Broken Brackets; What do I do? - Braces R Us

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Broken Brackets; What do I do?

Broken Brackets; What do I do?

Date: October 27, 2023
Braces, or orthodontic brackets, are bonded to the surface of the teeth with a special composite that is biocompatible with the tooth structure. These special adhesives are strong enough to allow the braces to stay in place in the hostile environment of the mouth. They are strong enough to withstand the forces necessary to move the teeth as well as the adverse forces placed on the braces when chewing resistant foods, and other pressures that the teeth must accept as part of daily life. Orthodontic adhesives are formulated to be strong enough to withstand most of the normal pressures placed on the braces without breaking them, but chewing on something hard or sticky can break the braces off and bend the orthodontic wires.
The bonding adhesives could be made strong enough to keep the braces in place under any circumstances, and the patients would never need to worry about avoiding hard foods or other circumstances that consistently break brackets off. This would remove one of the biggest complaints about having braces; the need to avoid hard and sticky foods and items. This would be fantastic during treatment and while the braces need to be in place. The problem with this solution is that it would be extremely difficult to remove the braces at the end of treatment, or to reposition a bracket that could not be placed in the proper position initially. The bonding adhesives must have the unique characteristic of being able to withstand normal forces, but be weak enough to make removal easy for the patient. Removal must be easy enough that there is minimal risk for damage to the teeth when the braces are removed. This is a very difficult balancing act, but modern orthodontic adhesives are excellent at achieving both of these mutually exclusive, opposing characteristics.
The braces and the wires work in concert with each other to move the teeth. The braces act as a handle that the wires can attach to and exert a force on the tooth that is sufficient to move the tooth to the desired position. It is the wires, not the braces that move the teeth, but the details of tooth position is determined by where the braces are placed on the surface of the teeth, and in relation to the brace positions on the adjacent teeth. If each brace is placed in the ideal position on each tooth, a straight and level wire shaped in the proper arch form would put the teeth in an ideal healthy, cosmetic, functional position.
If a brace gets broken it can cause significant and severe problems with the tooth movement very quickly, or it may have minimal adverse affect. How adverse or benign a broken brace will be depends on the individuals treatment and the location of the broken bracket or brace. Normally, a broken bracket is not a true emergency that requires immediate care, but it should not be ignored for an extended time period. If there is oral trauma, with teeth being displaced or broken, and the braces are broken or wires are causing pain or damage, this needs to be addressed immediately. If you are unable to contact the orthodontist or their staff, you should contact your dentist as the first responders unless there is other critical bodily injury that requires immediate emergency medical care and a visit to the emergency department of the closest hospital. If you go to the hospital, they will have a dental specialist on call that can address the oral component of the trauma just as the rest of the medical team cares for the accompanying bodily trauma. Thankfully, a visit to the emergency room, or the need for immediate dental care is rarely needed when a bracket gets broken and a more relaxed approach t0 care can be followed.
Typically, a bracket will break because something hard has been chewed on, or something “not so hard” has been working on loosening the brace by multiple small impacts rather than a single substantial impact. If this happens, you should contact your orthodontists office and let them know that a bracket has broken. It is helpful if you can tell them what tooth has the loose brace. They will be in a better position to understand how urgent it is to repair the breakage, and what else may need to be done in conjunction with the broken bracket. The staff will give you an appointment to make the repair.
Occasionally, the broken bracket will be one that is being used to hook an elastic or rubber band. If elastics are being hooked to a broken brace, this will adversely affect the elastic wear and it is best to stop wearing the elastic. If you need to discontinue elastic wear due to a broken bracket, it is best to stop wearing the elastics on both sides. Continuing to wear the elastics on only one side may create an asymmetry that would be more difficult to correct than the original problem being addressed by the elastic wear. Your orthodontist will be able to instruct you on elastic wear when you have your appointment and the bracket has been replaced.
Although the bracket adhesive is strong and does an amazing job, occasionally, broken brackets are an unfortunate part of orthodontic treatment. When this happens, call your orthodontists’ office at your soonest ability to let them know, and to make an appointment to replace or repair the broken bracket as they instruct. If you are attaching an elastic to the broken bracket, it is best to stop wearing all elastics unless you are instructed to do otherwise by the orthodontist when you call to report the breakage. Avoid traumatic breakage by wearing a mouth guard when participating in sports or other activities where trauma is a possibility, and avoid hard and/or sticky foods and items to minimize the risk of bracket breakage otherwise.

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