Fixed or Removable Retainers: Which Should You Have?
For adults weighing up a fixed or removable retainer: wear, stability, cleaning, failure and having both. The 2023 Cochrane review drew no firm conclusions about any one approach. A fixed retainer asks less remembering and more cleaning; a removable one depends on being worn.
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Clinically reviewed by Dr Ibraheem Ijaz, dentist · GDC 301711
Medical disclaimer: This page is for general information only. It does not replace an examination or treatment by a dentist.
Dr Ibraheem Ijaz, principal dentist, reviewed this page. He is a General Dental Practitioner: BDS, BSc (Hons), MSc (Leeds), PG Dip Implant Dentistry, PG Cert Restorative and Aesthetic Dentistry.
How do fixed and removable retainers work?
A fixed (bonded lingual) retainer stays glued behind the teeth, while a removable retainer works only when worn.
| Fixed (bonded) | Vacuum-formed (removable) | Hawley (removable) | |
|---|---|---|---|
| What it is | Glued behind the front teeth | Clear plastic over the teeth | Plastic plate, usually with a thin front wire |
| Seen when you smile | Usually hidden | Clear | Wire shows |
| Depends on wearing it | No | Yes | Yes |
| Cleaning | Extra time around it | Comes out to clean | Comes out to clean |
| Typical problem | Comes loose or breaks, sometimes unnoticed | Lost, ill-fitting or broken | Wire or plate breaks |
Sources: British Orthodontic Society (BOS) guidance and a 2019 UK clinical guide.
The guide adds that fixed retainers may stop the bite settling, and Hawley retainers may help back teeth settle, vacuum-formed ones less. Our page covers why an orthodontic retainer is needed.
Which retainer depends least on remembering?
A fixed retainer: BOS says you need not remember to wear it, while removable ones depend on remembering.
In a Swedish trial of 104 adolescents, all with an upper removable retainer, 72% of those answering at 5 years had stopped or seldom wore them. A 2017 review of removable appliances, not specific to retainers, says patients routinely overestimate wear. Our page covers how long to wear a retainer.
As general guidance, the routine and retainer type are given at the end of treatment, and your plan confirms this.
Do fixed retainers keep teeth straighter than removable ones?
Not consistently: a 2022 review of five trials favoured fixed over vacuum-formed in the lower arch at 3 to 6 months and 4 years only.
Searched to August 2021, it found no difference from 12 to 24 months or in the upper arch, and called most of its evidence moderate certainty. Cochrane, searched to April 2022 and excluding aligner studies, graded its 12-month fixed versus removable comparisons very low certainty. In single lower-arch trials, clear plastic retainers allowed 0.92 mm more relapse than multistrand wire when part time (56 people, wear unknown) and 0.60 mm when full time (84), which Cochrane calls not clinically significant.
At 4 years, in 42 people, lower irregularity was a median 1.64 mm higher with vacuum-formed than fixed after adjustment, with some relapse in both groups. At 5 years in a Swedish adolescent trial, among 74 finishers, it rose a median 0.6 mm with partial vacuum-formed and 0.1 mm with a retainer bonded to the canines, a significant difference but below the 1 mm the authors treated as clinically relevant.
A 2026 review of 18 trials, none past 2 years, searched to January 2026, found no definitive superiority of any type, with very low certainty for alignment, though two trials showed more arch length increase with removable retainers, at low certainty. Our page covers orthodontic relapse. If your teeth have moved, show a dentist.
Are bonded retainers harder to keep clean?
Bonded retainers take more cleaning: BOS says a high standard of cleaning around them is essential to avoid gum problems.
In a 2018 UK trial of 60 patients, median age 16 to 17, removable wear unknown, bonded wearers found them harder to clean; Cochrane reports the opposite in another (81 people). Over 12 months the UK bonded group had more plaque and calculus (hardened plaque) than vacuum-formed wearers and minimally worse gum inflammation, not apparently clinically significant. Cochrane places the plaque difference in the upper arch, calculus and gum in the lower.
A 4-year trial of 42 people found no statistical gum or plaque difference from vacuum-formed, with inflammation and plaque common in both groups. A 2022 review linked bonded with more plaque and calculus after 12 months; a 2026 review, pooling two trials (up to 2 years), found no significant difference in gum or plaque scores, at moderate certainty. A 2007 study compared 32 people 9 to 11 years into lower fixed retention with 32 at 3 to 6 months: the long-term group had more calculus, recession and probing depth, with plaque and bone level no different, and the authors questioned fixed retainers as standard for all patients regardless of attitude to hygiene.
Our pages on cleaning and caring for retainers and cleaning between your teeth cover daily routines.
Questions about this treatment? Book online or call the practice.
How do fixed and removable retainers fail?
Fixed retainers tend to detach or fracture, sometimes unnoticed, and removable ones to be lost, worn or cracked.
A 2023 review pooled 28% failure of fixed retainers across 31 studies with differing definitions, or 35% after excluding high-risk studies, on very low quality evidence: 21% within a year (9 studies) and 42% at 5 to 6 years (3 trials).
In a 2018 UK trial, removable wear unknown, 50% of lower bonded and 80% of lower vacuum-formed retainers survived 12 months, with no significant upper difference. Cochrane's full-time lower 12-month trial found more vacuum-formed failures (77 people); it graded both very low certainty. Over 5 years in a Swedish trial, 15.4% of lower canine-bonded and 7.7% of lower partial vacuum-formed retainers failed, though many had stopped wearing removable ones. A 2022 review found greater upper vacuum-formed failure after 2 years, and greater lower bonded failure.
If a fixed retainer comes loose or breaks, contact a dentist promptly: BOS says a tooth may start to drift if the glue fails. Do the same if a removable retainer is lost or damaged.
What is dual retention, and who recommends it?
Dual retention means having both fixed and removable retainers; a 2019 UK clinical guide says they can be combined in some cases.
The guide's reason: a fixed retainer can break unnoticed, and the removable one also maintains back-tooth alignment; its table says a back-up should be supplied. BOS says more than one type is sometimes recommended to reduce the chances of relapse. A 2022 NHS trust leaflet says patients with fixed retainers should have a removable one too, and a 2024 narrative review calls it recommended for patients at high risk of relapse.
A 2026 review's one dual arm came from a 12-month trial of 27 people with protruding teeth: changes were clinically insignificant in fixed, vacuum-formed and dual groups, with less upper incisor tipping under dual. A 2011 study of 45 patients found calculus rose more with fixed plus Hawley than vacuum-formed alone, with no other significant difference at 12 months. A 2025 uncontrolled dual retention study found upper arch size fairly stable at 24 months, but 36 of 78 people had a vacuum-formed retainer failure, mostly wear.
How do vacuum-formed and Hawley retainers compare?
Cochrane's one 12-month lower-arch stability trial, of 30 people on matching wear, found no difference between vacuum-formed and Hawley retainers, at very low certainty.
A UK trial of 397 patients, wear differing by arm, found less incisor change with vacuum-formed than Hawley at 6 months (median 0.56 mm lower, 0.25 mm upper), unlikely to be clinically significant upper but possibly so lower if at one tooth. Hawley retainers broke more, and a 2007 analysis found vacuum-formed more cost-effective over 6 months.
Among 86 adults in a Saudi trial, all also with lower bonded retainers, vacuum-formed rated higher for speech and appearance over 6 months, and Hawley was believed more durable. One trial in Cochrane found more lower vacuum-formed failures (111 people, very low certainty), though not by survival analysis.
Which retainer suits which person?
BOS says several factors affect the choice. In general:
- If teeth had severe rotations, closed gaps or combined gum and orthodontic treatment with support in doubt, the 2019 guide says a fixed retainer may be considered.
- If you might stop wearing a removable retainer, a fixed one, needing no remembering, may be more suitable.
- If cleaning around a retainer would be difficult, a removable one, which comes out, may be more suitable.
Are retainers priced on the practice's fee list?
The practice's current fee list does not name retainers, and it does not say whether any of its lines covers them.
Frequently asked questions
Is one retainer type better for everyone?
The evidence does not show that. A 2026 review's discussion says the choice should stay individual, weighing relapse risk, gum health, preference, expected wear, retainer design and clinician judgment. A 2017 review reported insufficient high-quality evidence on the type of retention.
How long can a fixed retainer stay in place?
Often many years, with repairs. Among 88 people 10 to 15 years after treatment, 98.9% of lower and 97.6% of upper original retainers remained, but only 40.4% of one lower wire, 61% of another and 74.4% of upper retainers had no failures. Bias cannot be excluded in this retrospective study.
Can a fixed retainer affect your bite or speech?
It can affect the bite, the 2019 guide says, especially with an increased overbite, but is unlikely to interfere with speech. In a 2018 UK trial, wear unknown, more vacuum-formed than bonded wearers reported speech difficulties and discomfort. If your bite feels different or speech does not settle, tell a dentist.
Do fixed retainers need checking?
Yes. BOS says they need regular inspection, and the 2019 guide says they should be checked thoroughly at least annually for intact wire and composite, distortion and calculus. A 2021 paper's introduction says most bond failures occur within two years of placement.
Do retainer trials apply to adults and clear aligners?
Only partly. Many trial patients were teenagers, and Cochrane, whose review covers braces, excluded aligner studies. An archived 2013 BOS guideline found no evidence for a different adult protocol where gum support is normal and no bite settling is needed.
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Reviews of Deepcar Dental Care are on our patient reviews page. Our page on orthodontics at Deepcar Dental Care covers orthodontic treatment at the practice.
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