Tricks of the Trade: Secure Spring Separators

Accidental aspiration or ingestion of orthodontic materials is a common problem among patients and a major concern for orthodontists. It may lead to unnecessary medical emergencies and further, more serious, consequences. Spring separators are often used by practitioners to bring about tooth separations. In order to avoid misplacement after separation, a simple and economic technique has been devised which is comfortable for both patients and orthodontists.

Spring separators are commonly used devices in daily practice for tooth separation, especially in a patient with tight tooth contacts. From a patient's perspective, these are easy to tolerate, both when being placed or removed and as they separate the teeth. They have an obvious advantage over elastomeric separators, which are difficult to insert, are radiolucent and can give rise to a series of problems if they are lost in the interproximal space.¹

However, a major drawback of these separators is that they tend to become loose and may fall out as they accomplish their purpose. Sometimes, it may happen without the notice of the patient and may pose a threat of aspiration or ingestion, which can be the cause of a medical emergency.²

In order to avoid this situation, the authors have modified the placement of these separators to prevent dislodgement in the oral cavity and improve patient awareness.

Procedure

Fabricate the spring separators from 0.018” SS AJ Wilcock Wire.

Tie a long segment of dental floss in the helix of the separator (Figure 1).

Place the separator by grasping at the base such that the longer bent end is placed in the lingual embrasure and the shorter leg slips beneath the contact into the interdental area with the helix placed buccally (Figure 2).

The long segment of the dental floss is placed in the interdental region of the adjacent tooth and secured with a square knot (Figure 3).

The excess end is cut and the patient is informed of the procedure (Figure 4).

If the brackets are bonded in the adjacent tooth to be separated, a ligature wire can also be used instead of dental floss, which can be tied to the adjacent bracket to prevent the dislodgement of the separator.

Advantages

The method is easy and does not employ any extra armamentarium;

Floss is thin and smooth in texture, does not swell in the oral cavity like elastomerics, and is comfortable to the patient;

Increases patient awareness, the patient can be asked to report as soon as possible to the clinic in case of misplacement (Figure 5);

A little precaution can help avoid major complications.