True orthodontic emergencies could be considered rare, but occasionally minor problems can cause minor discomfort. As a general rule you should call the office when you experience severe pain or when you have a painful appliance problem that you can’t take care of by yourself. We will be glad to help you schedule an appointment to resolve the problem as soon as possible.
In the event that an emergency occurs at night or over the weekend, you can call the office and you will be directed to an answering service that will put you in contact with one of our staff members. Sometimes visiting the office to take care of your emergency can be challenging or impossible.
You might be surprised to learn that you may be able to temporarily solve many problems yourself until you can make it to the office.
What problem are you having?
Click the problem to see the solutions that may relieve your discomfort.
Broken or Loose Bracket
A bracket is considered broken when you can see that it’s off centered and it can slide back and forth along the wire. If the bracket is not causing discomfort, it could be left in place; you may wish to place orthodontic wax to minimize the movement of the loose bracket.
If the loose bracket has rotated on the wire (you can’t see the “O” ring) and is sticking out, using your fingers or a pair of tweezers you may attempt to turn it back into its normal position. Apply wax to minimize the movement of the loose bracket.
If the bracket becomes extremely bothersome you may attempt to remove the bracket from the wire. Using a pair of tweezers or a small unbent paper clip, remove the “O” ring (usually the “O” ring is a colored elastic around the brace) from the bracket. Slide the bracket to the interproximal area and remove the bracket from underneath the wire (see pictures 2-3)
Poking or Broken Wire
If the wire brakes or it’s poking your cheeks or soft tissue, try covering it with orthodontic wax to protect the cheek.
If the wire is extremely bothersome and the patient cannot make it to the office soon enough, you may attempt to cut the wire using a pair of fingernail clippers. Cut the wire against the next brace it is attached to. Reduce the possibility of swallowing the snipped piece of wire by using folded tissue or gauze around the area to catch the piece you will remove. You may still need to use orthodontic wax to provide comfort to the irritated area.
Poking Steel Ligature
Sometimes to secure the brace to the wire we twist a very small stainless steel ligature around it. It is rarely possible for the twisted end of the ligature to move and start to feel sharp. If this happens, use a Q-tip or a pencil eraser and gently push it towards the tooth and away from the soft tissue or in into a comfortable position.
Archwire has Come Out of the Last Bracket
If the wire has come out of the last bracket and is not poking the gums or the cheek, simply let it be. If it is poking the gums or cheek, using a pair of tweezers, gently grab the wire and reinsert it in the brace. If you are unable to reinsert it the brace you may try moving it above or below the bracket to get it away from the gums. You may need to apply some wax on it to secure it and provide comfort.
Lost Ligature or “O” Ring
Tiny rubber rings known as “O” rings, are often used to hold the archwire into the bracket or brace. If the “O” ring comes off a brace, this can usually wait till the next appointment. Often times you can replace it by using tweezers and stretching it back on to the bracket or brace. If this is not possible please call the office so we can schedule an appointment (if necessary) to have it replaced.
Lost Spacer or Separator
If a separator/spacer is lost, try replacing it with floss (see pictures). If you are unable to replace it, please call the office so we can make an appointment to replace it. If it is lost the day prior to the appointment, do not worry about it.
Step 1: Thread a piece of dental floss thru the center of the separator.
Step 2: Double the floss back on itself. Repeat this with one more piece of floss.
Step 3: Hold one piece of floss on either side of the separator. Slide the floss between the teeth where the separator has come out.
Step 4: Pull the separator thru the contact. Keep a finger on the replaced separator. Gently pull on one end of the doubled back piece of floss out of the mouth. Repeat with the other piece of floss.
If the expander becomes loose call us immediately, please do not turn or activate it until you are seen in our office. The expander can be pushed back onto the tooth until you can make it into our office.
Lost Space Maintainer
If the space maintainer becomes loose call us immediately. The space maintainer can be pushed back onto the tooth until you reach our office.
Sharpness Felt on the Tongue Side of the Brace or Band
Rarely the tongue side of a back brace may feel sharp. You may solve this problem by taking a spoon or a pencil eraser and pushing the cleat back in toward the brace or band.
It is normal to have discomfort for three to five days after your braces, retainers or any other orthodontic appliances are adjusted. Although temporary, it can make eating uncomfortable. Eat soft foods and you may rinse with warm salt water. Over the counter pain relievers, acetaminophen or ibuprofen, are effective.
To make a salt water rinse, dissolve one teaspoon of salt in 8 ounces of warm water, and rinse your mouth vigorously. If the soreness is extremely severe, please call the office immediately.