Why Braces Can Come Off of Your Teeth
As you know, in our office we do our best not to make a big deal out of loose braces. We’d like it not to happen, and will do what we can to aid you in helping them stay on your teeth. It can be frustrating when you are doing your best to avoid difficult foods – what causes this and how can it be avoided?
Variable #1: The Tooth
Ideal bonding strength of an orthodontic bracket is most easily achieved between normal ivory colored enamel and a new orthodontic bracket. Our orthodontic adhesives have enough strength to hold a bracket on a normal tooth under regular conditions. When an orthodontic bracket is attached to any other surface besides normal enamel, there is a loss of bond strength that results in more frequent debonding. The quality of tooth enamel varies from patient to patient and from tooth to tooth, so some teeth will naturally have a lower bond strength and, therefore, a higher likelihood of having a bracket come loose. Another tooth-related cause of loose brackets is a bad bite. If a tooth in the opposing arch hits on a bracket when the patient bites down, or even if a cusp tip in the opposing arch is directly across from a bracket, it is more likely that bracket will become dislodged during chewing.
Variable #2: The Bonding Technique
The second variable that determines if a bracket stays on the tooth is the clinical technique used by the orthodontist. Modern bonding techniques require that teeth are clean and dry before they are sealed. A second step in the procedure that can affect bond strength is how well the adhesive is forced into the mesh pad on the back of the bracket. If the cement is not thoroughly incorporated into the mesh, weaker bond strength will result. Finally, there is also a direct correlation between the amount of time that the doctor takes “positioning” the bracket before curing it and the strength of the bond. The more times the bracket is moved, the thinner and less uniform the cement on the back of it is and, therefore, the weaker the resulting bond. To minimize the impact of all of three factors on your bond strength we use an Indirect Bonding Technique which greatly reduces the time it takes to put the braces on, and therefore reduces the potential impact of all of these variables.
Variable #3: The Patient
Although all patients receive instructions about what they can and cannot eat with their braces on, changing eating habits is challenging. Hard and sticky foods must be avoided. This includes ice! Some patients forget that even some healthy foods (like whole raw carrots) are not good for their braces and must be avoided during treatment. Sports mouthguards are essential, but they can also dislodge brackets which should be reported to the orthodontist. Last, but not least, any habit that involves foreign objects going into the mouth (like pens, fingernails, etc.) must be identified and stopped.
It is important that you check your braces every night when you brush to make sure that none of the brackets have come loose during the day. Although patients commonly tell me a bracket came off during brushing, in reality it was probably already loose but was merely discovered at that time. You can tell if a bracket is loose by gently pushing on it with your finger. If you notice that it moves but the tooth does not, it is probably no longer attached. Any time you suspect a loose bracket, you should call your us to schedule an appointment to have it repaired within one or two business days. Waiting longer than that could result in unwanted tooth movement that may lengthen your treatment time.