Getting braces often leads to straighter, better aligned teeth. But once the braces come off, retaining those results is crucial. Orthodontists frequently recommend permanent retainers to hold teeth in their new positions. These devices remain bonded to the teeth long term. Are permanent retainers annoying to live with? Let’s explore the pros and cons.
What is a permanent retainer?
A permanent retainer is a wire that gets bonded to the tongue-side surfaces of the front teeth. Unlike removable retainers that patients take in and out of the mouth, permanent retainers stay in place 24/7. They are usually made of thin metal that an orthodontist custom shapes to fit the teeth.
Permanent retainers help keep teeth from drifting back toward their original positions after braces. They are especially useful for maintaining corrections of bite issues like underbites, overbites, crossbites and spacing. Some orthodontists recommend them for nearly all patients post-braces. Others reserve permanent retention just for more complex cases. Either metal wire or clear fiberglass types may be used.
Are permanent retainers uncomfortable?
In general, most patients report that permanent retainers are not uncomfortable once in place. Since they are custom fit to each person’s teeth, they should not rub or pinch the tongue. The wire or fiberglass lies smoothly against the tooth surfaces.
However, some people do notice the retainer during the first few days until they get used to having it bonded in. The tongue may feel slight pressure from it. This usually subsides once a patient adapts to the permanent retainer’s constant presence.
One exception is that fixed lower retainers sometimes irritate the gums or inner lips. This often occurs when the wire does not fit tightly to the tooth surfaces. Saliva and food can collect in open spaces between wire and teeth. Thorough oral hygiene is essential to prevent gum irritation.
Does a permanent retainer affect speech or eating?
A permanent retainer takes some getting used to but should not significantly impact speech or eating. Clear speech may be slightly impaired for the first day or two as the tongue adjusts to the device. Most patients report their speech returns to normal quickly. Eating is rarely affected other than perhaps a little extra care needed with sticky foods if lower retainers are present.
In some cases, a permanent retainer may make it harder for food particles to clear from between teeth. Brushing and flossing thoroughly after meals prevents trapped debris. Using a proxy brush or floss threader can help dislodge any stuck particles.
Is keeping the retainer clean difficult?
Oral hygiene around a permanent retainer does require a bit more time and attention. Food particles and plaque can easily collect around the fixed wire. Thorough brushing and flossing is a must to avoid tooth decay, gum disease and bad breath.
These tips can help:
- Use an extra soft-bristled toothbrush and gently brush each tooth surface near the retainer.
- Floss carefully up and down each tooth, sliding the floss out sideways rather than snapping it back.
- Rinse thoroughly with an antiseptic mouthwash.
- Clean carefully with proxy brushes, floss threaders or an oral irrigator if needed.
- See your dentist or hygienist frequently for professional cleanings.
What are signs of retainer problems?
Schedule an orthodontist visit if you notice any of the following:
- The retainer feels loose, rubs or pinches.
- You have discomfort or irritation of gums, lips or cheeks.
- You have swelling or redness around any teeth.
- It is hard to floss between certain teeth.
- You have bad breath or unpleasant tastes.
- Breakage, bending or distortion of the wire.
- Visible plaque buildup, stains, decay or abcesses.
The retainer may need to be repaired, replaced or removed if bothersome problems persist. Leaving issues unchecked can lead to tooth and gum damage.
What are pros of permanent retainers?
Advantages of permanent fixed retainers include:
- Prevent teeth from shifting, so braces results last longer.
- May be more effective at holding corrections than removables.
- Convenient since they are always in and don’t require compliance.
- Often recommended after complex orthodontic treatment.
- May allow some slight natural tooth movement.
- Less visible than removable options.
What are cons of permanent retainers?
Disadvantages of permanent retainers include:
- Must be placed by an orthodontist.
- Can break or come loose over time.
- May require occasional repairs or replacement.
- Can make maintaining good oral hygiene more difficult.
- May be costly if not covered by dental insurance.
- Require more visits for cleaning and monitoring.
How long do permanent retainers last?
With proper care, permanent retainers can last for many years. However, they do not last forever and may eventually need to be replaced. How long a fixed retainer lasts depends on several factors:
- Material used – Metal wire retainers tend to be more durable than clear ones.
- Type of bond – Flowable composite bonds last longer than light-cured composites.
- Patient habits – Grinding or clenching can cause them to break or debond.
- Oral hygiene – Poor cleaning increases risk of problems.
- Checkups – Monitoring and timely repairs extend longevity.
Many retainers last 5-10 years or more with proper care. But braces patients should expect to replace permanent retainers at some point, often more than once.
When can a permanent retainer be removed?
Only an orthodontist should decide when a permanent retainer can be removed. Premature removal risks teeth moving again. General guidelines include:
- Lower retainers usually stay in indefinitely due to risk of lower teeth crowding.
- Upper retainers may be able to be removed after several years if teeth are stable.
- Additional use of removable retainers is needed after any fixed retainer removal.
- Retainers on just the 6 lower front teeth may stay in longer than full arch wires.
Ideally, permanent retention continues until all wisdom teeth are fully erupted to avoid late shifting. Your orthodontist will determine when your teeth have settled enough to safely remove fixed retainers.
Conclusion
Permanent retainers have advantages and disadvantages when it comes to comfort, convenience, oral hygiene, longevity and cost. They are very effective at holding teeth in position long-term after braces. But they do require commitment to diligent oral care and dental visits.
Overall, permanent retention is a reliable approach to sustaining a beautiful orthodontic outcome. Some minor annoyances are likely. But following good care practices, checking for problems, and keeping regular appointments can minimize difficulties.