dr amanda with straight smile solutions street smile solutions.com and today we're going to
talk a little bit more about second molars bands and brackets when you put them on do
they even need to go on and that's a really individual question for each individual patient
and certainly there are some cases i can look at them at the start and i'm going to be like you're
going to need bands or brackets on the second molars and you're going to need it done early
and there are other cases where i'm like might not need them might not need them at all you
know or we'll see if we need them on we'll put them on towards the end why don't we put bad
second molar bands brackets on all the time at the beginning well i mean some doctors do
but i don't because first of all they are very very easily broken off like
very quickly broken off and when you ban them it's really bad for the gums back there i mean
not to mention gums and teeth just infections and pericornitis and all kind of nasty bad breath and
very uncomfortable very pinchy if you've ever had them you're not going to want them and it's just
not healthy i don't think long term to have bands on second molars now if a patient is repetitively
breaking brackets we're going to go ahead and put a band on there because you got a few tries
you couldn't keep it on for whatever reason they a patient might go several months without breaking
any regular brackets but as soon as you put that second molar bracket on there's a good chance
they're gonna break it because it's just further back there's a higher bite force it's a small um
you know low profile tooth like it's short so it's easy to knock things off on it and it's not it's
just not comfortable it rubs it rubs your cheek it cuts your cheek so i wouldn't want one unless
i really needed it and i wouldn't really want it until i needed it which is why i don't put them
on until i really need them if i even need them which is usually only in about 50 of the cases
so when do i know that we always need a second molar bracket well if you took out any premolars
or you're closing an extraction space not an anterior but a posterior or a premolar or a molar
yeah you're going to need them so they're going on as soon as before we even get to the heavy wire
maybe when we're in the 18 night high stage is generally where i'm going to put them on
um if there's an issue that you're having difficulty coordinating the transverse or
fixing the transverse you're going to need them so you're going to put them on um if there's in a
case where you're fixing the ap or the sagittal or the bite be it an underbite or an overjet you're
probably going to need them but for a regular run the mill easy to moderate class 1 crowding case
without transverse issues without bite integration issues you're probably not gonna need it assuming
that they didn't come out really funky like buckle or anything strange like that you know they didn't
come in all weird and wonky if they came in pretty straight you're probably not gonna need
it um but you know that's just generalizations um certainly in deep bite cases and we definitely
tackled this a little bit in some of the other videos about deep bytes specifically
about reverse curve wires if you want to watch all my other content that i made on those you can go
to my channel to get to my channel put in straight smile solutions in your youtube search bar
it takes you to my channel which has a green background once you're there there's a little
magnifying glass towards the right you can put in any keyword like rcs deep bite bite plate you
know anything like that and it'll bring you all those videos by keyword you can also scroll down
on the homepage and there's about 10 different playlists um for different things like invisalign
like braces like phase one like impacted canines like retention scanners saps and you can watch
those playlists um where we sort my seven thousand pieces of content because there's a lot of content
that's that's hiding in there but certainly on deep bike cases if you were unable to level the
curve of speed appropriately at the beginning i normally level the curve speed with a fixed
bite plate is my preference especially in growing kids it works really fast i don't even do an adult
it works way faster because you get a great combination of relative extrusion of the molars
absolute intrusion of the lower incisors and if you want absolute intrusion of the upper incisors
you can place the brackets slightly incisal you can do a um intrusion arch there's a lot of things
that you can do to get absolute intrusion of the incisors in braces favorite favorite trick would
be that fixed bite plate works super well i know nobody likes a lab fee but guess what it works
so much better and i take that any day i mean think about what your chair time is going to be
every time a patient breaks a second molar bracket it's going to probably take you 15 20 30 minutes
of doctor time to clean it up and rebound it that much doctor time to me is valued at four
to six hundred dollars so i can tell you that a 100 lab fee one time without any breakage is
way more valuable than six hundred dollars wasting fixing multiple brackets each time
so just think of it that way that's how i think of it all right hopefully this was helpful take care