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.
After getting braces, it is important to know how to take care of your teeth in order for your braces stay intact and do their job. This helps to ensure that your teeth are in top-notch condition after completing orthodontic treatment. Our team at Sondhi-Biggs-Hansen Orthodontics recommends the following tips to ensure successful cleaning of your braces.
Permanent retainers work well for individuals who desire less maintenance. Once the permanent retainer is placed there is no need to worry about daily retainer schedules. Because teeth tend to shift as we age, a permanent retainer is typically a better long-term solution. One draw back for some patients is the extra effort of cleaning around a permanent retainer, which can sometimes become a "food trap" and does take a little more time to keep clean.
Every child develops at a different rate. Although we have general age guidelines when baby teeth should be lost and replaced by an adult tooth (eruption), there is a broad spectrum of when this will actually occur. Generally, the first baby tooth falls out around the age of 6 years old. Some children may have the majority of their adult teeth by the age of 10 and others it may be the age of 15. This is one reason the American Association of Orthodontist recommend a child be screened by an Orthodontist around the age of 7. It is the job of a dental professional to determine if your child is delayed in their dental development, and if so, is there a reason for it. Orthodontists are specifically trained to be aware of such problems. Aside from delayed development there are other reasons baby teeth do not fall out as expected. Some reasons for delayed eruption of adult teeth include extra teeth that may get in the way, inadequate space for the adult tooth to come in, or it may be that an adult tooth is missing. Some children would benefit from interceptive treatment to help create space to guide adult teeth into the proper path to enter the mouth.