Orthodontic treatment with braces is a highly effective process for aligning teeth and correcting bite issues. These appliances, composed of metal or ceramic brackets, specialized bonding agents, and archwires, are designed to withstand normal daily function. Despite their durability, the components of fixed braces are subjected to constant mechanical forces and environmental stressors throughout the treatment period. A compromised appliance can interrupt the prescribed movement of teeth. Understanding how to address component failure helps keep the treatment on track.
Defining Breakage and Expected Frequency
Breakage refers to any mechanical failure that compromises the appliance’s integrity or causes discomfort. The most frequent issues include a loose or detached bracket (when the adhesive bond fails) or a broken archwire that snaps or bends out of shape. Less severe incidents involve a lost elastic ligature or a loose molar band.
A small amount of component failure is a recognized part of the treatment process. Studies suggest the overall bracket bond failure rate ranges from 6% to 11% over the course of treatment, with most events occurring within the first six months. Most patients experience at least one minor issue, such as a poking wire. While a single bracket failure every few months is normal, breaking components every few weeks is excessive and indicative of an underlying issue.
Common Causes of Component Failure
Mechanical stress from dietary choices is the most common reason for a bracket or wire to break. Consuming hard foods, such as nuts, hard candy, or ice, creates concentrated force that can shear the bracket from its adhesive bond. Similarly, sticky and chewy items like caramel or taffy can pull directly on the wires and brackets, causing them to distort or detach.
Oral habits also introduce damaging forces. Patients who habitually chew on non-food items, such as pen caps or fingernails, risk placing unnecessary pressure on the components. Ice chewing is particularly destructive, as the extreme temperature change combined with the brittle nature of the ice can easily fracture the cement bond. Accidental trauma from a fall or impact during sports without a protective mouthguard is also a significant cause of component damage. Less frequently, failure occurs due to technical reasons, such as improper bonding technique or natural wear from an opposing tooth hitting the bracket during biting.
Immediate Action and Handling Emergencies
Managing a breakage immediately focuses on relieving discomfort and preventing further damage until an appointment can be made. If a bracket is loose but still attached to the archwire, gently cover it with orthodontic wax to keep it from irritating the cheek. If the bracket has completely come off the wire, safely remove it and keep it to bring to the orthodontist’s office.
A broken or poking wire should also be covered with orthodontic wax to create a smooth buffer. If the wire is causing severe pain and cannot be repositioned, a sterile pair of nail clippers can be used to carefully clip the protruding end, but this should only be done as a last resort. For a loose molar band, avoid chewing on that side and contact the office immediately, as attempting to re-cement it at home is not advised. Rinsing the mouth several times a day with a warm saltwater solution can help soothe irritated tissue until the appliance is repaired.
Preventing Future Damage
Proactive patient behavior is the most effective defense against recurring component failure. Strict adherence to the restricted food list is necessary; hard, crunchy, and sticky items must be avoided for the duration of treatment. Instead of biting directly into foods, cut items like apples or carrots into small pieces to be chewed with the back teeth.
Maintaining meticulous oral hygiene protects the hardware by preventing plaque buildup that can compromise the bond. Brushing after every meal and using specialized floss threaders or an oral irrigator ensures food debris is not trapped. Patients who participate in contact sports must consistently wear a custom-fitted orthodontic mouthguard, which shields the braces from accidental trauma. Attending all scheduled adjustment appointments allows the orthodontist to monitor the appliance, address minor issues, and ensure optimal function.