Why do braces break or become loose?

On the day you start your treatment with braces, careful attention is paid to adhering (sometimes calle bonding) braces to your teeth. The way braces are bonded is similar to how a tooth-colored filling is done on a tooth. If the technique is done carefully and the oral environment is dry, the bond is very strong.

In our practice we take the same careful steps on each patient we place braces on. We keep the teeth dry using a retractor that keeps the tongue and cheeks away from the teeth and removes excess saliva from the mouth using suction. We carefully clean the teeth and make sure there is no food or plaque on the surfaces where the braces will go.

At the end of placing braces, we give each brace a tug to make sure it is adhered securely and check the bite to make sure patients are not biting directly on braces. Advice is given to patients on things to

1. Social concerns. Teeth that are very prominent, crowded, or affecting a child’s confidence can be a good reason to start sooner rather than later.
2. Early loss of primary teeth. If a baby tooth is lost or extracted long before the permanent tooth is ready, a space maintainer (often a lower lingual holding arch) can hold the parking place for the next tooth.
3. Functional concerns. Crossbite, finger or tongue habits, airway concerns, and very large overbites, overjets, or underbites. A single upper tooth sitting behind the lower teeth can also wear enamel and stress the gumline if it is left alone.

In many of those cases a second phase is still needed once the permanent teeth are in. The first phase is about intercepting a problem so the second phase is simpler, shorter, or more stable — not about skipping comprehensive treatment forever.

If you are not sure whether your child is ready, the first visit is complimentary. We will look at growth and bite, talk through timing, and only recommend early treatment when it actually helps. See New Patients for forms and what to expect, or Services for examples of expanders, space maintainers, and crossbite correction.

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