Good News, Bad News

August 18, 2026
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Posted By: Swords Orthodontics

It was a bit of a Good News, Bad News appointment.

I was fitting the replacement brace for the guy that lost his brace while out for a walk. This was half of a brace system called a “twin block” where there is one brace on the top jaw and one on the lower. He’d lost the lower one and we had a replacement made. I had asked him to continue to wear the upper brace in the meantime. When he came in, his mum said

“well we have a bit of news with the upper brace. Show Stephen the brace…”

The patient duly takes out the brace and it’s broken in two bits. But if you put the bits together and press it into the mouth it still clips on to the teeth. Which means that it stays in passively but it’s not really a long term solution for moving teeth because it will fall apart when it applies pressure on the teeth to move them.

Fortunately, the replacement for the lower brace fit perfectly. Otherwise I would have to be adjusting it as well as rectifying the new problem with the broken upper twin block brace. The upper brace might be amenable to repair, but almost certainly will need to be completely replaced. So I went through the process of making a replacement upper brace for him and in a few weeks he’ll be coming back to get the replacement one fitted (or the repaired original if possible), and with luck we will be back to where we were a couple of months ago.

On further questioning the fate of the broken upper brace was established:

“My sister hit me in the face. We weren’t having a fight, she was dancing and her elbow hit me in the face.”

“Her elbow hit your face so hard that a brace in your mouth fractured into two pieces? That’s a huge amount of force. Were you knocked out? Any broken bones? I’ll need to check for a fractured cheekbone. The force needed to crack the brace on the other side of those bones could easily have broken your jaw. Any double vision since the injury?” His mum seemed a bit concerned with the chain of events.

“Well it wasn’t in my mouth when the break actually happened. Her elbow sort of caught my mouth and knocked the brace out of my mouth and it landed on a hard floor and broke.” This was a development in the story that his mum wasn’t aware of.

I looked up from the teeth, made eye contact with his mum, then returned my gaze to the teeth and the replacement lower brace.

“But we have good news… we found the lost lower brace!”

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