hey this is dr amanda with straight smile solutions straightsmilesolutions.com and
today we're going to talk about putting on posterior bite bumps how do we do that
why do we do that and what's the easiest way to do that so i'm going to go ahead and show
you so posterior bite bumps are basically little globs of bumps of glue of composite that you put
on back teeth temporarily in orthodontic cases to help keep patients from breaking brackets
and or like in this situation here see how number seven and 10 or the upper twos are in crossbite
they won't likely jump forward as easily once you get brackets on them and engage them because
they're tucked behind the lower laterals so if you raise the bite a tiny bit like this
then they're much like more likely you know because even though we're in a resting
position mostly during the day at night time often we're like this right so that's like
and when we're stressed we're like this so that's like half your day that they won't be able to move
if you're locked in like that so it just makes things move quicker and easier
now remember you don't want to necessarily put posterior bite bumps on all your patients because
if you leave them on too long the tooth teeth that you put them on actually can intrude over time
and the teeth so we don't want to do that right so we only want them on as short as possible and
we want to make sure we take them off the reason why i don't like them when they're done clear or
white or tooth colored is that you forget they're on they kind of quasi start to wear down they look
just like a lumpy filling and you forget right and then later at the end of treatment patients
like aren't you going to take this off and now those teeth are intruded and now you're going
to spend another four months in braces trying to upright them so that's why i like to color them
so i'm going to show you how i do it there are a couple different ways to do it so let's pretend
like we're putting bite bumps on this patient we're only going to leave them on as short as
possible maybe only one or two months and we're going to color them so we know to remember to take
them off so this is how i do it i go ahead i make my two little blobs of glue express it out one
or you can just do one big one and split it in half either way two okay this is my little trick
i take a piece of articulating paper i like the blue side not the red side because
red side looks like blood blue side looks like blue and i put a just a drop of primer on the
articulating paper with the micro brush and i mix it around and see how my micro brush is now blue
it's really easy and then i use that to mix the composite
just it's just a really subtle blue okay mix it up
mix it all around
now here's the thing is i don't etch and prime the muller when i do this because i don't really care
if it falls off my face i want it to fall off it makes my life a heck a lot easier if it does right
so i'm gonna go ahead and roll it around okay you can even just dot it in here if
you want that's another way to do it when you roll it around and then i'm gonna go ahead
and just put it with the microbrush on the tooth it doesn't matter if you do top bottom whatever
tooth is easier obviously if it's on a mixed dentition case i would prefer to do it on a
baby tooth than a permanent tooth because that way it can fall off and i don't have to worry
about it but usually i'll do it on premolars or molars you need to make sure it does not
um you need to make sure it does not go in between the contacts or anything you also want to put
it where they're biting so it's a good idea to like have the patient tap tap tap grind around
make sure you find the spot where they're biting you know all extrusive movements and everything
so if possible you're gonna do that and make sure you do it bilaterally
because oh goodness of course this patient's like biting all kind of random spots but anyways
maybe i'll put it like right there okay and then that's pretty much it i just put it on
sometimes i'll have them lightly tap down oopsies let's not do that it's a little different on a
type of dot than on a real patient and then i just go ahead and light char
and that's that
and of course there we go and you're gonna have to do a lot of light curing because
normally of course you're putting these on in layers you know so it'll stay on for a
few months and like i said if not you remember it's blue and you'll remember to take it off
okay so we got to do that bilaterally so i have two of these here i might as well
do this correctly go ahead and do my other one what happened to my articulating paper here we
go lost it so yeah i don't do red because red looks like blood and patients freak out with that
and that way i remember to take them off if they're blue just kind of turn it blue
a little messy all righty now let's go ahead and light cure this sucker
i'm going to pause this for a second when i finish light curing and then we'll show you
all right we're done light curing let's see if this did the trick
and now you say yes it's probably a little bit overdone which you're going to find happens
which is okay honestly they're probably going to fall off anyways if not i'm going to take them
down they're going to wear them down so this is okay this is not something super crazy this will
definitely do the trick and if it doesn't come off as soon as these jumps cross bite i'm going to go
ahead and drill them off remember they're blue so they're really easy to notice that they're there
you won't forget to take them off at the end you'll make sure you get it all off too
you know which patients appreciate and that's the trick of bite turbos posterior right turbos and if
you want to do anterior bite turbos that's okay too that's for something different i tend to do
anterior bite turbos either on the backs of the canines or the backs of the front teeth you can
buy actually a mold for those which makes them a really nice shape if you want to or you can just
do the style that i just did of course you want to check your bite first that is meant for deep
bites where you want to open the bite and level the curve of speed with elastics like um triangle
elastics or posterior box elastics and you can just put it right back here if you have occlusion
again as always check your occlusion that's an alternative to a fixed bite plate which i
actually like better those are pallet supported um i think it's healthier my concern always doing the
anterior bite turbos is that it can cause some firmatus some widening of the pdl's
you definitely want to pick your patients wisely because you don't want to pick somebody with short
roots who's already maybe had some trauma to the front teeth but it's definitely an option but the
posterior bite bumps like i said are short term to clear anterior crossbite or posterior crossbite
to lift the occlusion and or to deal to reduce the likelihood that you're breaking lower brackets
during treatment but try not to keep them on any more than two months which is why we're coloring
them blue and by the way if you don't have articulating paper which i think you probably do
another way you can do this is with one of those denture pokey sticks you know those ones if you if
you see patients use those little like blue sticks to to tap a denture sore spot you can use that as
well that works just as well as the articulating trip all right hope that helped thanks so much