A bonded retainer is an orthodontic device designed to secure tooth alignment after active treatment, such as with braces or clear aligners. Its function is to prevent relapse, the natural tendency of teeth to shift back toward their original positions. This retainer is a thin wire custom-fitted to the back surfaces of the teeth, providing continuous support while remaining hidden from view. It is effective because it eliminates compliance issues associated with removable retainers, stabilizing the dental arch 24 hours a day.
How Bonded Retainers Are Applied
The installation of a bonded retainer typically occurs immediately after the removal of braces. The retainer consists of a thin, multi-strand wire, often braided stainless steel, custom-shaped to follow the contours of the teeth. This wire is most commonly placed on the lower arch, spanning from canine-to-canine, though it is sometimes applied to the upper front teeth as well.
The bonding procedure begins with a thorough cleaning and isolation of the lingual surfaces of the teeth. Next, a mild acid solution is applied to the enamel in a process called etching, which creates microscopic porosities essential for a strong mechanical bond. After rinsing and drying, a dental adhesive is applied to the etched surface, and the custom-fitted wire is positioned against the teeth.
Dental composite, similar to the material used for tooth-colored fillings, is placed over the wire at each contact point to secure it firmly to the enamel. A specialized curing light is then used to rapidly harden the composite, creating a durable bond. The final steps involve smoothing any excess composite for comfort and checking the patient’s bite to prevent interference.
Essential Daily Care
Oral hygiene is essential when living with a fixed appliance, as the wire and bonding sites easily trap plaque and food debris. The primary challenge is flossing, which requires specialized tools to clean under the continuous wire. Patients must use a floss threader or a product like Superfloss, which has a stiff end that can be threaded beneath the retainer wire at the gumline.
Once the floss is passed under the wire, it cleans the sides of the teeth and under the gum tissue. A water flosser is an addition to the daily routine, as the pulsating stream of water effectively dislodges plaque from the hard-to-reach areas around the wire and bonding material. Brushing should be done at least twice daily using a soft-bristled toothbrush, paying extra attention to the gumline and the area above and below the retainer wire to prevent the accumulation of calculus (tartar).
Dietary caution is necessary to protect the retainer. Patients should avoid biting directly into hard foods such as apples, carrots, nuts, and ice, which can cause the wire to bend or the bonding material to chip away. Sticky foods like caramels and chewing gum should also be avoided, as they can pull on the wire and loosen the bond over time. Consistent preventative care helps prevent breakage and localized gum inflammation.
Longevity and Removal
Bonded retainers are intended to be a long-term solution to maintain tooth alignment. While they are expected to remain in place for many years, their longevity depends heavily on the patient’s oral hygiene and dietary habits. Lower arch retainers often remain effective for over a decade, but upper retainers may have a shorter lifespan due to bite forces.
Regular checkups are necessary to inspect the retainer for signs of wear, such as a loose bond, a bent wire, or calculus buildup. If any portion of the composite bond breaks, an orthodontist must address it promptly to prevent teeth from shifting. A loose wire can also irritate the tongue and must be re-bonded to restore function.
When the retainer needs to be fully removed, the procedure is performed by a dental professional. The orthodontist uses a specialized bur to grind away the composite material securing the wire to the enamel. Once the wire is detached, the remaining bonding material is polished from the tooth surface.