Loose Molar Bands & Molar Band Troubleshooting

Are your molar bands bothering you? Do you have a molar band that’s broken, loose, or just hurting your cheek or gums? It’s more common than you think, so don’t panic, you’ll have it fixed in no time.

Loose molar bands are an orthodontic emergency and need to be recemented as soon as possible. A molar band that stays loose for too long can lead to longer orthodontic treatment and even tooth decay.

So first things first, you should call your orthodontist’s office. But how do you know if it’s your orthodontic band that’s loose and not your tooth? And what about other discomforts caused by your molar band? We’ll try to answer all those questions in this article.

Loose molar band – what can you do at home?

You probably already know what molar bands are if you have them on your teeth. But if you’re just researching this, in preparation for braces, I wrote an entire article on molar bands and why patients need them.

Let’s cover the basics – how can you know your orthodontic band is loose? It can be a little tricky when it’s not always obvious. During the first months of orthodontic treatment, teeth, and molars especially, will become loose.

So if you feel like your molars have a slight wiggle, it might be your tooth being mobile. I’m talking about minimal mobility here.

Molar bands that are loose are different. You can visibly see them lift on the tooth, and you can sometimes see the cement inside (it should be white or blue).

Here’s what causes molar bands to become loose:

hard foods like pretzels, popcorn, etc.
sticky foods like toffee or gum;
chewing on ice;
FLOSSING;
bonding failure.

Molar bands come loose far less than buccal tubes – that’s why they’re a great alternative – but they still debond from time to time. Let’s address the last two reasons in the list:

Flossing – You might be flossing diligently, and that’s a great thing for oral hygiene, but did you know that flossing the wrong way when you have dental crowns or molar bands can cause them to come off?

When flossing, if you’re pulling the floss thread towards the occlusal side, it can engage the cement, or edge of the molar band, weakening its bond.

This is why I recommend you follow this technique – insert the floss beneath the contact point, in between the molar band and the neighboring tooth. Move side to side to get the food out. To remove the floss, don’t pull vertically – slide the floss to one side until it’s all out.

Bonding failure – Molar bands, just like brackets, sometimes come off through no fault of your own. When cementing them, the orthodontist needs to make sure the teeth are completely dry – which is easier said than done.

Any drop of saliva can compromise the bond strength and cause your molar band to eventually pop off.

What to do at home in case your band comes loose?

If your molar band has come off completely, or if it seems unstable, it’s best to just take it off. Use your fingers, and try to wiggle it out. It may stay stuck in between the contact points, but do your best to remove it.

KEEP the molar band and take it with you to your orthodontist appointment. Your molar band is custom-fitted to your molar and can be reused, as opposed to buccal tubes when you often get new ones bonded to your teeth.

Next, you’ll be left with excess wire on the side of the molar. If it’s bothering you or poking your cheek and you can’t wait until your appointment, grab a pair of heavy-duty clippers, and cut the wire close to the last bracket.

DO NOT pull on the wire when cutting it close to the bracket – you can cause that bracket to become loose too.

If your molar band is visibly loose, but seems to stay in place, and also has the archwire running through it, it’s best to leave it in place. Schedule an emergency orthodontic appointment to recement the band, and eat soft foods so you don’t accidentally displace it and swallow it.

How will your orthodontist fix your loose molar band?

If you’re curious about how your next appointment will go, we’ve got you covered. Fixing a loose molar band in the office is really easy. Your orthodontist will:

Remove all the elastic ties off your brackets;
Remove the archwire;
Remove the molar band;
Clean the hardened cement off the molar band;
Dry the band, isolate and dry the tooth;
Mix the cement and spread it on the band;
Seat the band on the tooth;
Clean the excess cement;
Optionally, light-cure the cement.
Check for other broken brackets.
Put the archwire and ligatures back in.

Aside from recementing the band, the entire appointment looks very much like a wire change, so if your orthodontist already does this, expect not to go back for a wire change any time soon. I guess there’s a small benefit to breaking your molar band – at least you won’t have to go to the orthodontist’s office twice.

Molar band hurting your cheek

If you have brand new molar bands and you haven’t become accustomed to them, they might be hurting your cheeks.

Ulcerations in your cheeks due to braces, even if they look impressive, are usually not serious and not considered orthodontic emergencies. So, while we empathize, we see the soreness usually go away in a couple of weeks.

Your molar band might be hurting your cheek because of a large hook that’s digging into your cheek when you’re eating or speaking. The only thing you can do is cover the hook regularly with a pea-size piece of orthodontic wax.

In time, the ulceration should heal, and the mucosa on your cheek should ‘harden’, much like a callus, so that you don’t feel any more discomfort.

If that doesn’t happen, and you’ve given it a couple of months, you can ask your orthodontist to switch to a different type of molar band or bond a buccal tube (if possible).

Molar band digging into gums

If you’ve had your molar bands for quite a while, you might have a different problem: your band is digging into the gum, or gums are growing on top of your band.

I’ve already addressed this topic in my article on gums growing over braces. It’s mostly a hygiene issue that causes gums to become puffy and red, and cover components of the band.

The tubes and hooks on the molar bands are often bonded close to the gums, and food can easily accumulate underneath the hook and the gum.

Your toothbrush alone is not enough to clean every surface of your molar bands, that’s why it’s so important to use accessories like interdental brushes and water flossers.

Going to regular hygienist appointments while wearing braces is very important for your gum health, so be sure to make it a priority.

If your gums are already very swollen, it’s difficult to make the swelling go down while still wearing bands. But no need to worry, once your bands will come off, the gum puffiness should subside within a few months.

If you’re worried that your gums are still ‘floppy’ around your molars, consult a periodontist – they should probe the gums around your teeth to find and treat problem areas.

How does your orthodontist remove molar bands?

Many patients are curious about how orthodontists remove braces when the treatment is over, but what about bands? They’re quite different and surround the teeth, so they should be more difficult to remove, right?

Well, that’s not always the case, but there are a few situations where removing orthodontic bands needs to be done with maximum care.

To remove molar bands, your doctor will use special pliers called band-removing pliers. These pliers are very handy for removing bands, as well as removing adhesive and brackets.

Quality pliers have one side that’s quite sharp, it can grab and hang on to the orthodontic band edge that’s seated beneath the gum. The other side of the plier is a plastic or rubber stop that rests on the occlusal surface of the molar. As the rubber side presses down on the occlusal surface, the sharp edge lifts the band off, until the cement snaps.

This process should be quick and shouldn’t hurt, but you might expect some pain if:

The band is seated deep beneath the gums (nothing a little Lidocaine spray can’t fix);
The molar is loosened because of orthodontic treatment or periodontal issues;
The molars are loosened after wearing a rapid palatal expander.

Obviously, your orthodontist will notice these things and be as gentle as possible, but you can also let them know ahead of time that your molars are sensitive and might hurt.

Conclusion

It’s important that you take action when you notice your molar bands are loose, or when the gums are becoming inflamed around them. Hopefully, we’ve offered useful instructions and some peace of mind for when it’s time to take your braces off.