What are the side effects of shaving a tooth?

Question

Hello doctor,

My daughter recently had fixed braces fitted. Shortly after, one of the brackets came off from the tooth. Four days before, the orthodontist re-fixed it to the tooth. We were told that it might happen again because of the shape of the tooth sticking out. The orthodontist added that if it happens again, they will probably need to shave off part of the tooth. The bracket came off again yesterday.

However, that tooth is perfectly ordinary and is not a weird shape. Is it normal to shave off part of a tooth for this reason? Have you ever done that just to fit a bracket, on and is it quite common to do so? What are the possible consequences or side effects, both aesthetically and to the health of her teeth or other consequences? How likely are any of those consequences in your experience?

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Bracket breakages are common in the initial phase of orthodontic treatment. Breakages happen due to several factors such as incorrect bonding or excess forces to the tooth. From a patient's perspective, breakages can occur from eating something that was restricted, sleeping on the side where the breakage happened, or fiddling with the braces. In either case, previous material is removed from the tooth surface and cleaned. A fresh bracket or using the old bracket after cleaning is placed again for the treatment. However, if it happens again, modification of the treatment plan is usually done.

Regarding your daughter's case, if the breakage has happened twice, a fresh bracket should be placed after cleaning the tooth surface, or maybe we can even delay the bonding of that particular tooth for one appointment and let the other teeth get settled with the forces. The shaving off of the tooth is done to remove the previous composite material (which is used to stick the bracket to the tooth) from the tooth surface, but only the material is removed from the tooth surface, and not any tooth material is removed/shaved.

If the doctor is intending to only remove the composite material, it is a common procedure. The side effects however included loss of enamel (first layer of the tooth), roughness of the tooth surface, and since the thickness of the tooth is reduced, chances of food deposits and cavities are increased.

Proper finishing and polishing have to be done when the tooth surface is cleaned, and a fresh bracket is placed. However, altering the tooth surface only to bond the bracket is not recommended.

I would recommend properly enquiring the doctor about the reshaping process he/she is intending and if possible, sharing the photo of the tooth that is having the issue and I can give you my opinion precisely.

I hope I have answered your question.

Let me know if I can assist you further.

Regards.