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hey this is dr amanda with straight
smile solutions
straightsmilesolutions.com and today i'm
going to show you how to take off
braces and i've hesitated putting on
this video
actually since i started making videos
many years ago just because i didn't
want this to turn into like a
thing where people learn to take their
own braces off at home instead of going
to the dentist or the orthodontist
so um i can so i'm gonna make this and
i'm gonna talk in dental terms at high
level so hopefully hopefully crossing
fingers if i make this video only
this is only for dentists who maybe if
you're a general dentist and you have a
patient in the chair
it's an emergency or like there isn't an
orthodontist nearby
and you need to take the braces off so
you can do a filling or a restoration
or sometimes patients just have braces
on forever um
and they get kind of held hostage with
their braces which really really makes
me sad personally i think that's illegal
to do
in my opinion um i never ever ever did
that
just because it's i think it's wrong i
think it's morally wrong i mean if a
patient didn't pay for their braces
especially if it's a kid why would you
held
hold them hostage by leaving braces on
and something that could be doing damage
but that's a whole other diatribe so
i want to teach general dennis so that
he can be empowered to take
braces off on their patients now first
step always
is going to be to get a discontinuance
form signed
now i have discontinuous forms on my
website this is key
if you you legally should not be taking
off somebody's braces
in your office eat someone else's work
it's like you're messing up someone
else's work
and you could be affecting a contract so
if you go and take them off you might be
liable
and you may need to pay for new braces
for this patient so you
absolutely should not touch anyone's
braces unless
first of all you know the story behind
them try to get a hold of the
orthodontist first who put them on now
if the patient doesn't give you the name
or is unable a lot of times
you know people put braces on and they
disappear you know like there's all i
mean it happens
um legitimately um so you give it a shot
you get the page the doctor's name you
try to find out what's going on you try
to talk to them doctor the doctor
if you can get a hold of the person you
let them know you're going to be
discontinuing treatment
you know as a courtesy for
hygiene or patient requests or whatever
just letting them know
then you have the patient sign the
braces removal it's different than
a form that you sign when you are done
with ortho treatment and it's
completed it's a discontinuance as in
treatment has been interrupted a
patient has chosen to have them removed
for the following reasons you know like
you can
say hygiene period decay
patient's choice whatever you need to
have that sign
because otherwise patient can come back
to you later and say
this doctor took my braces off without
my request
i want free braces again and you will as
a dentist you'll be buying new braces
you'll either be putting them on
yourself and doing the case over again
at no cost
um or you'll be paying potentially the
dentist back so the orthodontist back so
this is why i think it's critical that
you don't just rush in
and try to be the hero and take the
braces off because
um you know this is somebody's work that
you're interrupting which might be just
right
okay so anyways so as soon as you get
that signed
the next thing you need to take a look
at and if you don't know how to do this
maybe this is something we should talk
about
but if you're taking off braces you may
need to be delivering
retainers now obviously in the case of
this patient this fake patient here
no reason to deliver retain well i don't
know you know like
let's let's think about where the
patient was what's been done because
teeth are going to go back to their
original spot slowly so
is taking off braces going to make
things worse or better should we retain
you know maybe not in this situation but
yes maybe in this situation you know
patient can waive the right to retainers
but you need to put in writing
that they understand that their teeth
may move and you're not responsible for
any movement or any health conditions
that may occur with the movement right
so what would i charge for removing
braces on a patient
um so again it depends on what's going
on
remember anytime you remove braces
you're responsible for what happens when
you take the braces off so if there's a
cavity under the bracket
and the breath the tooth breaks you
might be responsible for that so
it really depends on the the health of
the teeth um you can't just pop them off
you really have to go clean the glue off
with a high speed too so i mean
it's going to take me a good 20 minutes
to take braces off good and then the
patient should get a cleaning afterwards
so 20 minutes of doctor time i know in
some states they can the assistant can
pop them off
and clean the super gingival glue off
and the doctor needs to clean the
subject will go off and do the
polishing but i mean i generally charge
um i would say at least three or four
hundred dollars for a case just for
removal only at least
and then if they want retainers too
depends on if they want same day or they
want to send out
you know it's going to be going up from
there um
yeah that's pretty much it okay so let's
go over the armamentarium for taking off
braces
um there's a bunch of different ones
this is some of my favorites so you just
need to find what works for you
this is just your standard bracket
anterior bracket removal plier
so this one can be used on the front
teeth like these
you know because it's easy but you can't
easily do it back here right that's not
going to work
they make one that has a right hand
angle that goes like this for the back
teeth
personally my favorite is just the old
pin cutter or the ligature cutter
it will totally dull your luggage cutter
if you do it so just fyi and it's not
going to work for cutting ligatures
anymore
but it's really easy so i like these too
and then this is the adhesive removal
to get the glue off you kind of scrape i
have some other videos about that we'll
show you how to do that today
they make one that has a little claw or
a little hook that one's great too
to get the you know the big chunks of
glue off and then you'll use like a high
speed um
like a white stone to smooth it up and
then
maybe a series of greenies and brownies
to clean them up after that
garrison makes a really great they make
some rally cups those are really great
rally stuff points discs those are
really great they're kit for taking off
braces but
you know ultimately just use what you
have in your office it should be fine
you should have
pretty much everything you need so let's
go ahead and get started um
metal braces generally are pretty easy i
always leave the wires on
because it's that way it comes off in a
piece and you don't have all kind of
random pieces flying
around but good idea to you know have
some two by fours around
and maybe some high speed suction and
stuff like that too so
always always always put safety glasses
on your patient because it will fly
in people's eyes okay little things tend
to fly
metal braces are much easier to take off
than ceramics um
ceramics often shatter so i would double
the time you need and double your price
for ceramics if you have ceramics so
um certain types of ceramic brackets
actually need to be
untied and squeezed with a wine guard
plier
this is not the brand that does so i'm
assuming i can take it off
the other way and by the way these are
models from my digital
straightwire class so sometimes you know
if
doctors work on them they eventually
start breaking off so i just figured i
might as well destroy these
since we've got it all right let's go
ahead and get started i'm uh
i kind of switch my hands around just to
let you know i'm kind of a righty i'm
ambidextrous depending on what i'm doing
so you might see me do things in my
right hand in my left hand and sorry it
drives people crazy so
um so see how i just loosened that up
now this one's not engaged in the wire
so it's gonna go flying there we go
and that's pretty much it we're just
gonna sorry it's almost harder to do
this on my type but not because it's
moving
and now i'm moving to my left hand
just a little squeeze in a rock that's
all it is to squeeze in a rock
and no you shouldn't be reusing brackets
after
you do this that's really gross even if
you sterilize them i know some people do
and i think that's absolutely disgusting
all right so this pretty much will come
off as one unit what happened back here
oh i gotta take this one off
so here's how you use the pin cutter
just to let you know
kind of looking through the lens of my
ah see
it's so satisfying as my daughter would
say all in one nice piece
and then you got to go with your
adhesive remover
and just take off the big big chunks
these are tads by the way you guys
fake tad so obviously i can't yank those
out of the oral surgeon needs to take
those out
but you just go like this
you get the idea pretty easy all right
so we got the metal one done
this one's debonded let's do i should
probably put my safety glasses on before
i do this this one's gonna probably
gonna go flying so
okay oh it's pretty easy
this is really easy i wonder why it was
breaking ah did you see that that piece
of shard go flying
did it go flying yeah
see this is what happens that's we don't
want patients to be choking
so actually you know the best way to do
it is to loosen five to five
first i'm kind of getting ahead of
myself loosen five to five so it's just
anchored
in the molar tubes and then get those
last ones off so let's do it that way so
i can show you the proper way to do it
this is ceramic did you see those shards
that would be so bad oh
oh darn what a mess
this is getting all over my office
oh no that okay that actually hit my
face and i'm
not wearing a mask and i should be so
let's okay oh
what a mess this is why i hate ceramic
bra i mean i like them they're very
pretty but
i hate taking them off oh so messy
all right well that kind of came out and
then
we can use our ligature cutter to get
the molar bands off
that was easy
okay so people always ask me you know
what if i don't have a ligature cutter
what if i don't have
this one is junk it's like spraying
everything everywhere
um truthfully you can buy this stuff
from ebay
okay so see the difference on what's
left on the tee
oopsies i kind of got this out of focus
here can you see all that
that's what's left on the teeth um from
ceramic there's there's actually a lot
of ceramics still on here see this one
if it's got porcelain you're gonna have
to get your diamond high speed and just
get most of this stuff
off because it's not i can try with my
adhesive remover but
it's probably not going to come off very
good
okay so all right
that's pretty much it and then you get
this little sucker and try to
get the big chunks off the best you can
just keep going i actually think it's
easier on enamel than it is on this
plastic type or not but um you're going
to scrape your way all the way around
and then get the white stone or if
there's still porcelain get the diamond
and then do a you can always go to like
a 12 fluted carbide
white stone greenish brownies
and then polish and done so
that's how you take braces off all right
hopefully that was helpful i just made a
huge mess
have a great day and don't hesitate yeah
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hopefully this video video is being
watched by dentists and not consumers
but it's good to know what to expect
when you're getting your braces off also
so
um oh one more tip that i can give you
it's
really really kind of painful to get
your braces just because of the torquing
you know and if they have perio or if
they have any like loose teeth or
sensitive teeth it's gonna really hurt
so
i recommend that you have them bite down
on like a
cotton roll or even a chewy it's really
great from like a liner chewy because
it's more
um more elastomeric have them bite down
hard on it
and squeeze while you take each one off
and then move the chewy around
as you debond it and clean the glue is
really really helpful so that's just a
little
a little tip for you if they can't bite
down like they don't have the posing
dentition you can always
brace the tooth for them while you take
it off that really really helps
it's all about the experience right and
safeties first make sure they're got
eyewear and um you know if anything kind
of flies down their mouth you know i
always stop
and get the high speed suction if i
can't find it i tell them not to panic
sit them up and go rinse out um if we
can't find the piece
nothing in here is going to kill you if
you swallow it you know it's nothing
crazy like that but
the right thing to say is tell the
patient you know if if it got swallowed
don't worry about it
just monitor your symptoms if you have
stomach pain or
you know blood in your stool or anything
like that give us a call
you know they're not going to see it
come out but i've never in my
career had any issues like that but i
mean people do panic so
just give them you know give them that
advice and everything should be fine but
yeah
just main thing is just have them sit up
and rinse out because usually it's kind
of stuck somewhere in the vestibule or
something like that all right thanks so
much have a good one

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