A permanent retainer, also known as a bonded or fixed retainer, is a thin wire cemented to the tongue-side surface of your teeth, typically placed on the lower front six teeth. Many people consider removal after several years, often to simplify their oral hygiene routine. While removal is possible, this procedure must be performed by a dental professional, such as an orthodontist or a dentist. Attempting to remove the device yourself can lead to significant damage to your tooth enamel and underlying dental structure.
The Critical Function of Permanent Retainers
The primary purpose of a fixed retainer is to prevent orthodontic relapse. This is the natural tendency for teeth to gradually shift back toward their original, misaligned positions once braces or aligners have been removed. The periodontal ligaments surrounding the teeth hold a memory of the previous position and exert a subtle, continuous pull that causes movement over time.
The retainer is secured using small dots of dental composite resin, a type of bonding material, which holds the teeth rigidly in place. This passive retention is particularly effective for the lower front teeth, which are highly susceptible to minor crowding and shifting years after treatment concludes. Fixed retention ensures stability without requiring daily compliance from the patient, unlike removable alternatives.
Assessment and Professional Removal
The decision to remove a long-standing permanent retainer follows a careful clinical assessment by an orthodontist. One major factor considered is the time elapsed since the initial orthodontic treatment finished, with greater stability expected after many years. The most common reasons for seeking removal relate to the challenges of maintaining proper oral hygiene around the fixed wire.
The retainer can trap food particles and plaque, leading to the accumulation of calculus, or hardened tartar, around the bonding material. This buildup is a significant risk factor for localized gum inflammation (gingivitis) and can increase the likelihood of developing tooth decay. Damage to the wire, such as a break or a dislodged bond, also necessitates professional attention, as this can cause irritation or allow teeth to shift rapidly.
The professional removal process is safe and straightforward. It begins with specialized instruments gently breaking the bond between the composite resin and the enamel. Once the wire is detached, the orthodontist meticulously removes the remaining bonding material, often using a low-speed dental drill. The final step is cleaning and polishing the enamel to ensure the surface is perfectly smooth and free of any residual adhesive.
Post-Removal Retention Options
Once a permanent retainer is removed, the teeth immediately become vulnerable to relapse, meaning a different retention method is almost always necessary. Orthodontic retention is generally considered a lifetime commitment because tooth movement can occur at any age due to natural aging processes and forces from chewing. The primary alternatives are removable retainers, which require strict patient adherence to a prescribed wearing schedule.
One popular option is the clear plastic retainer, often referred to as the Essix retainer, which is a transparent, vacuum-formed tray that fits snugly over the entire arch of teeth. Another common device is the Hawley retainer, which features an acrylic body and a thin metal wire that spans across the front of the teeth. Initially, the commitment typically involves full-time wear, except during meals and brushing, for several months to allow the surrounding bone and fibers to stabilize. After this initial phase, the orthodontist will usually transition the patient to nightly wear, which may eventually be reduced to a few nights a week indefinitely.