Getting your braces on and then having them come loose can be quite frustrating. What causes this and how can it be prevented?
There are at least three variables that need to be considered when trying to identify the cause of orthodontic bracket failure. These include the patient, the placement technique, and the tooth.
Ideal bonding strength is easily attained between a new orthodontic bracket and standard ivory colored enamel. While there are multiple different orthodontic adhesives on the market today have sufficient strength to hold the bracket on a tooth under normal conditions.
However, when the bracket is attached to any other surface other than the enamel, you can experience a total loss of bond strength, something that results in more frequent de-bonding. These other surfaces may include
• Any number of dental restorations including silver fillings and tooth-colored composites
• Hypo-calcified enamel (normally brown or yellow staining visible)
• Hyper-calcified enamel (normally have chalky or whitish appearance)
Other than being attached to any of the above surfaces, a loose bracket can also be caused by a bad bite when a tooth on the opposing arch is impacting the fixture during chewing or biting.
While all patients receive instructions about what they can and cannot eat with their braces on, it is naturally quite challenging to change people’s eating habits.
To start with, sticky and hard foodstuffs must be avoided. And that includes ice. Some patients easily forget that even some healthy foods such as raw carrots are not good for their braces, and hence must be avoided in the course of treatment. Also, any habits that involve chewing foreign objects such as fingernails, pens, etc. must be stopped if the brackets are to stay where they are supposed to be.
While sports mouth-guards are important, they can also cause dislodging of the bracket.
The placement technique
The clinical technique used by your selected dentist in Perth can also determine if a bracket stays on or not. Contemporary bonding methods demand that teeth be cleaned, isolated and then dried prior to being sealed. While there are some bonding cements, for instance glass ionomer, and some conditioning systems such as self-etching primer, that are more forgiving of saliva and water contamination, both generally produce bonds that are clinically weaker than standard sealing and etching.
How well the adhesive is forced into the mesh pad on the back of the braces can also affect the strength of the bond, with a weak bond resulting when cementing substance is not thoroughly integrated into the mesh.
Last but not the least, there is also a direct connection between the amount of time the doctor takes fiddling with the brackets prior to curing it and the bond’s strength. In fact, the more the bracket is moved around, the less uniform and thinner the cement on the back becomes, and thus the resulting bond is weaker.
All in all, patients are advised to regularly check their braces every night when brushing their teeth to make certain that none of the brackets have come loose during the day. If they notice a moving bracket, it is most likely lose. In this case, it is advised to call your dentist or orthodontist and get an appointment to have it repaired or replaced