To think braces break and sometimes it’s unavoidable for the child?

[MumEeeee]

DS has braces and the orthodontist today threatened to remove them if they break again. They’ve broken twice.
He’s conscientious and follows the rules, keeps them very clean (confirmed in check ups) and eats the food they say.
Two days ago the back bracket popped off when he was eating rice. Soft food, our theory is it was maybe a teeth clash moment. His teeth are unusually crowded and I’d guess have more pressure, there’s also some overlapping of teeth.
When he just had them, about six months ago, two brackets popped off. One they said was just the pressure at the front but the other at the back (same place) was his fault. I was with him this time also, he was eating a smooth peanut butter soft bread sandwich.
They won’t listen than he hasn’t been eating crunchy food or gnawing on bone.
Has anyone else had this issues with an nhs orthodontist?

4 teeth, the tension over the biggest gap where one tooth is far back I think is the root of the issue

Ds1 had a bracket come off twice the whole time he had braces on. DS2 has had brackets come off or wires come loose about 100 times!

Ds hovers between the first and second centile for weight, and my least favourite bit about the braces is the increased food issues. Always soft, limiting amounts, overly particular. It’s the last thing he needs.
I think I need to explain to the orthodontist the impact the shaming over food choices has, that he’s anxious and it’s not good for him

We'd been waiting five years. The orthodontist made one child cry. Horrible man. And yes brackets come off, wires dislodge. When we were at the surgery last year one kiddy came back in with their mum as a bracket had popped before they'd even left the car park. They only tried to make her rebook her kiddy in for an appointment at a later date.
The NHS provision for orthodontics is poor but, as you say, why should you have to pay for something which ought to be as good quality for free.

It sounds like the braces don't fit properly? They can't kick him out of the service and remove them mid way through treatment because they broke. He may have been saying that as a deterrent for you kid, clearly thinking he's eating something he shouldn't be. He sounds awful tbh. Is there a more senior one at that place you could ask to be referred to?

Just reading your post many months later. I'm an adult having braces abroad. Rarely came off as a teenager but now seems to happen more. Think I also eat more junk now. Plus I'm living in a hotel and have been for 7 months due to being abroad. I can only eat out and I can't have a predictable diet for my teeth. My orthodontist said he'll fix it each time (private in India) but he seemed really put out. I mean it means regluing it and any delay in the final product is my fault but cant see the big deal. It takes 5 mins🤦

If you aren't in there with him, isn't this more just a jokey thing that people say to kids to scare them but it's actually an empty threat

I work in ortho and there are a few things going on here.

Very often a broken brace means that we can't progress onto the next wire and so delays treatment, sometimes by several visits depending on the breakage.

The longer braces are on teeth the higher the risks are, especially around root reabsorption and decalcification, both of which are permanent.
Risks vs benefits have to be considered and if the patient is at high risk of permanent damage due to short roots/high sugar diet/poor oral hygiene etc. it's hard to justify keeping braces on when treatment isn't progressing.

All clinicians should be monitoring breakage rates and trying to help keep them to a minimum through education around diet and good brace care, and by making sure the patients teeth aren't biting off their own brackets.

It is our job to make patients aware of what's going on, and sometimes "We're finding it hard to move up the wires due to repeated breakages, I really need you to stop chewing gum if you want these off in the 18 month time-frame" can be reported as " I got shouted at/she said they're never coming off" etc

Some orthodontists have terrible chair-side manner and many have collosal egos. I've cringed hearing the way some speak to patients.

You also get patients who swear blind to you and their patents that they're doing everything, as instructed as you pull strings of chewing gum or jumper sleeve fluff from their wires, or look at their florescent blue (sweet induced) tongue or their bottle of licozade in their blazer pocket.

The most common reason brackets come off is diet-related but it can be chewing pens or sleeves, picking/pressing at them etc too. Anything that applies excessive pressure.

It can be tricky if a tooth is very out of line compared to the tooth next to it, you need to put pressure on it for it to move, but too much pressure might mean the bracket pops off, often during the appointment or very shortly after.

It can also be clinical factors like poor bonding technique or poor isolation (lots of saliva everywhere). Less regularly you can get faulty materials or equipment. Sometimes the patient has little grooves or pits or areas where the enamel is slightly abnormal and this reduces the bond strength too, likewise if there's been a filling placed where we want to bond.

But ultimately patients should always be treated with respect and clinicians should always be working towards the best patient outcomes.

Had 2 kids in braces and had them myself. The wires are the most prone to breaking. Brackets do occasionally come off. If it's happened twice with the same orthodontist I do wonder if it's something the dentist is doing wrong and he's blaming your DS for his own failure.

I'd have to push back and say something. Firmly, that she is wrong and tell her that if she keeps blaming ds wrongly and unfairly I'll be complaining.

Exactly this happened to me when I had braces in the nineties. Once, the bracket popped off as I was walking home after my appointment. I was extremely careful to avoid foods I wasn’t allowed and it just seemed to happen all the time anyway. Orthodontist was constantly telling me off, it was horrible.

My DD had a 'button' glued on as part of her braces process. It fell off and was swallowed the very next day. She wasn't even eating. We went back and had it replaced and the second one lasted a week before it fell off while eating a soft sandwich. At this point they gave up and tried a different technique. My daughter was not blamed.

I think orthodontists can be quite horrible to kids sometimes and also maybe braces are not as tough.

I had braces as a kid and I don't remember any of these rules, I never worried about what I ate. I only broke my brace once (in fairness eating a toffee!!). I never had a retainer either despite the modern warnings if you don't wesr your retainer FOREVER your teeth will move back.

To update the thread- The orthodontist left and there’s been another one since. No brackets have come off and nothing has broken since. It’s been smooth sailing. Ds says the wires are trimmed better, no bits digging in and less pain