An orthodontic emergency exists when something unexpected occurs with your braces that causes discomfort or unexpected tooth movement.
True orthodontic emergencies are very rare, but when they do occur we are available to you. 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 yourself. We’ll be able to schedule an appointment with our office.
You might be surprised to learn that you may be able to temporarily solve many problems yourself until you get in to see us…
The following solutions may help you relieve your discomfort:
1. Poking Wire: Using a pencil eraser, push the poking wire down or place wax on it to alleviate the discomfort.
2. Loose Bracket or Band: If your bracket or band is still attached to the wire, you should leave it in place and put wax on it. If the wire comes out entirely, wrap the bracket with a tissue.
3. Loose Wire: Using a tweezers, try to place your wire back into place. If doing this and using wax does not 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 your discomfort continues, place wax on it.
4. Misplaced archwire, bracket, or tie: If it’s the wires or ties that are misplaced, they can often be manipulated back into place by gently using a pair of clean tweezers or the eraser end of a pencil. When wires or brackets shift and irritate your mouth, try a pinch of orthodontic wax over the parts that are poking out. This can help relieve the immediate discomfort, but be sure to contact our office as soon as you can so our doctors are able to determine what the actual problem is and correct it.
5. Loose Appliance: If your appliance is poking you, place wax on the offending part of your appliance.
6. Headgear Does Not Fit: Sometimes headgear discomfort is caused by not wearing the headgear as instructed by your orthodontist. Please refer to the instructions provided by your orthodontist. If the facebow is bent, please call our office for assistance. Surprisingly, headgear becomes more comfortable the more it’s worn, so be sure you’re getting in the prescribed hours.
7. Canker Sores: (that may or may not be associated with the braces) are best treated with over the counter remedies available at any drug or discount store. They have two modes of action. One group has some sort of numbing agent that just makes you more comfortable.
The other type seals the wound (either by depositing a layer of adhesive or by cauterizing the tissue with chemicals) helping you feel more comfortable. Suspicious swellings in the mouth should be evaluated by your orthodontist or dentist. One exception might be a mucocele.
8. 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. This can be relieved by rinsing your mouth with a warm salt water mouthwash. Dissolve one teaspoonful of salt in 8 ounces of warm water, and rinse your mouth vigorously. If the tenderness is severe, take aspirin or whatever you normally take for headache or similar pain.
9. Undesireable tooth movements: If you are wearing rubber bands and your bite goes too far, stop wearing them and call your orthodontist. If you are correcting your midlines and they go too far, stop wearing your elastics and call your orthodontist. Understanding what should be happening with your teeth and then evaluating the progress every day can help prevent over-correction that can add time to your treatment.
10. Swallowed appliance: If you’ve swallowed a piece of an appliance such as a bracket or a band, have someone shine a flashlight into your mouth and throat. If the piece can’t be seen and you’re experiencing excessive coughing or having trouble breathing, it’s possible it was aspirated, or, breathed into your lungs. Immediately go to the nearest emergency room.
If you’re not having trouble breathing, chances are the appliance will pass through your digestive system without causing a medical issue. It is wise to call the office and tell us that you have swallowed the appliance, so we can have you come in to get a new appliance.
11. Broken Retainer – bonded or removable: After orthodontic treatment, retainers are routinely placed. The retainers used are specific to your individual treatment plan and may be bonded (“fixed” or “permanent”) or removable. If a bonded retainer comes loose, please continue to wear your removable retainer full-time until you are able to be seen at our office for a diagnosis and repair.
This will prevent tooth movement and may be more comfortable to protect your tongue from irritation. If your removable retainer breaks or cracks, please contact our office and make arrangements to have the retainer replaced as soon as your schedule allows. Retainers – both bonded and removable – work together to prevent orthodontic relapse, as there is a chance your teeth will continue to shift throughout your lifetime.
12. Food Stuck in Bums: This typically will not constitute a call to the orthodontist, but can in severe cases where the food gets lodged into the bracket or the gum and all your attempts to remove it have failed. This scenario should be avoidable if you discontinue food you shouldn’t be eating while you’re wearing braces
13. Lost Aligner: A misplaced or broken set of aligners does not mean that you have to start over. Just make sure to contact your orthodontist as soon as possible to order a set of replacement aligners, as spending significant time without them will slow the treatment process.
Any time you spend not wearing your aligners is time your treatment is not progressing. Should you lose an aligner, make sure to wear the previous week’s aligner to hold the tooth movement we have done while waiting for your replacement aligners.
14. Pain from Braces: While braces are highly beneficial to patients with orthodontic issues, they can also sometimes be painful. Often, braces are most uncomfortable both when they are first placed, and each time they are tightened.
Some patients tolerate this discomfort well and rarely need any pain relief, while others benefit from home remedies that can help in reducing pain and discomfort so that orthodontic treatment is more comfortable.
15. Here are some things you can do at home to relieve your orthodontic pain:
✍️ Dr. Rajiv Yadav
Associate Professor & Head – Department of Dentistry
Maharajgunj medical campus, Institute of medicine,
T.U Dental Teaching Hospital, Kathmandu