Hot-Water Bath Facilitates Ceramic Debracketing

When orthodontists remove metal mesh brackets, we peel them off, similar to removing a pop-top on a can. Attempting the same method with sapphire brackets places an excessive load on the teeth. Because sapphire is harder than any material except diamond, it does not flex. Consider how workmen remove Formica countertops: they heat the surface first to soften the underlying adhesive, then peel the material away at the glue layer. That's how we remove ceramic orthodontic brackets in my office.

Metal brackets are removed first--still tied to the arches--and then the sapphire brackets are untied. The patient is given a mug of plain hot water with instructions to hold the water in the mouth for one minute without swallowing, while allowing the water to cover the front teeth (Fig. A). We keep a coffeemaker in the reception area with hot water for tea, hot chocolate, or debonding, so we always have water available at a safe temperature.

Immediately after the patient swallows the hot water, a cotton roll is placed between the teeth to be debonded, and the patient is instructed to bite down hard and hold it in place. This provides a firm, resistant platform. Then we use a vinyl debracketing plier^* to squeeze the occlusal and gingival bracket wings of each ceramic bracket (Fig. B).