Handling Orthodontic Emergencies

Orthodontic emergencies can happen anytime and it is always a good idea to be prepared. If any of your orthodontic appliances breaks or becomes loose, you better know what to do. The first thing you need to do during an orthodontic emergency is to contact our office as soon as possible. Even if you already have an appointment scheduled previously, you should get in touch with us so that we can be ready for your emergency during your appointment. Many of these emergency situations, however, can be dealt with at home. Here are some emergency situations that may come up and our suggestions on what you should do: Broken or Lost Retainer Call our office as soon as possible so we can set an appointment to provide you with a replacement. However, this is not a true emergency so if it occurs during the evening or on a weekend, you can simply contact our dental office in the next working day. You may have 2 retainers, one for use during the day and the other for the night. If one of those retainers is broken or lost, use the other one exclusively until we can provide a replacement. A Bracket Has Come Loose The brackets are part of your (or your child’s) braces which are attached to the teeth by means of a special adhesive. You will find a bracket on the center of each tooth. These brackets may be knocked off-center or loosened in an accident. It’s possible that the special adhesive for some reason has failed. You may have engaged in sports or any activity that hit your mouth area. It’s even possible that you failed to avoid eating hard or crunchy food items. Some foods can be hard enough to loosen or knock your brackets off-center, which is why we generally discourage you from eating them in the first place. When this happens, the first thing you need to do is to contact our office as soon as possible, especially if it occurred during office hours. We can schedule an appointment for you so that we can reposition the bracket/s properly. However, this emergency may occur after-hours or if it may not be possible for the patient to come to our dental office right away. In such cases, it is possible for you to perform a temporary fix to avoid any further damage and to alleviate any discomfort. Sterilize your tweezers and use them to put the bracket back into its proper position. Just use the tweezers to grasp the bracket and then slide it until it is in between 2 teeth. This gives you enough leeway to rotate the bracket back into its proper position. Afterwards, you can then gently slide back the bracket to the center of the tooth. The End of the Wire is Protruding It is possible that the end of the wire of your orthodontic appliance may somehow come out of place. This can cause irritation in your mouth, and it can be quite uncomfortable. Schedule an appointment with our office so that we can have the wire fixed. In the meantime, you can use a pencil eraser or a Q-tip to carefully push the wire to place it flat against the tooth. This should be more comfortable for you as it won’t protrude as much. If it is not possible for you to get the wire into a more comfortable placement, you can at least cover it with non-medicinal relief wax. (See the following section on “The New Braces May Be Irritating Your Mouth” on how you can properly apply relief wax.) But what if the wire is extremely uncomfortable, the relief wax provides inadequate relief, and the patient is unable to visit our office anytime soon? In such a situation, you may have to resort to clipping the wire as your last option. To start this procedure, you should place gauze or folded tissue around the area first. This will reduce the risk of you (or your child) swallowing the piece of wire you snipped off. You can remove the protruding piece of wire using a pair of clippers. Just make sure they’re sharp and sanitized. You can still apply relief wax to the area for added comfort. New Braces Causing Irritation This can sometimes happen, especially when you’re eating. However, you can apply a tiny amount of non-medicinal relief wax between your teeth and the metal orthodontic appliance. Just pinch a tiny amount of the wax, and then roll this piece into a small ball. It should then be the same size as a small pea. Then flatten this ball of wax and use it to completely cover the area of the braces that’s causing the mouth irritation. The wax is completely harmless. Even if you ingest it by accident, it won’t do you any harm. Mouth Sores Orthodontic braces actually do not cause mouth sores. However, you (or your child) may simply be more susceptible to having mouth sores, and the braces may be irritating enough that they may precipitate such episodes. The braces may also make them worse. Mouth sores can be quite uncomfortable, but they’re not considered an emergency. They may cause ulcerations of the tongue, lips, or cheeks. You can provide some relief yourself, by using a cotton swab to apply a tiny bit of topical anesthetic (such as Ora-Gel or Orabase) directly to the ulcerated areas. You May Feel Uncomfortable with Your Braces After your braces or retainers have been adjusted, it’s still common for patients to experience some level of discomfort afterwards. This should only last for a day or two as you get used to having these appliances in your mouth. It can, however, make eating rather uncomfortable, even if this is both common and temporary. In the meantime, you can stick to soft foods and then rinse with some salt water. If you (or your child) are allowed to take over-the-counter pain relievers, then this is a suitable time to take ibuprofen or acetaminophen. You’ve Lost a Ligature Ligatures are the tiny fine wires or the small rubber bands that hold the wire to the bracket. If you do lose a wire or rubber ligature, it’s not an emergency. You can inform us of what happened, and we can schedule an appointment for the next day. Food is Stuck in Between Your Teeth This is not a true dental emergency. However, it may feel that way as it can be quite uncomfortable (even painful) and really embarrassing. Dental floss, however, can provide a simple solution. You can tie a knot in the middle of the floss, and use it to remove the bit of food stuck in between your teeth. Other possible solutions can include using a toothpick or an interproximal brush to remove the bit of food. If all these options should somehow fail to dislodge the food between your teeth, you can get in touch with our office and we can set up an appointment to remove the problem.