Color-Coded Elastomeric Modules for Elastics Placement

As a relative newcomer to the specialty of orthodontics, I have already encountered several patients who have become confused about elastics placement. While none of these situations has been unrecoverable, increased treatment times have resulted, which is undesirable both for patients eager to finish their treatment and for a Craniofacial Orthodontic Fellow trying to complete cases.

I believe our patient instructions are similar to those presented in most clinics around the world: the patient and often the parent are shown the proper placement of the elastics, and diagrams are drawn on the elastics packets for them to follow. Here is a simple method I developed as a resident in New Zealand to help patients get the placement right.

In our clinic, we generally use edgewise appliances with colored elastomeric modules, and patients are allowed to choose their own colors. When elastics are required, I ask my patients to select two colors--a main color and a secondary one. I place the secondary color on the brackets where elastics will be attached and ask the patients to connect those colors with the elastics, as shown here in a post-surgical cleft-palate patient, who chose red as a secondary color (A). This technique is especially useful in avoiding confusion with complicated box-shaped elastics or when the elastics Pattern differs between the right and left sides. Patients and parents find these instructions easy to follow, which may increase compliance with elastics wear and thus the efficiency of treatment.