The day has arrived: Debond Day !!! The day has finally come. Debond day, or in patient lingo “Getting my braces removed.” Patients love getting their braces on. Then a few months go by and the famous question is asked, “When am I going to get my braces off?” It’s actually a simple procedure and every doctor has their own way of how the process works.
There are two different types of pliers the orthodontist will use when removing the brackets:
1. Bracket removing plier
2. Band removing plier
Objective: Removing the brackets, molar bands (if used) and the adhesive without damaging the tooth enamel in addition to having the procedure be as comfortable as possible for the patient.
Step one: First, do not untie! It’s important to leave the brackets in place attached to the elastic ties. This assures that the brackets come off in one piece with the arch wire. It’s safer and less messy than removing braces one bracket at a time.
Step two: Place the bracket removing plier on the gingival and incisal edge sides of the bracket. Then squeeze gently to break the seal from the adhesive that is attached to the tooth and roll towards the incisal edge to ensure the bracket is completely detached from the tooth.
Patients may feel slight pressure but, usually the process of removing braces is painless. The lower anterior teeth may be prone to being more sensitive to the removal process. Be careful with patients who have crowns, making sure not to damage the crowns. Patients with gum recession may also be more sensitive. Lightly squeezing the plier may be helpful in making the process less painful.
Clear brackets are a little more difficult to remove. This is because of the material the brackets are made out of; either ceramic or porcelain. These materials crack into small pieces, unlike stainless steel brackets that are less likely to break apart. They will become easier to remove as you get more comfortable removing traditional brackets.
Step three: Band removing pliers are used to remove bands from the molar teeth. The metal side of the plier tip is designed to engage the margin of the molar band and the silicone piece that looks like a plastic button is placed on the occlusal surface of the molar tooth. Once in position, squeeze the plier and slowly remove the molar band, rolling from one side to the other.
Step four: Once all the brackets are removed the remaining adhesive left on the tooth surface is usually removed by the assistant with a slow speed hand piece and a round bur or by the doctor with a high-speed hand piece and most commonly a white stone or diamond bur that removes the adhesive efficiently. There is usually very little discomfort when removing the adhesive. However, some patients with sensitivity from reasons mentioned earlier may need a break between arches.
After the braces and adhesive are removed, most patients describe the teeth as feeling “slippery” or “slimy” all while having a big beautiful smile on their faces. The gums may also be puffy but will go away after a few days with proper brushing and flossing. There is something very special as an orthodontic assistant getting to witness the process from beginning to end!