Conversations: Week 10, March 2019
Parent: "My son's brace is broken again. I am not happy with this, that's the third time and the braces are only on 3 weeks. I don't think you've done a very good job here"
Swords Orthodontist: "What happened when the bracket came off?"
Patient: "Well I was eating a (insert well known brand name here) mint and it got stuck between my tooth and the wire of the brace so I tried to push it out of the way with the tooth brush and the bracket came off".
Parent: "He didn't tell me that."
Swords Orthodontist: "Do you remember when you got the braces on, and we gave you a list of foods that you shouldn't eat while wearing braces, and a list of foods that would be OK with fixed braces? Which list were these mints on?"
Patient: "Those mints weren't on the list."
Swords Orthodontist: "OK, fair enough, we didn't list the mints by brand name. But let's say you had to use your imagination and judgement, do you think these mints would be on the safe list or the not-safe list?"
Patient: "The not-safe list."
Swords Orthodontics nurse: "I'm pretty sure we said any hard sweet was a bad idea with fixed braces."
Patient: "Yes, I think you did."
Swords Orthodontist: "Fair enough, I think we'll go over that list again after I fix the bracket back on."
I did an audit once on my bracket reliability. Out of every 1000 brackets I bonded, I found that I'd lose about 14 over the course of a year. So by and large, if a patient loses a lot of brackets, it's probably not bad luck, there's something strange going on, and we need to find out what.
Now fair play to the guy's honesty for admitting what went wrong.
Another typical brace problem:
For the record, the first two breakages weren't actually breakages with the brace, but the wire that connects the teeth being pulled out of the brackets and irritating the cheek - an orthodontic problem that's very easily fixed. That can happen more often when you eat hard food because right at the start of orthodontic treatment we have to use very bendy, flexible wires to connect all the teeth which are crooked. Hard food distorts the wire. As the teeth straighten out, we can put in stronger wires at each visit, and they're less likely to get distorted with the forces of eating and chewing food.
And all's well that ends well....