Permanent retainers, also known as fixed or bonded retainers, are used after orthodontic treatment to maintain tooth alignment. These devices consist of a thin wire, custom-fitted and bonded to the back surface of the teeth, usually the lower front teeth. Their main purpose is to prevent teeth from shifting back to their original positions, a phenomenon known as relapse, preserving orthodontic results. Many individuals wonder about the actual “permanence” of these retainers and when they might be removed.
How Long Do Permanent Retainers Stay On?
Permanent retainers are designed for long-term use, remaining in place for many years, even decades. Orthodontists often recommend lifelong retention to ensure orthodontic stability, as teeth can continue to shift throughout life. The duration a permanent retainer stays on is influenced by the patient’s tooth position stability after braces and the orthodontist’s assessment of long-term needs.
While the term “permanent” suggests indefinite wear, it refers to the fact that the patient cannot remove the retainer themselves. This continuous presence helps prevent teeth from moving, making them highly effective for retention. The decision to keep a permanent retainer in place for an extended period, or potentially for life, is a shared one between the patient and their orthodontist, based on ongoing dental health and alignment stability.
When Permanent Retainers Are Removed
Permanent retainers may be removed due to specific issues or patient preferences. A common reason is poor oral hygiene, leading to calculus (tartar) buildup around the wires. This accumulation of plaque and bacteria can cause gum irritation, inflammation, or increase the risk of cavities, making removal necessary for dental health. Cleaning around a fixed retainer can be challenging, requiring careful attention to hygiene.
Damage to the retainer itself, such as a broken or debonded wire, is another frequent cause for removal. Biting into hard foods, trauma to the mouth, or general wear and tear can compromise the retainer’s integrity, leading to its detachment. If a retainer is damaged, it becomes ineffective at holding teeth in place and can cause discomfort or further dental issues. Persistent discomfort or pain, or a patient’s desire for removal, can also lead an orthodontist to consider taking the retainer off, especially if an alternative retention plan is established.
What Happens During and After Removal
The removal of a permanent retainer is a procedure performed by an orthodontist. The process typically involves using specialized tools to gently detach the wire and remove the bonding cement from the tooth surfaces. This is generally a quick and painless process, though some patients might experience minor pressure. After the retainer is removed, the orthodontist will clean and polish the tooth surfaces to remove any residual bonding material.
After a permanent retainer is removed, it is necessary to implement an alternative retention method to prevent teeth from shifting back. This usually involves wearing a removable retainer, such as a Hawley retainer or a clear Essix retainer. These removable appliances are custom-made to fit the new tooth position and must be worn as prescribed by the orthodontist, often full-time initially and then transitioning to nighttime wear. Adherence to this new retention plan is crucial to preserve the orthodontic results and avoid relapse.