Bite Blocks Falling Off & Bite Blocks Troubleshooting

If you just started your orthodontic treatment, you probably have a lot of questions. Your orthodontist informed you what to do in case one of the brackets comes loose. But what if something else breaks, like your bite blocks?

Bite blocks are pieces of resin bonded to your molars or incisors. One or both bite blocks may break from chewing hard foods or bonding errors. Waiting too long to replace them can have serious implications on your treatment and may cause damage to your teeth from direct contact with the brackets.

In this article, we’re going to cover everything that might go wrong while wearing your bite blocks. Whether one has fallen off, or they feel uneven, or something just feels off, we’re here to help. Read on to see if you fit any of these scenarios.

Bite blocks – what They Are and how they’re made

Bite blocks do just what they’re told – they block the bite. You probably noticed that you can’t bite all the way down now that you have braces.

Bite blocks are also called turbos, bite ramps or bite bumps, in case you heard them mentioned by a different name. They can be blue, white, or tooth-colored – the color only helps identify them better, especially when it’s time to take them off.

These resin blocks are technically made up of the same material as dental fillings, so they go on your teeth following a similar process:

  • the enamel is etched, rinsed, and dried
  • bonding is applied
  • resin is applied
  • a UV lamp is used to harden the resin
  • the orthodontist checks for bite interferences
  • a burr is used to level the bite blocks

The purpose of bite blocks is explained in depth in this article – they’re mainly used to open up your bite so that you don’t accidentally break your brackets. Functional uses of bite turbos include correcting a deep bite and using bite ramps to get teeth out of crossbite.

Bite blocks troubleshooting:

Because they’re so similar to fillings, bite turbos can sometimes fall off or parts of them can break. You may notice that your bite blocks are uneven from the very beginning, which is also something you should mention to your orthodontist.

So here’s everything you need to know in case something goes wrong with your bite blocks:

1. One (or both) bite blocks have fallen off

Bite blocks sometimes fall off – just like dental fillings do – so don’t worry too much if it happens to you. The same things that cause brackets to fall off – hard and sticky foods – can cause bite ramps to break as well.

If you’ve been very careful with your diet since getting braces, it might be that you’re grinding your teeth at night (a condition called bruxism), or that saliva or water accidentally ended up on the enamel while bonding, which caused bonding failure.

Whatever it is, your bite turbo needs replacing now, so what do you do?

If only one bite turbo has fallen off, and you only have 2-3 weeks left until your appointment, it’s safe to wait before your orthodontist sees you again. The bite can become uneven for a short while but nothing irreversible. Call your orthodontist’s office to make sure it’s okay and be careful with your food choice now that you only have one turbo to chew on.

If you’ve lost both turbos (which rarely happens within the same day, but you can lose the second one shortly), then it’s time to see your orthodontist. Your teeth will now be biting down on your braces causing one or multiple brackets to fall off. If the bite is deep, this can happen within a single day so don’t wait too long.

Some patients with underbites or deep bites can bite on their braces so hard that they end up chipping their teeth – which is far worse than a bracket coming off. If you’ve lost both bite blocks, please go in for an emergency appointment and have them replaced.

2. Bite blocks feel uneven

Do you know that “high filling” sensation you sometimes get after filling a cavity? Your dentist will grind and grind until you don’t feel the resin anymore, but you still get a lingering feeling that something is not quite right.

The same thing can happen when getting bite blocks. Your orthodontist will check to see that everything is even, but those “sensors” you have in your gums, called proprioceptors, may still signal to your brain that one side is higher than the other.

Getting your bite opened like that is a massive change to adjust to, so having both sides even is important. If the difference between sides isn’t too great, and your orthodontist has already worked on leveling your bite blocks – don’t worry, the feeling will wear off in about 24hrs.

However, if you visibly notice a big difference between your bite turbos, it’s important you tell your orthodontist. Wearing uneven bite blocks can potentially hurt your TMJ (temporomandibular joints), place too much strain on one tooth, and potentially weaken it.

3. Bite blocks and TMJ pain

If you’re getting headaches or TMJ pain (which you may experience at the ear canal level), bite blocks can potentially cause this, because they change the trajectory of the mandible.

In some situations, like a deep bite where your turbos will go on the back of your upper incisors, you may feel your bite shift significantly and sometimes feel unstable. The mandible’s new position inside the TMJ socket can cause pain to certain susceptible individuals.

Fortunately, this is not common, and most patients do just fine. It’s better to know about your TMJ issues anyway so that the orthodontic treatment can help correct them.

4. Cavities under Bite blocks

If a tooth that has a bite block is suddenly sensitive to sweet or cold foods, you might have a cavity underneath the turbos.

The risk for cavities is higher if you have a diet that’s rich in sugar and if you already have dental fillings on those particular teeth.

Molars are more susceptible to cavities because they have deep grooves that can harbor bacteria (S. mutans) that dissolve enamel and go deep into dentine. These types of cavities aren’t very obvious until the damage is much larger than what’s visible on the outside.

If the turbos aren’t covering the entire occlusal surface, or if they don’t seal off the tooth perfectly, you’re at risk. Your orthodontist should check your molars regularly and your hygiene should be exemplary.

5. Bite blocks giving you a lisp

Molar turbos won’t give you a lisp, but bite ramps on the back of your incisors are a different story. Bite ramps will temporarily interfere with the position of the tip of your tongue, affecting the pronunciation of consonants like “s” and “z”. This will go away after they’re removed, or you may even manage to get rid of your lisp with your bite ramps in place after a bit of practice.

Another cause for lisping during your orthodontic treatment is tooth movement coupled with tongue thrusting. When your upper front teeth move or tilt forward slightly, you might experience lisping because of incorrect tongue positioning (tongue thrusting through your front teeth).

This type of lisp has nothing to do with bite blocks, and you may need sessions with a speech therapist if it doesn’t correct itself towards the end of the treatment. Permanent speech modifications because of orthodontic treatment are rare, though, so don’t be alarmed.

Can bite blocks damage teeth?

Bite blocks aren’t strong enough to damage teeth because they’re made up of a resin that’s softer than enamel. So there’s no way your tooth can get broken or chipped when biting on bite blocks (unless that tooth is already fragile, but your dentist should take care of that before getting braces).

The only way bite blocks can damage teeth is through unwanted intrusion. This means either the tooth that has a bite block on or the opposite one gets pushed into the bone, often becoming more loose. Some degree of intrusion is usually to be expected, and it’s even something we want to happen, but some people’s bones are too soft and teeth temporarily move in ways we didn’t plan.

The bottom line is, no, bite blocks aren’t harmful, at least not in the short run. As your orthodontist makes them shorter, they should be much easier to handle.

How are bite blocks removed?

You won’t have bite blocks forever, and at some point, your orthodontist will remove them. You’re probably wondering how it’s done. Well, like most things in dentistry it involves a high-speed burr.

Your orthodontist will carefully grind away layers of resin with a high-speed burr until there’s nothing but a sheer layer of resin left. This is where the blue color turns out to be useful – the blue resin is easy to discern from the enamel.

The final burr should be a special kind of burr that doesn’t scratch enamel, and your orthodontist will gently clean the remaining material. This is the same type of burr that will be used to get your braces adhesive off.

If your bite blocks are big, expect to have resin residue in your mouth, rinsing and spitting a lot. But overall, it’s not a big procedure and it’s over in no time.

Conclusion

Bite blocks can break, like everything else, when wearing braces. They can cause all sorts of issues, but thankfully, these issues are minor and have an easy fix. It’s good to know what to expect, and hopefully, we’ve eased your mind a little. Thanks for reading!

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2 Comments

  1. Cathy Loft says:

    Hi
    Thank you for a very informative article. I just got bite blocks and I have already had partial bilateral glenoid fossa implants (TMJ jaw implants with screws 23 years ago. My question is because my TMJ jaw joint is screwed in will my bite still change. Nervous bc I have had no TMJD pain for 20 years and hoping the horrible pain doesn’t return
    Thanks
    Cathy

    1. Adriana Sim, DMD Orthodontist says:

      Hi Cathy, I’ve never encountered a situation similar to yours, but I can tell you how bite changes, and how bite blocks work: Gradually, the teeth that aren’t touching will descend (together with the bone and gum on them) to meet each other. The teeth that have the bite block on will temporarily slightly go deeper inside the bone. So yes, your bite will change regardless of what’s going on with your TMJ, because it will change at tooth level, not joint level.
      In patients with TMJ issues, bite blocks, elastics, etc can sometimes cause problems and pain, but so do random things, as you probably know. Your orthodontist surely knows how to navigate around your TMJ implants. Best of luck to you!

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