Why Do Braces Break, and What Should I Do?

Two questions come up in our office, why do the braces break off of the teeth and what should I  do if a part of your appliance or braces breaks or is uncomfortable.  The first thing you should know is that everyone in braces will break an occasional bracket. It happens even to the most careful patients.  If the bracket comes off within the first 24 hours of placement it usually means there was a bad bond of the cement to the tooth. Although we use the highest quality orthodontic cements available (3M Unitek) any saliva that gets onto the tooth while bonding will disrupt/weaken the bond of the cement to the tooth.  However, if the bracket comes off after 24 hours of bonding then it usually is due to biting or chewing.  This is due to either the bracket being in the "way of the bite" or patients biting into something too hard which can put a lot of force onto the bracket an knock it off of the tooth.

The second question we get is" what should I do about a broken bracket or appliance"? Rarely ever is this an "emergency" that needs to be treated immediately, unless there is something that is hurting or preventing you from being able to eat or talk.  If the wire or appliance is not bothering you then you should make an appointment to come back in to get the bracket re-cemented. If you are in the first 6-8 months of your treatment you should come back in within 1-2 weeks. If your teeth shift back a little at this stage we can recover from this very quickly with no increase in overall treatment time.  But if you are in the later part of your treatment (12-20 months) you should come back in within a week so the teeth don't shift too much.

There are a few easy ways to manage discomfort or broken appliances on the go. Many orthodontic discomforts can be relieved by the use of over-the-counter analgesics like acetaminophen or ibuprofen or with the use of relief wax. For minor tooth discomfort, use whatever pain reliever works best for you when you have a headache. If a wire or bracket is causing your cheeks or gums discomfort, relief wax can be found at our office or at major chains and just needs to be applied to the area to make the uncomfortable appliance smooth to the touch. If a wire is too long, you can often use new nail clippers to clip the wire until you can make it into our office.