Are Permanent Retainers Worth It? Experts Weigh In

After you've had braces or any other type of dental work that changes the positioning of your teeth, there's a good chance your dentist may tell you that you need a retainer. A retainer helps keep your teeth in the correct position and prevents them from shifting. Hearing you need to wear a retainer is a bit of a buzzkill, but you'll be happy you wore one in the long run.

Many people are familiar with removable retainers. But if an orthodontist told you to wear a permanent retainer, would you know what they are talking about? Below, we break down everything you need to know about permanent retainers.

What Is a Permanent Retainer?

"A permanent retainer is a metal wire—similar to braces but not as obtrusive—that is glued to your teeth," Tasios says. "It is used after braces are removed to keep teeth in place." The wire is flexible and is attached to the inside of your teeth with dental cement, either in the upper or lower arch of your mouth.

Who Needs a Permanent Retainer?

Your dentist or orthodontist might recommend a permanent retainer for several reasons. The first is if you're not following guidelines about wearing a regular, non-permanent retainer. "Since so much time and money are spent on straightening the teeth, a retainer is highly advised simply because the teeth will generally move back if not worn," Kalasho says. "If you know you will lose or never wear a removable retainer, we advise a permanent one."

Some dentists are also now having people wear removable and permanent retainers to improve long-term results. In this situation, permanent retainers are placed on the bottom teeth, and removable retainers are used for top teeth, Tasios says.

What are the Benefits of a Permanent Retainer?

One significant benefit of a permanent retainer is that you can't lose it. You also won't need to bother taking it on and off regularly, which can be annoying. Permanent retainers are also pretty resilient to damage.

If you're self-conscious about how a retainer might make you look or sound, a permanent retainer has some benefits. "Another key advantage is a permanent retainer is secured behind your teeth, so it's invisible to the world, and it doesn't affect how you talk," Tasios says.

Do Permanent Retainers Have Any Drawbacks?

There's no way to sugarcoat this: permanent retainers can get a bit icky. Because permanent retainers are stuck in place, they can be tricky to brush around and clean. This can lead to a lot of gross gunk and buildup if you're not careful about cleaning.

"The biggest drawback of a permanent retainer is it causes a lot of buildup, which leads to bad breath, cavities, and gum disease in the area," Kalasho says. "I have yet to see a well-kept permanent retainer. Most of the time, due to the position of the salivary gland and the roughened surface of the cement, bacteria hardens relatively quickly on a permanent retainer, leading to bleeding and irritated gums at the site of the retainer."

Permanent retainers can also be uncomfortable, especially if the metal rubs against your tongue or the wire breaks or detaches from your teeth.

How To Prepare for a Permanent Retainer

There isn't much preparation required for a permanent retainer—the process is a lot like getting braces, Tasios says. The permanent retainer will be custom-made and cut to fit in your mouth. It's usually held in place with cement. You won't feel any pain and the whole process is pretty straightforward, Kalasho says. Before your appointment, brush and floss your teeth and ensure you fully understand all aspects of caring for a permanent retainer.

You might want to mentally prepare for how long your permanent retainer will be sticking around. As the name implies, people wear permanent retainers for a long time—far longer than they'd wear a removable retainer. "A patient will wear a removable retainer from four months to a year but will need to wear a permanent retainer for years," Tasios says. "Some even wear them up to 10 or 20 years, but that is decided on a case-by-case basis."

How to Care for a Permanent Retainer

If you have a permanent retainer, don't slack on cleaning. You'll need to clean your permanent retainer every day, carefully covering all ground with your toothbrush, including small crevices and other hard-to-reach areas. Kalasho recommends using an electric toothbrush with a round head that can fit behind your teeth and more easily access areas that are hard to get to. She also recommends using a water flosser. "Use the water flosser at a higher setting to push any food or debris that will get caught between your teeth and on the retainer," Kalasho says.

If you don't have a water flosser, use dental floss regularly. Kalasho recommends seeing a dental hygienist every three months for a cleaning. "They are the only people who can clean it well enough to keep you from developing gum disease in the area," she says. "Remember gum disease is the cause of tooth loss because its most progressed form involves bone loss.

The Cost

A permanent retainer's price tag can be a bit of a drawback. They typically cost between $150 and $1,000, Tasios says. But, you'll also need to pay for regular visits to your orthodontist and dentist for check-ups and cleanings. You'll also need to factor in-office visits to address issues, like a broken wire or a loose retainer.

The Takeaway

Permanent retainers can be helpful for people who might have trouble getting themselves to wear a removable retainer. But permanent retainers are very tricky to keep clean and can lead to problems like cavities, gum disease, and bad breath. If you're considering a permanent retainer, ensure you're fully aware of everything involved before taking the plunge.