Orthodontic Emergencies

Many orthodontic emergencies can easily be dealt with at home.  Please refer to the illustration at the end of this section to assist you in describing to our office what exactly has occurred.  There are certain items that should be handy at home to aid you or your child with certain emergencies.

Q: What should I do if a bracket (brace) is knocked off?
A:  Brackets, more commonly termed braces, are usually bonded (glued) to the center of each tooth.  If you notice that a certain bracket is not in the center and is mobile, or is rotated on the wire and sticking out, call our office so we can direct as to the proper action required.  Orthodontic wax can be used around the area to limit the movement of the bracket.  If you are experiencing pain contact our office so we can help you address the issue.  If there is no pain, this is not a true emergency.  Contact our office at your convenience so we can schedule an appointment to re-bond the bracket.
Note: It is important to remember that brackets usually get loose due to chewing on hard, chewy or sticky foods, or physical trauma while playing sports or rough housing.  Make sure you are using a mouth guard when engaging in contact sports.

Q:  What should I do if my archwire is poking me?
A:  The archwire is the main wire used to align the dentition that fits in the slot of each bracket.  Following the initial alignment of the teeth the archwire may extend past the furthermost bracket in the mouth and poke the cheek or gums.  Place orthodontic was on the end and contact our office to schedule an appointment with Dr. Y to clip the end of the wire.  In circumstance where there is more moderate to severe discomfort and your are unable to see Dr. Y immediately, as a last resort, you may clip the wire yourself with a fingernail clipper.

Q:What should I do if a “Ligature Wire” is poking my lip or cheek?
A:  A ligature wire is a thin wire used to hold the main archwire in the slot of a brace.  Dr. Y uses both wire ligatures and rubber bands to secure the archwire in its place.  Use either a Q-tip or pencil eraser to guide/push the ligature wire flat against the tooth.  If you are unable to do so, use orthodontic wax and contact our office.

Q:  What to do with loose brackets, wires or bands?
A:  If there are loose brackets, wires or bands contact our office so we can properly address the problem.  Please save any pieces of your braces that fracture and bring them with you to your appointment.

Q:  My lips or cheeks are irritated.  What should I do?
A:  Sometimes, especially during the first week of treatment, the braces can irritate the oral tissues.  Using the orthodontic wax can protect the lips, cheeks and tongue during this period.  Use a pea-sized ball of wax, place on the area causing the discomfort and flatten the wax all over it.  Drying the area first will ensure a longer lasting retention of the wax in the area. Swallowing the wax is very common and does not present a physical problem, it is approved for dental use. 

Q:  What about mouth sores?
A:  If you or your child experience mouth sores you can apply either a topical anesthetic (such as Orabase or Ora-Gel) or Glyoxide (a non-prescription clear gel) to the sore as needed using a Q-tip.  The anesthetic effect is short lived and may exacerbate the inflammation if used excessively.  Try the Glyoxide first, and if that is not sufficient apply the topical anesthetic
prior to eating your meals.  Most sores heal within one week.  If your sore remains for greater than 1-2 weeks contact our office.

Q: What should I do if I experience discomfort?
A: It is quite normal and expected to have mild to moderate discomfort for several days after the placement of braces or wire adjustments.  Remain on a soft diet during this period, rinse with warm salt water and if necessary use over-the-counter pain medication such as tylenol or ibuprofen. 

Q:  I lost a ligature (Rubber or Wire)
A:  If a ligature, whether rubber or wire, is lost, contact our office so we can advise you as to when you or your child should be seen. 

Q:  What if my lips or cheeks get caught on a brace?
A:  Call our office immediately and apply ice to the injured site until Dr. Y can address the situation.

Q:  I am having difficulty opening my mouth?
A:  There are severe reasons why a person has difficulty opening their mouth, but the most common is pathology in the jaw joint leading to swelling and lack of mobility.  Please contact our office and inform us of your symptoms.

Q:  Food gets caught between my teeth.  What can I do?
A:  This is not a true emergency.  It can be addressed with a dental floss, water-pik, toothbrush or an inter-proximal brush (miniature brush specifically designed to clean small crevices)  It can be resolved with a piece of dental floss. 

Illustration of Braces
The illustration below should help you better describe an emergency to our office so we can better assist you or your child.  This section should be replaced with GURU mini-clips.