All About Fiberotomy

A fiberotomy is a procedure that helps the teeth to stay in their new positions after they have been moved during orthodontic treatment. Retention of teeth in a new position is an important part of orthodontic measures such as braces, and this procedure is just one of the ways dental professionals prevent the teeth from sliding back into their original spots. While it is a surgical procedure, this treatment is minimally invasive and is used only for teeth at the high risk of relapsing to an unfavorable position.

Fiberotomy: Keeping Teeth in Place

A removable appliance called a retainer is the usual way orthodontically moved teeth are kept in their new positions. This approach requires the patient to cooperate by wearing a removable appliance, made of fitted wire or plastic, for as long as it takes to keep the teeth from relapsing. A bonded or fixed retainer might also be installed, for which a section of teeth is cemented together on the inside by thin wires. Both types can be worn on the upper and lower arch of the mouth. However, even retainers may not be enough to prevent teeth from shifting.

Why Do Teeth Move?

Teeth must be moved through bone and gum tissue by orthodontic appliances, which cause the hard and soft tissues around them to adapt to a new position. The soft tissue contains very tough fibers that are stretched when teeth are moved. They then exert pressure on teeth to pull them back to the original position. This is most likely to happen when the teeth were severely rotated or otherwise dramatically moved, according to the Journal of Dental Lasers. These fibers are resilient and may relapse even if the patient wears a retainer.

Fiberotomy Surgery: What To Expect

This surgery is a minimally invasive procedure in which the fibers are cut and then allowed to heal with less tension on the newly-positioned teeth. The fibers are just below the base of the sulcus (the slight gap between the gum and the base of the tooth) and above the alveolar bone (the bony ridge that holds the teeth). A dentist will administer local anesthesia before inserting a scalpel blade or laser tip into the sulcus of the teeth involved and cutting across the fibers holding each tooth. There is no flap, rip or change in the outer position of the gums. No stitches or suturing are necessary, and most patients experience only minor discomfort afterwards. A fiberotomy is usually performed just before a patient's braces are removed, but if necessary, it can be done after the braces are gone and any fixed or removable retainers are in place.

Recovery After Fiberotomy Surgery

The procedure may be performed by your orthodontist or by a periodontist or oral surgeon. As with most oral surgeries, you can expect a small amount of swelling for the first day or two after your procedure. Pain is usually minimal, but some patients experience tooth sensitivity for up to a few weeks after the procedure. Your practitioner will give you instructions for dressing the area, oral care such as rinsing, and what foods or liquids to avoid during your recovery.

Fixed or removable retainers are still necessary with a fiberotomy. Even though the procedure reduces the chances of relapse, there is no guarantee that your teeth won't move. Many orthodontic patients benefit from a combination of braces, retainers and surgical or non-surgical procedures. Your orthodontist or dentist is the best person to ask about what your or your child's smile needs.

This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.

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  • Swish with water before brushing – instruct your child to rinse with water after eating. This will loosen food that may be caught in the braces, then brush thoroughly.
  • Floss once a day – each night help your child floss. Flossing helps loosen food debris and plaque at and under the gum line that would otherwise harden into tartar. It can also help reach the nooks and crannies in the teeth that might be difficult to reach with a toothbrush.
  • Use a fluoride rinse – after brushing and before bed have your child rinse with fluoride rinse to help keep teeth strong and healthy
  • Dental visits every six months – take your child to the dentist for a checkup and cleaning every six months. The dentist can point out areas that need more attention, and help make sure you're keeping your child’s teeth healthy and clean.