Fixed Post Orthodontic Retainers

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Happy Ides of March, whatever that is!  This time around I wanted to discuss the fixed or glued-in wire retainer that has become very popular with orthodontic patients.

While these glued in wires that string along the lower front teeth or upper teeth have been around for a long time, we are seeing a huge increase in their use in the last few years.  Let’s look at why!

First and foremost, ALL, and I mean every single case of comprehensive braces in the adult teeth MUST have long-term (forever) retention or the teeth will shift after braces.  This is a fact.  So if you are thinking about braces you must also think about what type of retainer you want to wear for 6 hours a day for the rest of your life.  Your options are removable retainers and/or glued in wires.

Prior to the widespread availability of in-office retainer-making equipment, most orthodontists would have a lab make a patient a post braces retainer.  These retainers are called a Hawley and have wires and acrylic.  The best thing about these retainers is that they could be adjusted to fit tighter or looser and lasted for years.  The drawback to them is they are brittle so can be broken easily and are expensive. The typical lab cost for a retainer is about $160.  Orthodontists charge $200 on up for them.

Lately, orthodontists have acquired thermoplastic heaters that allow them to make very tight-fitting mouth guards.  Using hard-to-heat plastics, they can now make a wide array of thick and thin mouth guards.  These mouth guards have now become night-time removable retainers.  While the equipment is expensive, the plastic sheet to make the retainers is about $6 and it takes an assistant about 20 minutes to make one.  Orthodontists still charge $200 on up for them.  The best thing about them is they are easy to make. The drawback is they cannot be adjusted, they fit or they don’t.  If you left the retainer out for a week of camping, you can’t get it to fit because your teeth shifted just a little.

Enter the glued-in wire retainer.  The fixed wire retainer is usually made of flexible wire and glued to the backs of your lower front teeth.  These are the teeth that most rapidly shift after braces. The orthodontist glues in this wire before taking off your braces so your teeth don’t shift, and if they do, IT’S NOT YOUR ORTHODONTIST’S FAULT.  The thinking goes you left the office with a permanent solution.

But that’s not what happens,  the kid or adult leaving the office still has to take care of the fixed retainer or it will fail.  Two things happen, the glue does not last forever, and it is a hassle to clean under the wire.  You and your dentist have to scrape the teeth around the wire, without pulling it off, and you have to make sure it doesn’t come loose.  Education can cue a person into recognizing if the glue fails, but I have seen virtually NO ONE who can adequately clean under that wire.  Studies have shown that the area under the wire can harbor the types of bacteria that can lead to periodontal disease.  So getting a wire retainer is not the end of the story, it’s the beginning!

So what do you do?  As a parent do I ask for removable retainers for my child and hope they wear them or do I get a glued-in wire and hope they clean them?  If they haven’t cleaned their teeth well with braces, both options have significant risks.  I usually recommend the glued-in wire for a while, then recommend removing it and wearing a nighttime removable retainer once the kid has matured and realized they can’t keep the wire clean.  The point is you have a choice and should ask your orthodontist about that choice.  Braces come with long-term commitments and consequences and they are not for everyone.  For more discussion on this topic or any other dental topic, call me on my cell at 970 481 6728 or greg@gobiggrins.com.  I love what I do, and I love helping you raise healthy, happy children!