What to Know About Permanent Retainers

Medically Reviewed by Robert Brennan on September 06, 2023
3 min read

After you finish an orthodontic treatment to straighten and align your teeth, your orthodontist may suggest retainers. The results of braces may not last long term if you don’t use retainers to help keep your teeth in place.

Orthodontic treatment to straighten and align teeth has been around for a long time, but the results have never lasted permanently. Orthodontists worked to create a retention solution to make results more permanent. At first, they used removable appliances designed to fit your teeth. Patients could take the retainers in and out as needed to maintain the aesthetic of their teeth.

Later, orthodontists started using fixed retainers that stay on your teeth and can't be removed. Permanent retainers prevent your teeth from moving back into the previous position, and you don’t have to remember to put the retainers back in your mouth.

A permanent retainer is a single wire made of metal or strong fiber fixed to your teeth using a special bonding agent. This wire keeps your teeth in a fixed position. Permanent retainers are more common on lower teeth and usually only impact your front four to six teeth. For best results, retainers should be in place within six months of finishing your orthodontic treatment.

Cost of permanent retainers. Cost depends greatly on your specific dental needs. Permanent retainers cost between $150 to $500 on average. This means that, at most, you might spend around $1,000 if you choose retainers for both your top and bottom teeth. With proper care, retainers can last 20 years before needing a replacement.‌

Removing, repairing, and replacing retainers costs just as much as putting them in initially. Treat your retainers as insurance to the investment you made in your orthodontic treatment. If you take care of your permanent retainers, you can save money in the long run.

There are two primary placement techniques for permanent retainers. The first is fixing them only across the front of your mouth to your canines. The second is fixing them across all of your teeth.

Reasons for fixing permanent retainers to your canine teeth include:

  • Severe rotation and crowding with your lower incisors
  • The total space between lower inter-canine teeth changed
  • Your case was treated with lower incisor surgery
  • Mild crowding treated without extraction of teeth
  • Deep overbite‌

Reasons for fixing permanent retainers to all of your teeth include:

  • The gap between your front two teeth on top or bottom closed
  • Gaps between your other front teeth closed
  • Your teeth are likely to migrate following orthodontic treatment
  • You experienced a loss of teeth before treatment
  • You had teeth extracted‌
  • Teeth were severely rotated or crowded before treatment

Pros of permanent retainers include: 

  • Longer lasting results
  • No need for the patient to remember putting them in
  • Less chance of relapse‌
  • Fewer follow-up appointments needed to replace lost equipment or repair damaged equipment 

Cons of permanent retainers include: 

  • The need for precise placement
  • Specific bonding technique
  • Fragility of the device‌
  • Weakened oral hygiene 

Most breaks happen within the first six months of having your permanent retainer. Biting into hard foods is the number one cause of broken permanent retainers. They may also wear down over time if they stay in place long-term, requiring replacement later in life. Your permanent retainers may fail if:

  • They aren’t bonded correctly
  • The wire separates from the bonding agent
  • The bonding agent separates from the tooth 
  • Pressure or impact causes the wire to break

Permanent retainers leave you at greater risk for having dental problems because they may create additional small spaces to clean around. Following treatment, your orthodontist outlines ways to care for your permanent retainer, which may include:

  • Brushing all around your retainers from different angles, using gentle pressure to avoid breakage. 
  • Using a floss threader to reach tight spaces and floss up and down in the spaces under your retainer wire. Your orthodontist gives you detailed instructions on this process.
  • When brushing and flossing, not skipping any spaces, no matter how small. Bacteria are more prone to build up in small spaces that aren’t easily reached.
  • Trying a water flosser if a floss threader doesn’t work for you.
  • Avoiding hard foods and things like seeds that may get stuck in your retainer.
  • Having more frequent dental cleanings to monitor plaque and bacteria

Make sure you contact your orthodontist immediately if you think something is wrong with your retainer. Leaving your retainer loose or damaged may cause harm to your health and your teeth.