Exactly How Permanent Is My Permanent Retainer?

(Will I die with it in my mouth?)

Artificial human skull.

About a decade ago, in the backseat of a car coming home from an engagement party, a friend’s then-girlfriend and I were talking about our permanent retainers. We’d gotten them during childhood after our braces were removed; a thin metal bar attached to the back of our bottom row of teeth. Neither I nor the friend’s then-girlfriend had any idea whether we were supposed to still have our retainers, or if we were supposed to have requested their removal at some point. I thought about this. “Are we going to die with our permanent retainers?” I asked her. She thought about this. “... I don’t know!”

Because the retainer has existed in my mouth for the majority of my life, it’s hard for me to determine whether or not I hate it. My tongue touches it constantly, and I have to maneuver around flossing it every night, and it’s affixed to my teeth at its right and left points with dental cement globs, and the glob on the right has gotten sharp, which is somewhat unpleasant. And once I told a boyfriend that I had one and he said “I know, I can see it,” which was a horrifying response. But, like an area rug that is fine, its presence doesn’t bother me enough to have ever considered removing it. When I got the retainer I certainly didn’t think, here is a new addition to my body that I will have forever. And yet here we are.

The only time its removal was ever mentioned was during its installation. My orthodontist said I would keep the retainer until at least a period of time after my wisdom teeth were extracted, to prevent shifting. Then my dentist introduced the idea of extraction this way: “Your wisdom teeth are fine, so we can take them out whenever you want.” Uh-huh. They’re fine, so I’m free to schedule the unnecessary procedure at my leisure? Okay, man. I chose to schedule it never. The idea of retainer removal hasn’t come up again, though the idea of wisdom teeth removal comes up every time a new dentist sees them; four glittering boney dollar signs begging to be unnecessarily and painfully and expensively removed. Two decades later, the retainer and my wisdom teeth persist. I suspect the retainer is doing nothing at this point.

But is it?

“The teeth would, and usually do, shift out of place when you remove the fixed retainer — even in your 30s and so on,” Joana Forsea, DDS, told me. (I thought maybe it would help the case for removal to let her know I am in my 30s and that my youthful energy is merely an affectation.) “Some form of retention is required after the fixed retainer is removed,” she said. Huh. I’m not one to trust anyone in the dental profession, but Dr. Forsea has nothing to gain by lying to me. Plus she was kind enough to entertain my questions, which got progressively stupider after this. I deem her trustworthy on at least a temporary basis.

I did ask another orthodontist, though, just to be safe. “Because your teeth can move, they tend to want to drift in unpredictable ways,” said David Covell, DDS. “So the best way to make sure they stay where you want them is to have some kind of retention system, whether it’s a bonded wire or a removable retainer of some kind.” According to Forsea and Covell, if I were to remove my permanent retainer I would need to wear a non-permanent retainer for at least a few nights every week. “It’s not predictable; I’ve heard maybe 10 to 20 percent of people might not need a retainer,” Covell said, hinting at the sort of gossip orthodontists may share. “In those people maybe it’s overkill to have the wire bonded there, but for most people you do need something there to keep the teeth straight.”

While it’s unfortunate that I cannot enter an exciting new non-retainer phase of my life without sacrificing teeth straightness, this is mainly a relief. The retainer is supposed to be there; I am not passively doing something wrong. But will I die with it? “Yeah, I would say so,” said Covell. “Currently the likelihood is high,” said Forsea. Haha. I’m sorry, I know it’s unprofessional to write “haha” but, LOL.

Both Forsea and Covell clarified, though, that dying with the retainer (of old age, for argument's sake) (and the answer to “wait, don’t most old people need dentures?” is apparently no) is dependent on patient choice and care. If you pick at the cement, or drink a lot of lemon juice, the cement might wear down and the retainer might come loose; at that point the retainer-wearer would have to choose to have it rebonded. Tooth decay can also fuck it up, so you have to take care of your teeth. You can also just request to have it removed at any point, and the dentist has to do it because you’re the boss, as we learned from my story about wisdom teeth. “I’ve known some people who have had their retainers in for decades and others who, after a few years, want them taken out,” said Covell. “So it’s really the person’s choice.”

Let’s say, then, that I’ve died with my intact permanent retainer. As we know from skeletons we’ve seen, teeth pretty much stick around forever in a way that is spooky. This dentist’s website says they are arguably the most durable part of a body after death, and that once a person dies the bacteria that attack their teeth die with them. “Death leads to an instant stop in dental decay, but that’s quite a hefty price to pay!,” says the site, and that’s true, plus it rhymes. Dr. Estelle Lazer, a forensic archaeologist, told ABC Science the same thing. "Teeth tend to survive well,” she said. “Some for tens of thousands of years.”

So that leaves it up to the dental cement, then. I spoke with a representative from Pearson Dental Supply about how long that might last. “Permanent cement is supposed to be permanent,” they said, “but with age, your gums recede, and sometimes air or fluid can get under that permanent bridge, and sometimes the cement is washed or weathered away.” At that point you would have to have it re-cemented. “Depending on when you had this done, technology has advanced, and so a new cement might be more advanced and last longer.”

I wasn’t able to get a clear answer about exactly how long dental cement would last on a skeleton, though. Apparently this is not something dental supply companies have studied. But it seems like without the sort of things that wear it away during life, it could last for quite some time. So, to be safe, and depending on how you feel about your retainer, you might want to ask your family to pry it out before the funeral.

But I would rather be cremated than buried, due to my fear of being buried alive and trapped in a coffin with bugs. So what would happen to it then? Over email, I spoke with one of the funeral directors at Neptune Society, a cremation service provider. They said that they do not personally remove permanent retainers before cremation, and if the family wants it removed, they “will need to coordinate with their dentist.” Ah, my final dentist-related revenge. (I’m going to make my family keep mine as an heirloom.) (Or actually I’m going to request that the next person in my family to need a permanent retainer has mine cemented to their teeth.) “FYI,” the funeral director added, “dentist charges vary and some will not perform this extraction at all.”

Neither Forsea nor Covell had ever heard of someone requesting a retainer removal post-death, if you’re wondering. “I have not heard about this occurring...however, I have historically heard of people removing gold fillings from their loved ones, so, I suppose it could happen,” said Forsea. “Yeah, no, frankly I haven’t heard of anyone requesting that,” said Covell. “That would probably be … a bit of a challenge. I don’t know how you would or where you would do it, even. I guess for most people, if they have it in, it gets melted down.”

Yes, or thrown away, according to Neptune Society. “Any metals that happen to be left over after cremation are usually disposed of because they are typically damaged and have no value.” Aw, sad. Pacemakers get removed at no additional charge, though, “as these will explode inside the cremation chamber during the cremation process causing inside chamber damage and possibly employee harm.”

That leaves just one question — and I think we all know it — for which I turned to Dom Villella, a paranormal investigator with Paranormal NYC. “If you reappear as a ghost it would be as an image of who you once were, not as you are,” he said. “You then would be seen with your retainer but not actually have it.”

Permanent, indeed.