After orthodontic treatment, such as braces or clear aligners, teeth have a natural tendency to shift back towards their original positions. This phenomenon, known as relapse, can compromise orthodontic results. To counteract this, retainers maintain the newly achieved alignment after treatment. Fixed retainers are a specific type of orthodontic retention device designed to provide continuous support to the teeth.
What Fixed Retainers Are
Fixed retainers are also known as bonded, permanent, or lingual retainers, indicating their attachment method and discreet placement. They consist of a thin wire, typically made from braided or solid stainless steel, fiber-reinforced composite, or nickel-titanium, custom-fit to the teeth. This wire is bonded with dental cement to the back (lingual) side of the teeth, making them virtually invisible from the outside.
Their primary function is to prevent teeth from reverting to their previous positions after orthodontic treatment. They exert continuous support, counteracting natural forces from the periodontal ligament and gingival fibers that can cause teeth to shift over time. They are most frequently placed behind the lower front teeth, spanning from canine to canine, but can also be used on the upper front teeth.
Advantages and Disadvantages
Fixed retainers offer several benefits, including continuous retention, which eliminates the need for patient compliance. Because they are permanently bonded, there is no risk of forgetting to wear them, providing constant pressure to maintain tooth alignment. Their lingual placement makes them virtually invisible, offering an aesthetic advantage over some removable options. They also have minimal impact on speech once a patient adapts.
Despite these advantages, fixed retainers have certain drawbacks. Oral hygiene can be more challenging due to the wire, which traps food particles and plaque, increasing the risk of tooth decay and gum inflammation if not cleaned thoroughly. The retainer wire can also break or debond, often caused by chewing hard or sticky foods, trauma, or teeth grinding. If breakage occurs, professional repair by an orthodontist is necessary to prevent unwanted tooth movement.
While initial discomfort may occur as the mouth adjusts, persistent irritation could indicate a poor fit or a loose wire, requiring attention. Fixed retainers are a long-term fixture, lasting many years, but only an orthodontist can remove them.
Care and Maintenance
Proper care is important for the longevity and effectiveness of fixed retainers. Brush teeth at least twice a day with a soft-bristled toothbrush, paying particular attention to the area around the retainer. For cleaning between the teeth and around the wire, specialized tools like floss threaders or water flossers effectively remove plaque and food debris that a regular toothbrush might miss. Rinsing the mouth with lukewarm water after meals also helps keep the area clean.
Avoid certain foods to prevent damage to the fixed retainer. Hard, sticky, or crunchy foods, like nuts, hard candies, or chewing gum, can bend the wire or cause the bonding to detach. Regular dental check-ups and professional cleanings are also important for individuals with fixed retainers. These appointments allow the dentist to assess the retainer’s condition, remove accumulated plaque or tartar, and address potential issues early. If the retainer breaks, feels loose, or causes discomfort, contact an orthodontist promptly for repair or adjustment.