Why Did My Bracket Come Off My Tooth?

There is nothing more frustrating than getting your braces on and then having one come loose. What exactly causes this and how can it be avoided? If there were only one reason that brackets come off (break), this would be a very short blog! Surprisingly, there are at least three variables that must be considered when trying to diagnose the cause of bracket failure, 1) The Tooth 2) The Placement Technique and 3) The Patient.

Ideal bond strength is most easily achieved between normal ivory colored enamel and a new orthodontic bracket. Although there are different orthodontic adhesives on the market, most have at least enough strength to hold a bracket on a normal tooth under regular conditions. When a bracket is attached to any other surface besides normal enamel, there is a loss of bond strength that results in more frequent bond failures. Examples of other surfaces include porcelain, hyper-calcified enamel (usually have a white, chalky appearance), hypo-calcified enamel (usually yellow or brown staining visible), or any number of dental restorations including tooth-colored composite and silver fillings. If a bracket must be attached to any of these surfaces, there will be a loss of bond strength. Another tooth-related cause of loose brackets is a non-ideal 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 broken during chewing.

The second variable that determines if a bracket stays on is the clinical technique used by the orthodontist. Modern bonding techniques require that teeth are clean, isolated, and dry before they are sealed. This is the reason why we use cheek retractors with built-in suction when placing brackets. Keep in mind that if a bracket breaks off from the tooth due to a bond failure, this will happen in a matter of minutes or hours. Brackets will not break off weeks later do to bond failure!

The patient is the third cause of bracket failure. 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 raw carrots) are not good for their braces and must be avoided during treatment. Sports mouth guards are essential, but they can also break brackets and should be reported to our office. Last but not least, any habit that involves foreign objects going into the mouth (i.e. pens, fingernails, etc.) must be 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 us 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.

If at any time you suspect a loose bracket, you should call 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.

Call Varghese Orthodontics to schedule your complimentary consultation with us in our North Aurora and Huntley areas today. Every beautiful smile begins with healthy, straight teeth, and that is the goal of Dr. Varghese and our team at Varghese Orthodontics ☺

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