Permanent Retainer - Cost, Comparisons & Pros vs. Cons
A permanent retainer (also called a fixed retainer) is a retainer that’s bonded to the teeth and can only be removed by a dentist or orthodontist.
What is a Permanent Retainer?
Wearing a retainer is an important part of orthodontic treatment. After wearing braces or aligners to correct your bite, the last thing you want is for teeth to shift back. Retainers keep your teeth in their corrected positions, “retaining” your new smile.
A permanent retainer usually consists of a wire and bracket system. Small brackets are cemented to the back of the teeth, and a wire is run through the brackets. The bonded wire keeps teeth in place and doesn’t allow for teeth to shift or migrate.
Permanent retainers can last for years if properly cared for and will keep your teeth from moving over time. Since they’re attached to the teeth, you don’t have to remember to wear them or take them out before eating. They’re also virtually invisible since they are on the back of teeth.
Fixed retainers do have disadvantages, however. They’re usually more expensive than removable retainers and can accumulate plaque and bacteria without a diligent oral care routine.
Permanent Retainer Cost
When considering the cost of a permanent retainer, fees for procedures and in-office visits should be considered in addition to the cost of the actual retainer. These out-of-pocket costs can add up, especially without insurance.
On average, a permanent retainer may cost around $500 to $850 per arch (upper or lower).
Your dental insurance may cover some of the cost, depending on your policy and benefits.
Permanent vs. Removable Retainers
There are two main types of removable retainers available today: traditional Hawley retainers (usually made with metal wiring and an acrylic or hard plastic base) and clear plastic retainers (sometimes called Essix retainers, after the brand who first brought them to market).
When many people think of a retainer, the image that comes to mind is that of a Hawley retainer — a metal wire goes across the front of the teeth and is attached to a plastic or acrylic base. The base is often tinted to match the gums and inner mouth.
Clear plastic retainers look like clear teeth aligners. They’re made of a clear, durable plastic-like material, and they fit over the teeth.
Removable retainers are a popular option for many after orthodontic treatment. The choice between a removable or fixed retainer is a personal one. Each offers different benefits and drawbacks.
Comparing Retainer Options
|Nonremovable, will keep teeth in place
|Not visible as the wire is attached to the back of teeth
|Durable and unlikely to be damaged with normal activities
|May need replacement every few years; annual orthodontist visits to check on retainer are recommended
|$500–$850 per arch
|Hawley removable retainer (metal and hard plastic or acrylic)
|Must be worn as directed to keep teeth in place
|Metal wire goes over front of teeth
|Made of durable materials but can be damaged from dropping or exposure to heat
|Can last 5–10 years with proper cleaning and care; if broken, replacement time may allow for teeth shifting; insurance may not cover replacement
|$150–$300 per arch
|Clear, plastic removable retainer
|Must be worn as directed to keep teeth in place
|Clear design; not visible
|May be more likely to be damaged or stain
|Depending on provider and care, can last 6 months to 3 years; replacement plans may be available to lower replacement time and cost
|$125–$300 per arch
Pros & Cons
Permanent retainers, like other retainer options, have advantages and disadvantages.
They work. Unlike removable retainers, there’s no chance of not wearing them enough. There’s no choice involved, so your teeth will stay in place.
You don’t have to remember to wear or clean them.
Because they attach to the back of teeth, they’re not visible and won’t significantly affect speech.
They can’t be lost and are difficult to damage.
They can make dental hygiene more difficult. Plaque and bacteria can accumulate in the area between the retainer and the gums and teeth, thus increasing the risk of tooth decay and gum problems.
They can be uncomfortable.
They may make it more difficult to eat certain foods, like chewy snacks or fibrous vegetables.
Getting a permanent retainer put on may require a long and uncomfortable visit to the dentist.
If a permanent retainer needs to be taken off for cleaning or replacement, the downtime while waiting for a new retainer or replacement permanent retainer can be lengthy, and it may provide teeth with an opportunity to shift out of place.
How to Clean a Permanent Retainer
Anytime there’s hardware in the mouth, there’s an increased risk of bacteria collecting in those hard-to-reach areas between hardware and your teeth. This is why a good oral hygiene routine is so important for anyone with a permanent retainer. It should include the following:
Brushing twice a day with a fluoride toothpaste
Flossing daily, being sure to pay extra attention to the back of the teeth where the fixed retainer is attached (threading floss in between hardware)
Using an antimicrobial mouthwash, which can also help kill or deactivate hard-to-clean bacteria
Here are some other tips for cleaning a permanent retainer:
Switch to an electric toothbrush, which may be more effective at reducing plaque and bacteria, and easier to use on the area with the fixed retainer.
Consider a water flosser to remove plaque and particles from back teeth.
See a dentist or hygienist every three months for a professional cleaning. They’ll be able to best clean the retainer and alert you to any gum or decay problems before they get worse.
Permanent Retainer Frequently Asked Questions
There’s no set time on how long a permanent retainer can last, especially if it’s cared for properly and cleaned with regular dentist appointments. By some estimates, a permanent retainer can even last up to 20 years. However, most fixed retainers will need to be replaced (or taken off) after one to five years. Check in with your dentist or orthodontist at least every year to check the status of your retainer.
Permanent retainers are applied by licensed dentists and orthodontists, and they are very safe. The most serious risk of a permanent retainer is not caring for it properly and having plaque build up that will result in tooth decay and gum problems. This is easily avoided by cleaning your retainer properly and keeping up with regular visits to the dentist.
If your retainer gets bent or moves, call your dentist or orthodontist right away. Any damage or change to the retainer could affect how it’s holding your teeth in place. If it’s no longer in the correct position, your bite could be at risk of shifting.
Teeth Retainer. (August 2022). Cleveland Clinic. Date fetched: January 12, 2023.
What I Wish I’d Known Before Getting a “Permanent” Retainer. (June 2022). Allure. Date fetched: January 12, 2023.
Removable vs. Permanent: Learn the Different Types of Retainers. Dental Associates Blog. Date fetched: January 12, 2023.
Retainers After Braces: Types and Maintenance. (January 2023). Colgate. Date fetched: January 12, 2023.
4 Reasons You May Have Your Permanent Retainer Removed. Colgate. Date fetched: January 12, 2023.
Are Permanent Retainers Worth It? Experts Weigh In. (September 2022). Byrdie. Date fetched: January 12, 2023.