1 January, 2022
Braces
Why Did My Braces Fall Off?
Why Did My Braces Fall Off?
Did you or your child recently get braces? Advances in technology have made it possible to use state of the art adhesives to put braces on teeth, have them stay on for years in a harsh environment, and then come off easily at the end of treatment. To achieve this, orthodontic brackets are placed on teeth in a complex and technique sensitive process. Additionally, there are different steps involved in preparing baby teeth, natural teeth, and teeth with crowns/fillings. I will not get into what the exact steps are because you instead want to know why the bracket came off at all!
We can divide the reasons why a bracket came off into two general categories. The first is a bracket coming off within the first couple weeks after brackets are placed and the other is any time after that.
My orthodontic bracket fell off right after they were placed!?
This category is braces that come off within the first month after they are placed.
Putting braces on teeth is technique sensitive and for various reasons a step may not be completed properly. The most common reason for inadequate bond strength is moisture exposure. When we place braces we prepare teeth by placing cheek retractors and use suction to remove saliva/moisture. If for whatever reason the area is contaminated with saliva/moisture the bond strength is severely compromised. The result will be braces that fall off relatively soon after they are placed with low force levels. When we look at the tooth and there is no adhesive on it we see that there was a problem the glue to tooth adhesion. In this case we can conclude there was a problem somewhere in the bonding process. This is not to say your orthodontist did something improper – some patients (and some teeth) are much harder to work on than others!
Other potential causes in this area are improper bonding protocol by your orthodontist, expired adhesive, patients biting on brackets, or inadequate light cure time. All of these fit into this category because the bond strength is low and the bracket comes off easily. This is different from our other category.
My braces are always coming off during treatment?!
Our 2nd category is braces falling off after the first month and sometimes these patients seem to have it happen many times.
This category is more focused on patient abuse of their appliances. The reason is that if your bracket survived the first month the bond strength is adequate and the braces are falling off due to other factors. A clue we look for is where the glue is. If there is some on the tooth and some on the bracket, we can conclude the bond strength was adequate and there is another problem involved. Your orthodontist goes through a list of foods to avoid while in braces for a reason! Some food is much harder than others and that can cause excessive force and resulting broken brackets. Additionally, we always stress to avoid chewing on things that are not food: Ice, pen caps and clothing are frequent culprits of broken brackets. Everyone can have a bracket come off when eating something improper from time to time. However, I have found that I have ‘those’ patients who are always coming in with broken brackets. In this case I have a high degree of confidence there is some patient abuse factors involved. Parents please don’t get mad at your orthodontist in these cases!
Big picture and no matter why the bracket came off it can be fixed. The biggest downside of frequent broken brackets is extended time in braces. Another side effect is an aggravated parent and orthodontist! If you have further questions about why brackets break off, please let me know. Also, if there are any orthodontic topics you have questions on do not hesitate to reach out. I am always happy to address them in future blog posts!