Permanent Retainers

What is a Permanent Retainer? 

Permanent or fixed retainers have a metal wire that is cemented to your teeth

This wire is typically smooth and solid or has a braided texture. It is adjusted to your bite to ensure your teeth do not shift or become crooked.

A fixed retainer is often recommended by orthodontists after braces to stop your teeth from moving back to their original position.1 

Your orthodontist may also recommend one if you have difficulties sticking to the guidelines for removable retainers. 

However, there must be a certain amount of tooth surface area for the bonding material to fix the retainer in place.

How to Take Care of a Permanent Retainer 

It is essential to clean your retainer daily to maintain it and protect the surrounding teeth. 

Brush your teeth as you usually would, taking care to get the bristles in and out around the crevices of the teeth to ensure every area is covered. 

Take extra care to clean the areas near the bonded material and behind the metal wire.

It may be more difficult to floss with a permanent retainer. Options for flossing include floss threaders or oral irrigators to remove food and plaque debris between teeth. 

What Problems Can Permanent Retainers Cause?

A permanent retainer can lead to dental problems if it is not maintained properly.

The retainer wires fix to the back of your teeth, and calculus, or tartar, can collect around the metal wires. Plaque, bacteria, and tartar build-up can damage your teeth and gums. 

It is essential to practice good, regular oral hygiene and attend preventive care appointments while wearing retainers.

If your orthodontic treatment has been successful, you should not experience much movement that leads to discomfort. 

However, a permanent retainer may cause some pain or discomfort. If the pain persists, your orthodontist may recommend some alternative options.

How Much Does a Permanent Retainer Cost? 

Permanent retainers cost between $150 and $500 to fix or replace. The cost of the placement may be included in the total price.

Permanent vs. Removable Retainers: Which is Right for You?

A permanent retainer can be an excellent alternative to a removable retainer. However, both retainers have their strengths and limitations.

In many cases, orthodontists use both permanent and removable retainers for the best long-term results. 

Recent surveys of practicing orthodontists prove that permanent retainers are becoming particularly popular.2

A removable retainer is best used for the upper teeth. A permanent retainer typically works well for the lower teeth.

Pros of Permanent Retainers

The advantages of permanent retainers include:

  • You do not have to take it on and off, making it easier to keep your teeth aligned once your braces come off
  • It is discreet because it is bonded behind your teeth. Nobody else will know it is there except for you.
  • It has little to no effect on the way you speak, so you do not have to feel self-conscious
  • You cannot lose it because it is securely fixed to your teeth with dental glue
  • It is hard to damage from typical everyday use of your mouth
  • It keeps your teeth in place to keep them aligned as the permanent retainer is always in place

Cons of Permanent Retainers

The disadvantages of permanent retainers include:

  • The process of fixing a permanent retainer may be long and uncomfortable. It can sometimes take up to one hour to fix a retainer to your teeth.
  • Brushing and flossing around a permanent retainer can be challenging
  • Your risk of cavities and gum disease increases if you do not take the time to maintain and clean your bonded retainer properly
  • Having a metal object in your mouth can be uncomfortable. Your tongue may rub against the wire, and if the bond comes off or the wire breaks, your tongue may get scratched or irritated.
  • Eating certain foods might change how effective a permanent retainer is. Biting into hard foods, like an apple or steak, can bend the wire out of place.
  • Foods high in artificial sugars or additives, like soda, may also wear away at the bonding material, loosening the bond to the teeth
  • The metal wire may break off or debond, requiring replacement or repair

Pros of Removable Retainers

The advantages of removable retainers include:

  • You can take out a removable retainer at any time, like when you are eating or brushing your teeth
  • It only takes 30 seconds to 1 minute to make an impression (mold) of your mouth to create a removable retainer that will last for years
  • You can easily clean a removable retainer by soaking it in a cleaning solution. This helps to clean bacteria build-up that collects quickly on removable plastic retainers.
  • It is easier to floss and brush because you can remove the retainer
  • A removable retainer is better for upper teeth as the lower teeth may bite on an upper permanent retainer

Cons of Removable Retainers

The disadvantages of removable retainers include:

  • A removable retainer must be taken out while playing sports or eating, which can be inconvenient at times
  • Patients can sometimes lose a removable retainer
  • It is usually a higher cost to replace than a fixed retainer.

Permanent Retainer: Common Questions & Answers

Who should get a permanent retainer?

A permanent retainer is an excellent choice for people who would like their teeth to stay aligned without any hassle.

Once your permanent retainer is fixed in your mouth, you do not need to worry about daily retainer schedules. 

It is a great option for people who don’t like the feeling of a bulky retainer in their mouth, have any sensory or special needs, or are worried about teeth shifting for any reason. 

When should I replace a permanent retainer? 

A bonded wire retainer can last for ten years or more with proper care, which is significantly longer than some other types of retainers.

If your permanent retainer breaks, a repair might be possible. A repair will cost less than a replacement.

Can your teeth shift with a permanent retainer? 

In cases where you are wearing a broken permanent retainer that has not been fixed for a few weeks or months, you will likely notice some teeth shifting.

Do permanent retainers make it more difficult to brush and floss your teeth? 

It can be challenging to brush and floss your teeth while wearing a permanent retainer. Try to brush your teeth as you usually would, ensuring you brush the crevices between the teeth so that no area gets neglected.

Flossing is a more significant challenge when wearing permanent retainers. However, it is not too tricky once you get the hang of it the first few times. Try not to be too forceful when flossing, or you may cut or injure your gums.

What should I do if my permanent retainer breaks? 

If your fixed retainer breaks, it is not usually an urgent matter. You will likely notice a loose or broken wire or a shift in one of your composite bonds. If you experience something like this, you should contact your orthodontist to have it repaired.

It is fine to wait a few days to have your permanent retainer repaired. However, you should not wait weeks or months to fix a broken permanent retainer. If you wait too long, you may experience unwanted dental movement.

Can I remove my permanent retainer myself?

As a permanent retainer is fixed into place, it should only be removed by a dental professional. If you attempt to remove a permanent retainer yourself, it could result in severe injury and damage to your teeth.

Resources

Lai, Caroline S et al. “Orthodontic retention procedures in Switzerland.” Swiss dental journal vol. 124,6 (2014): 655-61.

Pratt, Michael C et al. “Evaluation of retention protocols among members of the American Association of Orthodontists in the United States.” American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics vol. 140,4 (2011)

Kartal, Yasemin, and Burçak Kaya. “Fixed Orthodontic Retainers: A Review.” Turkish journal of orthodontics vol. 32,2 (2019): 110-114. doi:10.5152/TurkJOrthod.2019.18080

Al-Moghrabi, Dalya et al. “The effects of fixed and removable orthodontic retainers: a systematic review.” Progress in orthodontics vol. 17,1 (2016): 24

Al-Jewair, Thikriat S et al. “Retention practices and factors affecting retainer choice among orthodontists in Saudi Arabia.” Saudi medical journal vol. 37,8 (2016): 895-901

Navabi, N et al. “Orthodontic treatment and the oral health-related quality of life of patients.” Journal of dentistry (Tehran, Iran) vol. 9,3 (2012): 247-54.

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