Brackets are placeholders. They don't get saved into the chart.
Orthodontic retention (D8680), [upper and lower]. Active [clear aligner] treatment complete; [attachments removed and enamel polished] / [brackets debonded, adhesive removed, and enamel polished]. Final records: [intraoral scan and photos]. [Lower bonded lingual retainer placed #22-27: lingual surfaces cleaned, etched, and primed; multistrand wire bonded with flowable composite and light cured; wire passive, occlusion checked. Floss threader use demonstrated.] [Upper clear vacuum-formed retainer] delivered. Fit verified; insertion and removal demonstrated. Instructed to wear the [upper] retainer [full-time at first, then nightly]. Retainer care and cleaning instructions given, including [cleaning the retainer daily, storing it in its case, and keeping it away from heat]. Patient advised that teeth can shift whenever retainers are not worn [and that retention is long term]. Next visit: [retainer check in [6] weeks].
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When to use this template
Use this retainer delivery note template when active orthodontic treatment ends and retainers are placed, after braces or after aligners. CDT D8680 is orthodontic retention (removal of appliances, construction and placement of retainer(s)). For a braces case the removal step is the debond; for an aligner case it is usually removing the attachments and polishing the enamel. Record that step, the final records you took, and the retainers delivered. How payers treat D8680 next to a comprehensive case fee varies, so check the plan.
Know the codes that follow retention. A removable retainer adjustment is D8681. Re-cementing or re-bonding a fixed retainer is D8698 (maxillary) or D8699 (mandibular). Repairing a fixed retainer, including reattachment, is D8701 (maxillary) or D8702 (mandibular). Replacing a lost or broken retainer is D8703 (maxillary) or D8704 (mandibular). Removing fixed appliances for reasons other than completing treatment is D8695. A good delivery note makes those later visits easy to document, because it says exactly what was placed.
There is no single proven retention protocol. The 2023 Cochrane review of retention procedures found the evidence low to very low certainty and could not draw firm conclusions about one approach over another. That makes your own record more important: which retainer on which arch and why, for a bonded retainer the teeth it spans and the wire, confirmation that the wire is passive and the occlusion clear, and for removable retainers the fit and the exact wear schedule you gave. Record care instructions and that the patient was told teeth can move whenever retainers are not worn.
Step by step: how to document this retainer delivery
- 1
Finish active treatment
Record the debond or attachment removal and the enamel cleanup.
- 2
Take final records
Record the scan, photos, or radiographs taken at the end of treatment.
- 3
Bond any fixed retainer
Record the teeth, the wire, the bonding steps, that the wire is passive, and the occlusion check.
- 4
Deliver removable retainers
Record the arch and type, fit, and insertion and removal practice.
- 5
Set the wear schedule
Record the wear schedule as instructed and that teeth can move when retainers are not worn.
- 6
Instruct and recall
Record care and cleaning instructions, floss threader use for a bonded retainer, and the retainer check.
Tips for using this template
- check_circleName each arch and its retainer separately. "Retainers delivered" does not tell the next clinician which arch has the bonded wire.
- check_circleFor a bonded retainer, record the teeth it spans, the wire, and that it was passive with the occlusion clear. A wire bonded under tension can move teeth.
- check_circleRecord the debond or attachment removal and enamel cleanup, since D8680 includes the removal of appliances.
- check_circleTake and record final records. They are the reference when a patient says their teeth have moved.
- check_circleWrite the wear schedule you gave in plain terms: full-time for how long, then nightly.
- check_circleRecord that you told the patient teeth can move whenever retainers are not worn.
- check_circleKnow the follow-up codes: D8681 adjustment, D8698/D8699 re-bond, D8701/D8702 repair, D8703/D8704 replacement.
- check_circleShow floss threader or interdental cleaning for a bonded retainer, and record it.
Standards & references
- ADA Code on Dental Procedures (CDT): D8680 (orthodontic retention), D8681, D8695, D8698/D8699, D8701/D8702, and D8703/D8704.
- Martin et al. Retention procedures for stabilising tooth position after treatment with orthodontic braces (Cochrane 2023): Systematic review of fixed and removable retainers; evidence low to very low certainty, no firm conclusion favoring one approach.
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