True orthodontic emergencies are rare, but when they occur we are available to you. 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. If your braces are poking you, put soft wax on the piece that's sticking out. If the wire has slid to one side, you can pull it back to the other side with needle-nosed pliers, replacing it in the tube on the back tooth.
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.
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. An alternative (better tasting) mouthwash is the Healthy Gums Rinse by The Natural Dentist. Placing Orabase on the affected area may also help relieve discomfort; Orabase can be found in a pharmacy. 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!
Using a pencil eraser, push the poking wire down or place wax on it so that it is no longer poking.
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.
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.
Hook on Bracket is Broken/Lost
Hooks are added to brackets so rubber bands can be attached to that bracket to aid in bite correction. If a hook breaks or falls off please discontinue use of your rubber bands and call our office to schedule an appointment to come in and have the hook replaced.
Rubber Bumper or Colored “O” Ring Missing
Rubber bumpers and colored “O” rings are used to hold the wire against the bracket, which helps move the tooth. If a rubber bumper or colored “O” ring comes loose, please contact our office to schedule an appointment to come in and have the bumper or “O” ring replaced.
Separator (Spacer) has Fallen Out
Separators (Spacers) are used to open space between your back teeth so bands can be placed over the teeth at your next appointment. As the separator opens up the space between the teeth it may become loose or fall out. If this happens, you can try replacing at home by following the steps below or you may call our office and make an appointment to have it replaced.
Step 1: Thread a piece of dental floss through the center of the separator.
Step 2: Double to 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.
Palatal Expander is Loose
If a palatal expander in the roof of your mouth becomes loose please call our office and we will schedule an appointment to re-cement the appliance. The expander can be pushed back onto the tooth until you are seen in our office.
Loose Bite Spring
Bite springs are used to aid in bite correction during treatment. The springs are attached to upper and lower metal retainers (glued over the back teeth) with small hex screws. There are four screws total (one on the top and bottom of each side)
If a metal retainer becomes unglued, the retainer can be pushed back onto the tooth where it has come loose until you can be seen in our office. Please call our office to schedule an appointment to have the retainer re-cemented.
If a bite spring on one side comes loose, the bite may temporarily shift towards the side of the loose spring. When this happens, you can try replacing the screw at home using the Allen wrench supplied in your homecare kit the day the braces were initially placed or you can call our office for assistance. To replace the screw at home please follow these steps:
Step 1: Take the screw completely out of the mouth and find the miniature Allen wrench in your homecare kit. If you cannot find the Allen wrench, you should be able to find the correct size in most Allen wrench tool kits available at the local hardware store.
Step 2: Have the patient retract their cheek using their finger.
Step 3: Center the hole in the bite spring arm over the screw hole on the metal retainer that is glued over the back teeth.
Step 4: Insert screw and tighten with Allen wrench.
Sometimes 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 (metal piece) is bent, please call our office for assistance. The headgear should hurt less the more it's worn, so be sure you get in the prescribed number of hours.
Broken/Lost/Poorly Fitting Removable Retainer
If a removable retainer is broken, lost, or fits poorly due to inconsistent wear please call our office to schedule an appointment to have a new retainer made. It is important to have a new retainer made to prevent shifting of your teeth. There is a fee to have a new retainer made.
Broken Permanent Retainer
If glue on your permanent retainer comes loose, the exposed permanent retainer wire may be sharp and irritate your tongue. Teeth can also shift if the glue on your permanent retainer comes loose. If this occurs, please contact our office to schedule an appointment to have your permanent retainer repaired or replaced. There is a fee to have your permanent retainer repaired or replaced.
Severe Trauma with Loose Teeth
Call your dentist or an oral surgeon immediately or go to the emergency room at your local hospital. If a tooth has been severely loosened fractured, or knocked out, you may need immediate treatment and X-rays to determine the extent of the damage to the teeth and/or surrounding gums and bone. Wearing braces during a trauma can be beneficial because the braces often act as a “splint” for the teeth during the trauma minimizing injury to the teeth. If any of your orthodontic appliances have been broken or damaged, we can repair or replace them after your emergency needs have been addressed.
Small Cut or Ulcer from an Appliance in Your Mouth
To help a cut heal, rinse your mouth with a mixture of one teaspoon of salt and one cup of warm water. Over-the- counter numbing gels available at the grocery store or drug store can also be applied to the area for temporary relief.