True orthodontic emergencies are very rare, but when they do occur we are available to help you. As a general rule, you should call the office when you experience severe pain or when you have a painful appliance problem that cannot take care of yourself. We will be happy to schedule an appointment to resolve the problem as quickly as possible.
You might be surprised to learn that you are able to temporarily solve many problems. When working with your appliances, you need to know the names of the parts of your appliances so you are able to identify what part is broken or out of place. After alleviating your discomfort, it is very important that you call our office as soon as possible to schedule a time to repair the problem. Allowing your appliance to remain damaged for an extended period of time may result in disruptions in your treatment plan.
Handling Orthodontic Emergencies
Tools & Supplies
With these tools and supplies on hand (most of which you already have) you will be prepared to handle the most common orthodontic emergencies.
- Non-medicated orthodontic relief wax
- Dental floss
- Sterile tweezers
- Small, sharp clipper
- Interproximal brush
Food Caught Between Teeth
This is not an emergency, but can be a little uncomfortable or embarrassing. It is easily fixed with a piece of dental floss. Try tying a small knot in the middle of the floss to help remove the food. Or use an interproximal brush or toothpick to dislodge food caught between teeth and braces
Ligatures/Color Ties Come Off
If a rubber ligature should come off, you may be able to put it back in place using sterile tweezers. If a wire ligature comes loose, simply remove it with sterile tweezers. If the wire ligature is sticking out into the lip but is not loose, it may be bent back down with a Q-tip or pencil eraser to eliminate the irritation.
Of course, when one ligature pops off or breaks, others may follow. Please call the office to schedule an appointment for repair.
It is normal to have discomfort for a day or two after braces or retainers are adjusted. For the first week, it can make eating uncomfortable- some discomfort is both normal and temporary. Remember to stick with softer foods for the first few days. You can also rinse with warm salt water. If the patient is allowed to have over-the-counter pain relievers (and has no allergies or other contraindications) then acetaminophen or ibuprofen may be effective.
Some patients are susceptible to episodes of mouth sores. While braces do not cause them, they may be precipitated or exacerbated by an irritation from braces. One or several areas of ulceration of the cheeks, lips or tongue may appear. This is not an emergency, but may be very uncomfortable for the patient. Prompt relief may be achieved by applying a small amount of topical anesthetic (such as Orabase or Ora-Gel) directly to the ulcerated surface using a cotton swab. Reapply as needed.
Irritation in Mouth
Sometimes new braces can be irritating to the mouth, especially when the patient is eating. A small amount of relief wax makes an excellent buffer between metal and mouth. Simply pinch off a small piece and roll it into a ball the size of a small pea. Flatten the ball and place it completely over the area of the braces causing irritation.
Occasionally the end of a wire will work itself out of place and irritate the mouth. Use a Q-tip or pencil eraser to push the wire so that it is flat against the tooth. If the wire cannot be moved into a comfortable position, cover it with relief wax. (See Irritation of Cheeks or Lips above for instructions on applying relief wax.) You will need to make our office aware of the problem so we can schedule an appointment.
In a situation where the wire is extremely bothersome and the patient will not be able to see the orthodontist for a day or two, you may clip the wire. Again, please call to schedule a repair appointment should this happen.
Reduce the possibility of swallowing the snipped piece of wire by using folded tissue or gauze around the area. Use a pair of sharp clippers and snip off the protruding wire. Relief wax may still be necessary to provide comfort to the irritated area.
Loose Wires, Brackets or Bands
Brackets are the parts of braces attached to teeth with a special adhesive. They are generally positioned in the center of each tooth. The bracket can be broken by hard or crunchy foods (that you are instructed to avoid) or if the mouth is struck while at play. We encourage you to wear a protective mouth guard while playing sports. Please call the office if you notice a loose bracket so we can schedule a repair appointment.