An Overview of Permanent Retainers
Do you hate the hassle of remembering to put your retainer in at night? Or maybe you’re concerned you might lose it? Permanent retainers are placed by your orthodontist and remain in place with no worries about being careless or forgetful.
Permanent Retainers After Braces
Just because your braces have been removed, it doesn’t mean your orthodontic treatment is finished. Retainers play an important role in making sure your teeth don’t slip back into their crooked ways.
It takes time for teeth to settle in to their new position and for the bones, gums and muscles to adjust. Without retainers, teeth can shift and drift ruining all that hard work and money you’ve invested.
Choosing a Retainer
“There are so many varieties of retainers because there’s little research to evaluate the protocol of retainers,” says John Buzzatto, DMD, MDS, and President of the American Association of Orthodontists.
Your orthodontist will determine which type of retainer is right for you. Since retainers are custom fit for each patient, your specific orthodontic needs will be considered, along with other factors that could influence the success of this retention phase.
If it’s unlikely a patient will wear a removable retainer, a fixed retainer might be a solution. Your orthodontist’s personal preference and what he considers best for your orthodontic treatment will also play a role.
What Are Fixed or Permanent Retainers?
Permanent retainers, sometimes called bonded or fixed retainers, attach to the lingual or tongue side of the front teeth. In most cases, a permanent retainer is a single wire that is applied to the end teeth, or each individual tooth, with a glue or adhesive. (Some dentists prefer to attach the wire to each tooth so that it is more secure.) The wires can be stiff or flexible, depending on the need.
“In the United States, fixed retainers are the most common retainer type used on the bottom teeth,” says Dr. Buzzatto, who estimates they account for nearly 42 percent of all lower teeth retainers. Fixed retainers can also be applied to upper teeth but are used far less commonly. Statistics indicate permanent retainers are used on upper teeth in only about 11 percent of cases.
There is one exception to the rule about fixed retainers and upper teeth. “When there is concern about a gap between the two front teeth, and a patient needs a frenectomy, a permanent retainer may be used to get the teeth to stay together afterwards,” says Buzzatto, adding this pattern is appropriate for both children and adults.
A frenum is the fold of muscle or tissue that pushes down between the upper two front teeth. The procedure to remove the tissue is known as a frenectomy.
No one type of retainer is appropriate for every patient, and there are positives and negatives to each kind. Here are some pros and cons for permanent retainers:
Pros – Since they are cemented into place and can only be removed by your orthodontists, permanent retainers are great for patients who might otherwise forget to wear their retainer – or just choose not to. “As long as the wire is in place, teeth won’t move. You don’t have to rely on patient compliance,” says Buzzatto. They also eliminate the possibility the retainer will be lost.
Cons – The wire used in fixed or permanent retainers can become loose or damaged. “It’s a bit like a metal hanger. The wire can bend until it breaks, explains Buzzatto. “Patients who are prone to clinching or grinding their teeth are also more apt to break the lower retainers than patients who don’t.”
Buzzatto says brushing and flossing the front teeth can also be difficult for patients with permanent retainers. And this is a problem, since the area is prone to calculus buildup, especially in adults. Trying to maneuver around the wire can also loosen or bend it.
Lifelong Commitment to Permanent Retainers
Some dentists leave the permanent retainer in place only until the wisdom teeth come in, but most patients will need to wear their permanent retainer for life.
The teeth continue to move and shift throughout life. Retainers keep the teeth from drifting and help them settle after orthodontic treatment. Without a retainer to maintain the position of your teeth – you may just find yourself needing braces again.