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Posted on November 5, 2018
We previously posted about some of the important steps after ortho to ensure your teeth keep their new positions (https://www.lakebaldwindental.com/blog/2018-02-06-follow-what-happens-af…). However, most of that post centered on retainers that you can take out and which are usually worn overnight. But what about the retainers that get glued in place?
Permanent retainers, also known as bonded retainers, are frequently placed on the back (tongue side) of the lower front teeth, and sometimes on the upper front teeth as well. These retainers, unlike the plastic trays that can be taken out, stay in place for years at a time. Generally, a permanent retainer is a thin piece of hypoallergenic wire which is either glued to each tooth, canine to canine across the bottom front teeth, or glued only to the canine teeth themselves.
So, why are these retainers placed only on front teeth and what do they do? First, we need to take a look at the roots of the teeth (see the pictures below). Where the molars and premolars have several roots and a broad, well-anchored base, the front teeth have cone-shaped roots which can spin easily in the socket. Due to a phenomenon called mesial drift, our teeth are always shifting toward the midline of our face. To make room for the back teeth to move forward, our front teeth may spin in place to allow for crowding and overlapping. A permanent retainer basically prevents the front teeth from spinning and as a result keeps the entire arch in its ideal post-orthodontic position.
These retainers work wonders for alignment. However, they can be a bit of a maintenance nightmare. The very same surfaces where these permanent retainers are attached are usually the place where we build up the most tartar (https://www.lakebaldwindental.com/blog/2018-07-31-dental-calculus-worse-…). On top of the fact that a retainer provides more surface area and nooks and crannies for calculus to build up, these retainers make it very difficult to floss! Fortunately, there are a few tricks of the trade for keeping a retainer healthy and clean.
Other than flossing and/or WaterPiking your retainer, make sure you brush the area a bit extra as well. I usually tell my patients who use an electric toothbrush to finish their two minutes, then click the brush on again for an extra thirty seconds just on the retainer area.
While these bonded retainers are usually fairly permanent, the glue does wash out over time, and eventually one or more teeth may become detached from the glue. If this happens, it is important to have it evaluated by your dentist or orthodontist to determine whether it is necessary to glue the area back into place, replace the retainer, or remove it altogether. Some people do prefer to have theirs removed after several years, but the teeth will always have a tendency to shift and become rotated and crowded in these areas, so it’s important to talk to your dental team about what they think is best for you. Keep smiling with those straight teeth, Orlando!
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