Emergency Care
You probably won’t experience a true orthodontic emergency because they are rare. But since they do happen from time to time, it’s important for you to know how to handle them.
True orthodontic emergencies are rare, but when they occur we are always available to you with the touch of a button, especially in the evening and on weekends. As a general rule, you should call our office when you experience severe pain or have a painful appliance problem you can’t take care of yourself. We’ll be able to schedule an appointment to resolve the problem.
You might be surprised to learn that you may be able to solve many problems yourself temporarily until you can get to our office. If there is a loose piece that you can remove, put it in a plastic bag or envelope and bring it with you to your next appointment. Please see the common issues below for your specific need.
After alleviating your discomfort, it is very important that you still 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 to your treatment plan.
Common Issues
The following orthodontic emergencies and their treatments are listed in the order from least severe to most severe. Only the most severe emergencies may require immediate attention by Dr. Radu.
Loose Brackets, Wires, or Bands
If your braces come loose in any way, call Dr. Corina Radu to determine the next steps.
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 knocked off if you’ve eaten one of those hard or crunchy foods you are instructed to avoid, or if the mouth is struck while at play.
We encourage all patients, especially those with braces, to wear a protective mouth guard while playing sports.
If the bracket is off center, the adhesive may have failed. In this instance, it is best to immediately notify Dr. Corina Radu, who will determine the course of action.
If the loose bracket has rotated on the wire and is sticking out and you can’t come to our office immediately, you can do a temporary fix to alleviate discomfort and prevent further damage, but take care to prevent swallowing or another injury.
To put the bracket back in place, use sterile tweezers to slide the bracket along the wire until it is between two teeth.
Protruding Wire
Occasionally, the end of a wire will work itself out of place and irritate your 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 Irritated of Lips or Cheeks above for instructions on applying relief wax.)
You’ll need to make Dr. Corina Radu aware of the problem.
In a situation where the wire is extremely bothersome and you can’t see [Dr.] anytime soon, you may, as a last resort, clip the wire.
Reduce the possibility 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.
You Swallow a Piece of your Appliance
This is rare, but when it does happen, it can be alarming but stay calm.
If you’re coughing excessively or having difficulty breathing, you may have inhaled the piece into your airways or lungs.
If you are able to see the piece, you may carefully attempt to remove it.
DO NOT make the attempt if you could cause harm.
If appropriate under the circumstances, examine your braces for problems that may result from the missing piece, such as looseness or irritation, and treat as specified above.
If you are unable to see the piece and believe it may be have been inhaled, call Dr. Corina Radu immediately.
Ligatures Coming Off
Tiny rubber bands or small, fine wires, known as ligatures, hold the wire to the bracket. 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 your wire ligature is sticking out into the lip but is not loose, you can bend it back down with a Q-tip or pencil eraser so it doesn’t irritate your lip. Of course, when one ligature pops off or breaks, others may follow.
Be sure to examine all ligatures. Missing or broken ligatures should be brought to the attention of Dr. Corina Radu. If a rubber or wire ligature is lost, tell Dr. Corina Radu so he can advise whether you should be seen.
Discomfort
It’s normal for you to have discomfort for a day or two after braces or retainers are adjusted, but it can make eating uncomfortable. This discomfort is very normal and only for a short time.
Try eating soft foods and rinse the mouth with warm salt water.
Mouth Sores
You may be susceptible to mouth sores. While your braces don’t cause them, they may be made worse by irritation from braces.One or several areas patches of sores may appear on the cheeks, lips or tongue. This is not an emergency, but may be very uncomfortable for you.
Get quick relief by applying a small amount of topical anesthetic (such as Orabase or Ora-Gel) directly to the area with sores using a cotton swab. You can reapply as needed.
Irritated Lips or Cheeks
Sometimes new braces can irritate your mouth, especially when you’re eating. A small amount of non-medicinal relief wax makes an excellent buffer between the metal and your 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. Then, you can eat more comfortably. If you accidentally swallow the wax, it’s not a problem. The wax is harmless.
Food Caught Between Your Teeth
This is not an emergency, but it can be uncomfortable or embarrassing. It’s 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 your teeth and your braces.
General soreness
When you get your braces on, you may feel general soreness in your mouth, and teeth may be tender to biting pressures for three to five days. Stick to a soft diet until your teeth do not hurt to chew. Irritated gums and other sore spots can be relieved by rinsing your mouth with a warm salt-water mouthwash. Dissolve one teaspoonful of salt in eight ounces of warm water, and rinse your mouth vigorously. If the tenderness is severe, take Acetaminophen (Tylenol) or whatever you normally take for headache or similar pain. Aspirin, Ibuprofen (Motrin, Advil) and Naproxen Sodium (Naprosyn, Anaprox) actually slow the tooth movement, so it is not advisable to use them frequently while wearing braces.
The lips, cheeks, and tongue may become irritated for one to two weeks as they learn a new posture and become accustomed to the surface of the braces. You can put wax on the braces to lessen this. We’ll show you how!
Loose bracket
If your bracket or band is still attached to the wire, you should leave it in place and put wax on it if needed for comfort. If the bracket or band can be removed easily, place it in an envelope and save it to bring to your next appointment.
Loose wire
Using a pair of tweezers or needle-nosed pliers, try to put your wire back into place. It is okay to use a piece of floss to tie the wire into place: tie the floss around the bracket in place of the missing colored o-ring. If you cannot put the wire into a comfortable position, and covering the end with wax doesn’t help, as a last resort use a small fingernail clipper to clip the wire behind the last tooth to which it is securely fastened. If the end of the wire is still sharp place wax on it.
Poking wire
Using a pencil eraser, push the poking wire down or place wax on it so that it is no longer poking.
