Have you heard of "gap bands"?

The use of elastics in dentistry is not a new development. One of the earliest applications of elastics in dentistry was to extract teeth in patients with bleeding disorders. The practitioner simply placed a rubber band around the tooth to be extracted; because of the shape of the teeth, the rubber band slowly worked its way up or down the sides of the tooth roots, and the tooth just fell out in about 4-6 weeks. This use of elastics was intentional and considered a safe and effective procedure for extractions at that time.

For more than a century, similar examples of this type of elastics use have also appeared in the orthodontic literature, but in a negative sense. Such articles show the possible consequences of using these same principles to close a space ("gap") between the teeth. If placed around tooth by a patient without the supervision of an orthodontist, severe problems could result. The rubber band slides into the soft tissue, it is difficult if not impossible to retrieve it, and it continues along the distal surface of the roots, destroying the periodontal attachment and producing inflammation. As this happens, the teeth extrude, the crowns fan out as the roots are pulled together, the teeth become increasingly mobile, and could fall out.

This situation is made more difficult because elastics usually can not be seen on radiographs. As a result, consideration of the symptoms might not result in a definitive diagnosis. In the absence of the patient's or parent's acknowledgement of the use of rubber bands, trauma is usually suspected, and palliative periodontal therapy and splinting are usually performed. Alas, if the cause of the symptoms is a submerged rubber band, the teeth will continue to loosen and most likely be lost. Subsequent repair and replacement of the missing teeth and bone can require dental procedures that are complex and expensive.

Because of this known risk, orthodontists and other dentists generally consider the uncontrolled movement of the teeth using just elastics to be below the standard of care. Having attachments on the teeth with secured wire between them is the simple remedy.

A recent search using the words "gap bands" and related terms produced millions of hits. Although the term "gap bands" is newly minted, it is clearly commonly used around the world. Judging by the available videos, it is also clear that the topic is of considerable interest to many minors and adults. Please contact any one of our Sondhi-Biggs-Hansen Orthodontics team members to discuss appropriate approaches for treatment for a GAP between the teeth.