Following the completion of orthodontic treatment, retainers are necessary to help stabilize the new position of your teeth and prevent them from relapsing (shifting back to their pre-treatment positions). Retainers also help to prevent the natural changes in position of your teeth as you age. Retainers are essential to maintaining that beautiful smile you’ve worked so hard for!
While removable retainers are certainly the most popular type of retainer, another type of retainer you’ve probably heard of is a bonded, or fixed, retainer. A bonded retainer is a wire that is bonded (with composite filling material) to the inside of your anterior teeth in order to help maintain their position. These retainers are often referred to as “permanent” retainers, which is a bit of a misnomer because it is not uncommon for these retainers to have a breakage that necessitates repair. Nonetheless, bonded retainers can be a great form of retention for certain situations.
Let’s delve into the pros and cons of bonded retainers to help you make an informed decision about your orthodontic aftercare.
Pros of Bonded Retainers
- Convenience: Unlike removable retainers, bonded retainers don’t require remembering to wear them. Once they are in place, you can go about your daily routine without having to worry about forgetting to wear them or losing them.
- Esthetic: Bonded retainers are discreetly placed behind the teeth, making them virtually invisible to others.
- Continuous Retention: By nature of being fixed to your teeth, bonded retainers are always working to keep your teeth aligned. They are great for preventing relapse of stubborn spaces, significant rotations, or teeth that were significantly extruded.
Cons of Bonded Retainers
- Oral Hygiene is More Challenging: While bonded retainers offer convenience, they also make it more challenging to maintain good oral hygiene. These retainers require meticulous care to prevent plaque/calculus accumulation. This includes flossing above and below the bonded wire with special tools such as Superfloss from OralB.
- Risk of Breakage: Though we hope these retainers last for a very long time without concern, as with anything bonded to the teeth, there is a risk of breakage during eating of certain foods (i.e. biting into an apple, hard or sticky foods, etc.), flexure of the teeth during grinding/clenching, or if your teeth are more mobile due to a history of bone loss (periodontal disease) it can put more stress on the retainer. Lower bonded retainers generally are about twice as successful as upper bonded retainers (when only bonded to the two front teeth in the upper). As more teeth are added to upper bonded retainers, the failure rate increases substantially.
- Dietary Restrictions: As stated above, using your front teeth to bite into certain foods can lead to breakage of your bonded retainer. Exercising caution when eating hard, sticky, or crunchy foods will still be necessary.
- Can be Uncomfortable to Your Tongue: Though most patients’ tongues adapt to the presence of the bonded retainer within a short period of time, the back of your teeth will feel bumpy rather than smooth. Also, in the event that your bonded retainer breaks, the wire may poke your tongue until it is repaired or removed.
- Will Need to be Removed if an MRI is Needed: While you won’t have to worry about setting off any airport security alarms, in the event that you need an MRI of the head-neck region it is recommended to have your bonded retainer removed to prevent distortion of the image.
- REMOVABLE RETENTION IS STILL RECOMMENDED: Regardless of whether or not a bonded retainer is placed, you will be instructed to wear upper AND lower removable retainers nightly. This is because we consider bonded retainers as a secondary form of retention on the most unstable teeth. If your bonded retainer breaks and you are unaware of it, your teeth may move. Additionally, we worked hard to precisely position ALL of your teeth, not just the teeth that the bonded retainer is attached to, and as such we want to maintain the position of all the teeth.
Conclusion
The necessity of lifelong retention to prevent movement in the position of your teeth has been very well documented in the orthodontic literature (research). This is especially important in the first year or two after your treatment. If you’ve been out of treatment for a while then you likely won’t have an issue if you skip a night or two here and there, however we recommend building nightly retainer wear into your daily rhythms to be safe. While “permanent” retainers offer a convenient and effective form of retention for some of the teeth, Dr. Bates and many of his colleagues feel that they should be considered a secondary form of retention used to maintain teeth with a high likelihood of relapse. Whether a bonded retainer is recommended by Dr. Bates, or if requested by the patient, it is recommended to also wear removable upper and lower retainers nightly to maintain the changes in arch form and position of teeth not attached to the bonded retainer. Removable retainers also prevent movement of the teeth in the event that your bonded retainer has an issue, which will likely happen at some point. With proper care and regular dental visits, bonded retainers can be a helpful additional form of retention to ensure you enjoy a straight, beautiful smile for years to come.
Our team at Bates Family Orthodontics is always happy to provide you with personalized recommendations on the type of retainer(s) that would be best for maintaining your smile. Don’t hesitate to contact us with any questions!