Reality check: Do you really need that metal wire in your mouth?

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Do you need a permanent metal retainer after you’ve had braces?
WATCH: Do you need a permanent metal retainer after you've had braces? – May 21, 2019

If you’ve had braces in the last decade, chances are you’ve also been recommended a permanent retainer.

The slim metal bar is placed behind the front of one’s teeth, typically glued to the canine teeth on either side of the mouth.

It’s usually intended for years of use. In some cases, a patient can have a permanent retainer for decades.

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This can be frustrating for someone who has just completed many long — and expensive — years of orthodontic work.

But, according to Dr. Jay Philippson, a permanent retainer is the best way to maintain your newly straightened smile.

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Philippson works as an orthodontist in Duncan, B.C., and is the president of the Canadian Association of Orthodontists.

Most of his patients are given a permanent retainer on their bottom set of teeth.

“The bottom teeth are the teeth that tend to shift more than any others following treatment,” Philippson told Global News.

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“If the bottom teeth stay straight, and the occlusion (known as the contact between the upper and lower teeth) is where it’s supposed to be, they actually act as a bit of a foundation to help keep the top teeth straight.”

Permanent retainers are typically given to patients after they’ve had braces — including clear aligners like Invisalign.

If a permanent retainer is in your future, here’s what you need to know.

Why do I need one?

According to Dr. Brian Laski of Laski OrthoSmiles, teeth are susceptible to moving at any age.

“Retention is, unfortunately, something that we have to deal with for our entire lives,” he said. “If we don’t retain the teeth, they will move.”

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A number of factors can contribute to your teeth shifting over time.

“Some people believe it’s because there are fibres in the gums connecting the teeth that want to shift them back to their original position,” said Laski. “There’s also pressures on the teeth from our bite, especially if a patient is grinding their teeth at night. Even just normal chewing exerts pressure on the teeth.”

Our facial structure is also constantly changing, which can further move our teeth.

How much does it cost?

Orthodontic work doesn’t come cheap, and a permanent retainer is no exception.

The metal bar can cost anywhere from $300 to $500, but in Dr. Laski’s view, this is a small price to pay if it means maintaining the results of earlier orthodontic work.

“Think of it as an insurance policy,” said Laski.

“I think people would much rather invest a little bit extra for retainers at the end (of treatment) in hopes that they don’t need treatment again during their lifetime.”

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Philippson agrees.

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“I think we realized, as a specialty, that the teeth can and do move at any time… but people were going through a time-consuming and relatively expensive procedure to get their teeth straight,” Philippson said.

“It’s incumbent on us to provide them with the ability to keep those teeth straight.”

There’s no guarantee that the teeth will move, but the permanent retainer is an easy way to ensure they don’t.

“If I could tell a person, ‘your teeth aren’t going to move,’ it would be great! I just can’t do that,” said Philippson.

Is it forever?

While the glue that binds a permanent retainer to your teeth isn’t magic, the hope is that it lasts for a while.

In Philippson’s practice, he prefers that his patients keep the retainer until they are at least 20 years old.

At that age… if they want me to take it out, I will (but) I’ll caution them that those teeth can and do shift,” he said.

The main reason Philippson sees patients request to have the retainer removed is tartar retention.

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You likely suffer from this if your dental hygienist has to spend a fair amount of time cleaning the tartar off the area behind your front teeth where the retainer is.

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“I monitor my patients for three to four visits after the braces come off, every six months or so,” said Philippson.

“If my patients come in… and the tartar is building up, I’m not going to want to risk the gum disease that can go along with that.”

However, in this instance, Philippson would still recommend a removable retainer to replace the permanent retainer.

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Laski, on the other hand, recommends a lifetime retainer.

“These retainers need to stay in for life,” he said.

Laski treats several adults, many of whom are returning to an orthodontist after two or three rounds of treatment.

“That proves that it doesn’t matter if you’ve always had straight teeth or if you’ve had orthodontic treatment… teeth are susceptible to move at any age,” Laski said.

“It’s most frustrating for people who have had orthodontic treatment because they invest a lot of time and money. Certainly, they don’t want to have to go through it again.”

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