Why “permanent” retainers aren’t so permanent

Hey guys, your friendly neighborhood orthodontist here, and one of the questions I get a lot is about “permanent” retainers. First off, I’m not a fan of them or that name. They are anything but permanent. The appropriate name is "fixed retainers". But they are anything but permanent, as well. In my office, we don’t do fixed retainers, but we do remove a lot of them. And mostly in preparation for round two of braces.

Let me explain. 

A fixed retainer is a wire placed behind the teeth and bonded on to hold those teeth in place. It is usually attached to the front six teeth, from cuspid to cuspid (fang teeth). It can extend further back, but the more teeth included, the more opportunities there are for breakage. 

Related: Understanding your oral health.

Breakage is a major problem because eventually almost every one of them will break at some point. Now, if you continue to wear your regular retainer over it at night, it’s not such a big problem. You can simply return to your dental care provider and have them repair or replace it at whatever cost they see fit. The problem is that many orthodontists don’t give a removable retainer along with a fixed retainer, and many patients who get a fixed retainer feel so invincible that they don’t wear the removable retainer anyway. When you only wear the fixed retainer, the teeth not included will continue to shift over time, so your removable retainers might no longer fit when you try to return to them.

The next problem is how fast the teeth can shift once the fixed retainer is broken. Teeth don’t really become more stable when they are bonded together. So the day your fixed retainer breaks is like the first day you got your braces off, regardless of how long it’s been on there. 

The last issue I have with fixed retainers is hygiene. Just like when you have braces, you have to thread floss under the wire to floss properly, and I’ve seen the results of people who do not feel like they want to put forth that level of effort. Trust me, it’s not pretty. 

Now, sure, a removable retainer is a little bit more responsibility. But I’d much rather just wear something to sleep than have wires glued in my mouth indefinitely. But hey, that’s just me.