A permanent retainer is a device that keeps the teeth in the same place after a person has braces. The retainers remain in the mouth long-term and only an orthodontist can remove them.

With regular retainers, people can wear and remove them whenever they choose. Once they no longer have braces, they may wear the retainer 24 hours a day or just at night.

Permanent retainers stay in the mouth all the time and can last for up to 20 years.

This article discusses permanent retainers, including the advantages and disadvantages, costs, and removal procedure.

A person's mouth with a mirror held up to it, showing a permanent retainer on the upper teeth.Share on Pinterest
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A permanent retainer, or fixed bonded retainer, is a device that holds the teeth in their positions. After treatment with braces, orthodontists recommend using retainers to preserve the results and stop the teeth from shifting back into their original positions.

Permanent retainers consist of a metal wire that an orthodontist bonds onto the back of a person’s teeth. The wire usually rests behind four to six teeth at the front of the mouth. This might be on the upper teeth, lower teeth, or both.

However, orthodontists usually place permanent retainers behind the lower teeth, as permanent retainers on the top teeth are more likely to break.

Orthodontists usually install permanent retainers immediately after they remove a person’s braces. A permanent retainer can last up to 20 years, depending on how carefully a person cares for it.

Some orthodontists feel that permanent retainers work better than removable ones. For example, an older 2014 study in Switzerland found that 87% of orthodontists preferred permanent retention.

Another advantage of permanent retainers is that a person does not need to remember to put them in or take them out. This can be useful for those who forget to use removable retainers. People who have difficulty with memory or movement may also find a permanent retainer works better for their needs.

There are both advantages and disadvantages to having permanent retainers.

The benefits of permanent retainers are that they:

  • do not require a person to remember to wear them
  • are not visible on the front sides of the teeth
  • are durable
  • do not usually require replacements
  • require fewer follow-up appointments than removable retainers

The drawbacks of permanent retainers are that they:

  • can make it more difficult to clean and floss the teeth
  • may trap in food particles that eventually cause cavities or gum disease
  • may cause discomfort when a person’s tongue brushes against the wire

Permanent retainers require careful cleaning and maintenance to prevent breakages. Good dental hygiene is also essential to stop food from getting stuck behind the wires.

To care for a permanent retainer, people need to brush around the retainer at least twice a day. When doing this, the bristles of the toothbrush need to reach into the space between the retainer and the teeth. If this proves difficult with a regular toothbrush, people can get small interdental brushes that can get into small gaps.

It is also important to floss around the permanent retainer at least once daily. This process may pose some challenges. Some people find that floss threaders or floss picks help. Water flossing may also be an option. A person should ask their orthodontist what they recommend.

To avoid breakages, it may help to avoid very hard or chewy foods.

Below is a comparison of the features of permanent and removable retainers.

Permanent retainerRemovable retainer
Resultslong lastingvaries depending on use
Visibilityless visiblemore visible
Durabilitymore difficult to breakeasier to break
Replacementonly necessary if the retainer bends or breaksnecessary if the retainer gets lost, broken, or worn
Costmore expensive initially, but may cost less long termless expensive initially, but can require more replacements and follow-up appointments

Permanent retainers may cost $150–500 for the initial placement or a replacement if the initial retainer breaks. An orthodontist may include the amount in the overall cost for braces. However, permanent retainers do not often need replacing, and their longevity means fewer follow-up appointments.

Some orthodontic insurance plans may cover the costs of permanent retainers.

Below are some common questions about permanent retainers.

Are permanent retainers safe?

Permanent retainers are generally safe, as long as a person cares for their teeth properly. A person may have an increased risk of developing gum disease or cavities if they fail to clean properly around the permanent retainer.

The retainer may also cause some discomfort if it becomes bent or broken. If this happens, a person should consult an orthodontist as soon as possible.

What happens if the retainer breaks or falls off?

A person will need a replacement if their permanent retainer bends, breaks, or falls off. An orthodontist will need to insert the new retainer, which typically costs between $150–500.

Can an orthodontist remove a permanent retainer?

An orthodontist can remove a permanent retainer if someone no longer wants it or finds it too uncomfortable.

How long does a person wear a permanent retainer?

A person usually wears a permanent retainer for the rest of their life unless a dental professional advises otherwise.

Do permanent retainers work as well as removable retainers?

Many orthodontists believe permanent retainers are more successful at keeping the teeth in place than removable retainers.

A permanent retainer is a device that keeps the teeth in position after a person ends treatment with braces. Unlike a removable retainer, permanent retainers stay in the mouth long term. They consist of a metal wire that sits behind the teeth, making it almost invisible.

Many orthodontists believe that permanent retainers are more effective than removable retainers. People do not have to remember to wear them, and they are also more durable than removable retainers.

However, permanent retainers can make it more difficult to clean the teeth and have a higher initial cost. For this reason, people should discuss the advantages and disadvantages of getting a permanent retainer with their orthodontist.