Brackets response

Sir, we thank the authors for their comments¹ related to our letter² on orthodontic brackets for dental trauma. We are not recommending the use of orthodontic brackets in the management of dental trauma without adequate training and/or supervision. Indeed, we wished to highlight the need to be suitably trained and confident to place them.

The Royal College of Surgeons of England guidelines state that clinicians may place bracket and wire splints if confident to do so.³ The British Society of Paediatric Dentistry guidelines on the management of traumatic dental injuries during the COVID-19 pandemic state that a skilled operator is needed when placing brackets and highlight the need for passive placement to avoid unwanted orthodontic tooth movement.⁴ Clinicians should be mindful of their level of experience and not perform a procedure without the necessary training and skillset. In accordance with guidance, clinicians may use other well-known splinting techniques, including composite and wire splint.