Broken brackets are a pain for both parents, patients, doctors and teams. It is critical that the doctor solve the broken bracket mystery so that the case can get back on-track. Every broken bracket is often at least another month in braces. I normally don’t count brackets that break within 24 hours of bonding and I give 3-5 free broken brackets throughout treatment. Any breakage beyond that is “$X” if reported
and scheduled for repair immediately and “$y” if not reported. I also charge for extra treatment time if the breakage is chronic.
In my offices, I had a few questions I would always ask:
1. When did it happen?
* If it happened within 24 hours of the bonding appointment, it is likely the fault of the doctor or team. If it happened more than 24 hours later, it is likely the fault of the patient. Be sure that parents and patients are aware of this policy and that parents call immediately to report broken brackets. I’ve always bent over backwards to accommodate patients who had a broken bracket that was just placed within the 24 hour window because I know it’s likely an error on my end. Patients and parents should be checking their brackets daily. If they are flossing it will be quite evident if one is broken.
2. Where is the adhesive? Check to see where the adhesive is. The residual adhesive location gives more information on the source of the breakage.
Glue on Tooth:
1. Light Cure Unit needs Calibration
2. Too Heavy of a Wire
3. Too Much Force at Tie-in (heavy-handed)
4. Patient Diet Compliance
5. Bite Interference
Glue on Bracket
1. Improper Etching
2. Improper Isolation
3. Plaque on Tooth at Bonding
4. Using Fluoride Pumice or Toothpaste before Bonding
5. Using Listerine Before Bonding
6. Whitening too Close to Bonding Appointment
7. Improper Priming
8. Light Curing Improperly
9. Improper Calibration of Light Cure