I congratulate the authors on a well-designed survey identifying common retention practices in the United States. However, I remind readers that this article describes what orthodontists do.

The next step is to ask why orthodontists retain as they do. Retention, of course, is necessary. However, are these retention protocols based on sound scientific information or practice-management decisions? For example, it would be interesting to ask whether the retention protocol differs in extraction and nonextraction patients. Or does the original malocclusion such as overbite or any rotations influence the retention decision process or the retention protocol? What about the quality of the finished occlusal treatment outcome?

These results include 2 interesting findings: (1) there are regional differences in the use of fixed mandibular retention compared with removable retention, and (2) orthodontists who have practiced less than 16 years prefer lifetime retention.

These observations beg the questions “science or practice-management decisions or both?”

I encourage the authors to continue their work and follow up on the “whys” of what we do. With those data, we can study “why the differences.”