October’s Tip

      

Orthodontic Separators have an amazing variety of function in orthodontics and restorative dentistry. They are inserted with separator pliers, or two strands of dental tape, and their purpose is to create space.  The Orthodontic Separators are left in the interdental space for one week for younger patients, and up to two weeks in adults.  The patients/parents are instructed how to replace them with two strands of dental floss.  The patients are reminded that the separators must be in place 24 hours before the appointment. The number one reason for difficulties with fitting the orthodontic band is inadequate separation.  When the separator is missing, it is prudent to examine the health of the surrounding periodontium, as the separator may be compressed sub-gingivally. If it is left there, it may precipitate a periodontal distress.

    Orthodontic Separators are uncomfortable, particularly within the first two days.  The patient has to be forewarned to be on the soft diet for few days, to keep the areas clean, and if necessary, to take ODC analgesics (preferably acetaminophen, as the ibuprofen slows down the osteogenesis).

There is a plethora of functions of Orthodontic Separators. They create a space for:

1. Fitting the orthodontic bands
2. Accelerating the forced eruption of teeth, where the bite has to be opened
3. Accelerating the movement (translation, rotation, and eruption)
4. Fitting stainless steel crowns in the primary dentition, very little occlusal reduction may be required
5. Opening the space in the primary dentition (incipient decay), for interproximal application of the Silver Diamine Fluoride or impregnating the decay with flowable composite.
6. Just prior to preparation of the interproximal cavity (even if the separator is placed just at the time of administering anesthetic)

 

References:

1. Rondeau Seminars, Level I, Session 2; 61
2. Cerum OrthoOrganizers Catalogue; 172
3. Author’s Personal PP presentations