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Permanent or fixed retainers are made of a metal wire that is glued to your teeth. Usually, this wire is smooth and solid or has a braided texture. It’s attached to your teeth and adjusted to your bite to keep your teeth from shifting or becoming crooked.

Permanent retainers are often recommended by orthodontists after braces to prevent your teeth from moving back to their original place.

Your orthodontist may also suggest one if you have difficulty adhering to their guidelines for removable retainers. But there needs to be a certain amount of tooth surface area for the bonding material to secure the retainer in place.

In many cases, orthodontists use a combination of both removable and permanent retainers for the best long-term results. But recent surveys of practicing orthodontists show that permanent retainers are becoming increasingly popular.

Removable retainers are typically used for the top teeth and permanent retainers on the lower teeth, but retainer use depends on what is best for your teeth.

Let’s get into how permanent retainers work, how they stack up against other retainers, and how to clean and maintain them to keep up your best smile.

Permanent retainers also go by the following names:

  • bonded retainers
  • lingual wire
  • fixed retainers

Permanent retainers are more commonly used on the teeth of the lower jaw.

The retainer is called a lingual wire because it’s glued or bonded to the back surface oof your teeth. It’s easier to securely attach the bonding material to lower teeth such as the cuspids (canine teeth) for effective long-term use.

The name “permanent retainer” indicates exactly what the device does: stays on your teeth permanently to keep them from moving. You may have a permanent retainer on your teeth for the rest of your life.

Your dentist or orthodontist may remove your permanent retainer if it irritates your gums or teeth or causes too much plaque or tartar buildup on the teeth around it.

How much do permanent retainers cost?

A permanent, or bonded, retainer may cost from $150 to $500 to put in place or replace if lost or broken. The cost of the initial placement may be included in the overall cost of your braces.

Pros of permanent retainers

  • You don’t have to take it on and off, which makes it easier to keep your teeth in place after your braces come off.
  • No one else knows it’s there except you, because it’s bonded behind your teeth.
  • It has little to no effect on the way you speak, so you don’t have to feel self-conscious about wearing it in public.
  • You can’t lose it because it’s securely attached with dental glue.
  • It’s difficult to damage from normal everyday use of your mouth.
  • It keeps your teeth in place to help keep your teeth aligned, since the retainer is always in place.

Pros of removable retainers

  • You can take them out at any time, such as when you’re eating or cleaning your teeth.
  • It only takes 30 seconds to 1 minute to get an impression (mold) of your mouth to make a removable retainer that will last for years.
  • You can easily clean them by soaking them in one of the many types of cleaning solution available. This is highly recommended because bacteria can build up quickly on plastic removable retainers.
  • It’s easier to floss because you can take the retainer out.
  • Removable retainers may be better for upper teeth, since the lower teeth may bite on an upper fixed retainer. This can make the retainer less secure or damage it.

A permanent retainer may seem like a great alternative to a retainer you have to put on or take off all the time if you think it may be a challenge to use one for comfort or cosmetic reasons. Both retainer types have their strengths and limitations, however.

Here are some considerations and potential drawbacks of permanent retainers:

  • The procedure for attaching a permanent retainer may be long and uncomfortable. It can sometimes take up to an hour to bond a retainer to your teeth. All you have to do for a removable retainer is get a quick impression made that your orthodontist can use to fashion one that fits your mouth.
  • Brushing and flossing around a permanent retainer requires extra effort. Your risk of cavities and gum disease can increase if you don’t take the time to properly clean around your permanent retainer.
  • Having a metal object in your mouth all the time can be uncomfortable. Your tongue can rub against the wire. If the bond comes off or the wire breaks, your tongue may get irritated or scratched.
  • Eating some foods might change how effective it is. Biting into hard or tough foods, like a whole apple or a tough steak, can bend the wire out of shape. Foods high in artificial sugars or similar additives, such as soda, can also wear away at the bonding material, potentially loosening the retainer’s bond to the teeth.
  • The wire may break off or debond, requiring repair or replacement. You may have to pay a replacement fee to have a new one made.

For a retainer that’s bent or has moved, don’t attempt to fix the problem yourself. Applying too much pressure to the retainer can end up snapping the bonding material or wire and damaging your teeth.

If its shape is changed, the retainer won’t keep your teeth in their proper positions. If your retainer is bent or moves:

  • Make an appointment to see your orthodontist. If the retainer isn’t bothering you or injuring any other parts of your mouth, make an appointment as soon as possible with your dentist or orthodontist to have the retainer adjusted or repaired.
  • Call your dentist or orthodontist right away. If the retainer has broken off or injured another part of your mouth, see your dentist or orthodontist right away to minimize any further damage to your teeth, mouth, or retainer.
  • Check for emergency contact. Many dentists and orthodontists have an emergency line you can call or text in case of emergencies. Ask your dentist or orthodontist if they have one so that you can contact them for immediate help if your retainer breaks or injures you.

Clean your retainer every day to keep it well maintained and to protect the teeth around the area.

Brush as you normally would, taking care to get your bristles in and out around all the crevices between the teeth so that no area gets neglected, especially areas near the bonded material or behind the wire itself.

Tips for flossing with a permanent retainer

Flossing is the real challenge with permanent retainers.

But it’s not too hard once you get the hang of it the first few times — here are some cleaning tips for flossing easily with a permanent retainer:

  1. Use a 6-inch piece of floss along with a floss threader to shimmy the floss between two of your front bottom teeth, taking one end of your floss between your fingers and the other end in the threader.
  2. When the floss is between the teeth, gently raise and lower the floss along the sides of the teeth from their tops to where they meet the gums. Don’t be too forceful or you may cut or injure your gums.
  3. When you’re finished with one set of teeth, move the floss back up to the top of the teeth and slide the floss over to the next set of teeth.
  4. Pull the floss down between the next set of teeth and repeat step 2 to clean between them.
  5. Repeat these steps until you’ve flossed between each of the teeth that are secured by your permanent retainer.

You can find floss threaders online and in stores.

Permanent retainers can be a convenient alternative to having a removable plastic retainer, but they’re not for everyone.

Talk to a dentist or orthodontist (you can even get multiple opinions) about the options for your dental goals and needs, to see what’s right for you.