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What is a permanent retainer?

What is a Retainer?

A retainer is a custom-made appliance that is bonded to the teeth to hold teeth in position after braces have been removed. Retainers are an important part of orthodontic treatment as they help teeth stay in their new positions after the braces come off. There are two main types of retainers: removable retainers and fixed (permanent) retainers.

Removable Retainers

Removable retainers can be taken out of the mouth for cleaning. They may be made of clear plastic and fit over the teeth like a mouthguard. Or, they may be made of wires that are attached to acrylic that sits against the roof of the mouth. Removable retainers are usually worn full-time for the first 6 months after braces and then nightly after that.

Fixed or Permanent Retainers

A permanent retainer is, as its name suggests, fixed in place and not removable. A permanent retainer typically consists of a thin wire that is bonded to the back of the teeth. This wire keeps the teeth from shifting and maintains the progress achieved with braces. Permanent retainers are made to blend in with the natural color of the teeth. They are less visible than removable retainers.

Why Get a Permanent Retainer?

There are a few key reasons why your orthodontist may recommend a permanent retainer after braces:

  • To hold teeth in position, especially for corrections that were difficult to achieve with braces
  • To prevent teeth from shifting back after braces
  • For lifetime retention if you are at high risk of your teeth moving
  • For posterior or lingual retainers that you cannot see and may be prone to losing

Permanent retainers are commonly placed behind the six front teeth on the top and/or bottom. This maintains the correction achieved by closing spaces between the front teeth. Permanent retainers may also be used when extensive movement of the back teeth has been done.

Compared to removable retainers, permanent retainers have the benefit of keeping teeth in position 24/7. You cannot forget to wear them or lose them. This makes them ideal for long-term retention. However, good oral hygiene is still required to keep the area around the permanent retainer clean.

The Process of Getting a Permanent Retainer

Impressions and Fitting

To get a permanent retainer, your orthodontist will take impressions after the braces are removed. These impressions are used to create models of your newly straightened teeth. The orthodontist uses these models to design and custom-make the permanent retainer.

At your next appointment, the permanent retainer will be tried in and assessed for fit before bonding. You may be given a proxy retainer to wear in the meantime.

Bonding the Retainer

Once the permanent retainer is made, it will be bonded securely to the back of your teeth. The orthodontist will use a dental material to adhere the retainer wire to the teeth. This is similar to getting braces put on, though less intensive.

The bonding material will be cured with a special light. It is usually tooth-colored to minimize visibility. The whole process of bonding on the permanent retainer takes about 30 minutes.

Caring for a Permanent Retainer

Caring for a permanent retainer requires diligent oral hygiene and being careful not to dislodge it. Here are some tips:

  • Brush and floss thoroughly around the bonded wire every day
  • Use tools like floss threaders and proxy brushes to access hard-to-reach areas
  • Avoid biting into hard or sticky foods that could loosen or break the retainer
  • See your dentist regularly to ensure the retainer remains bonded and intact
  • Use a mouthguard if playing sports to prevent trauma to the retainer
  • Inform any new dentists you see that you have a permanent retainer

With good care, a permanent retainer can last for many years. But over time, the wire can occasionally break or come loose. See your orthodontist immediately if you notice any issues with the retainer so it can be repaired.

Life with a Permanent Retainer

It takes some adjustment getting used to a permanent retainer at first. Here’s what to expect:

  • Initial speech impediment – This goes away within a few days as your tongue gets used to the retainer.
  • Feeling of the retainer with your tongue – This sensation lessens over time.
  • Tightness at first – Teeth may feel tighter as they adjust to the retainer.
  • Slight irritation or rubbing – This usually resolves within a week or so.
  • Increased saliva flow – Your mouth produces extra saliva initially before adjusting.

Be patient during the first week as your mouth gets used to the permanent retainer. Minor rubbing and discomfort is normal at first. Avoid hard, chewy foods temporarily. Ibuprofen can help with tenderness. But if severe pain persists beyond 3-4 days, see your orthodontist.

Cost of Permanent Retainers

The cost of a permanent retainer varies based on your treatment specifics, orthodontist fees, and dental insurance coverage. Some key considerations:

  • Type – Lingual retainers behind the teeth cost more than anterior retainers.
  • Insurance – Retainers may be covered under dental insurance up to a certain age.
  • Fees – Orthodontist fees affect the total cost.
  • Materials – Gold wires vs metal wires.
  • Location – Cost of living differences based on geographic area.

On average, expect to pay:

  • Anterior permanent retainers: $250 – $600 per arch
  • Lingual permanent retainers: $500 – $1200 per arch

Additional fees may apply for repairs if the retainer breaks or comes loose. Talk to your orthodontist about costs specific to your treatment plan.

Permanent Retainer vs Removable Retainer

When choosing which type of retainer to use after braces, consider the pros and cons:

Permanent Retainer Removable Retainer
Pros
  • Retains teeth 24/7
  • No compliance needed
  • Less visible
Pros
  • Easier to clean teeth
  • Can be taken out
  • Lower cost
Cons
  • Harder to floss and brush
  • May need repairs
  • Higher cost
Cons
  • Must be worn as directed
  • Can be lost or broken
  • Less invisible

Your orthodontist will recommend the best retainer approach based on your unique situation. Often a combination of a permanent retainer plus a removable retainer is advised.

Other Common Questions

How long does a permanent retainer last?

With proper care, a permanent retainer can last 5-10 years or longer. But issues like breakage or coming loose can occur, requiring repair or replacement. See your orthodontist promptly if you notice any problems.

Can a permanent retainer be removed?

Yes, a permanent retainer can be removed by your orthodontist if desired. The bonded material will be ground down and the wire taken off. However, teeth may then shift without the permanent retainer in place.

Does a permanent retainer affect teeth cleaning at the dentist?

It can be slightly harder to thoroughly clean teeth with a permanent retainer in place. Your dentist will use special tools to clean around the wire. Extra time may be required at appointments to ensure adequate cleaning. Inform your dentist you have a permanent retainer.

Can I still get braces again if I have a permanent retainer?

Yes, it is still possible to get braces again if you have a permanent retainer. The orthodontist will remove the permanent retainer when putting on the new braces. A new permanent retainer can be placed after completing orthodontic treatment.

Conclusion

A permanent retainer provides ongoing retention of teeth after braces. The bonded wire holds teeth in their aligned positions long-term. Permanent retainers are commonly used behind the front six teeth and/or the lower back teeth. They have advantages over removable retainers, like not having to remember to wear them. Proper oral hygiene is key to maintaining a permanent retainer. With regular dental care, a permanent retainer can remain functional for many years. Discuss options with your orthodontist to decide if a permanent retainer is right for your situation.