The following orthodontic emergencies and their treatments are listed in the order of the least severe to the most severe. Only the most severe emergencies require immediate attention by an orthodontist. The majority of these are easily treated with a follow-up appointment.
Food Caught Between Teeth
This is not an emergency, but can be a little uncomfortable or embarrassing for the braces wearing patient. It is easily fixed with a piece of dental floss. Try tying a small knot in the of the floss to help remove the food, or use an interproximal brush or toothpick to dislodge food caught between teeth and braces.
Ligature Comes Off
Tiny rubber bands or small, fine wires, know 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 the wire ligature is sticking out into the lip but is not loose, it may be bent back down with a Q-tip or pencil eraser to eliminate the irritation. Of course, when one ligature pops off or breaks, others may follow. Be sure to examine all ligatures. If multiple rubbers or wire ligatures are lost, please call the office to schedule an appointment.
It’s normal for a patient to have discomfort for a day or two after braces or retainers are adjusted. But it can make eating uncomfortable. This discomfort is both normal and temporary. It could be helpful to initially eat soft foods and rinse the mouth with warm salt water.
Some patients are susceptible to episodes of mouth sores. While braces do not cause them, they may be precipitated or exacerbated by an irritation from braces. One or several areas of ulceration of the cheeks, lips or tongue may appear. This is not an emergency, but may be very uncomfortable for the patient. Prompt relief may be achieved by applying a small amount of topical anesthetic (such as Orabase or Ora-Gel as well as BraceRrelief, given during the appliance placement appointment), directly to the ulcerated surface using a cotton swab. The gel should be reapplied as needed.
Irritation of Lips and Cheeks
Sometimes new braces can be irritating to the mouth, especially when the patient is eating. A small amount of non-medicinal relief wax makes an excellent buffer between metal and mouth. Every patient is given a package of wax during the initial bracket placement appointment. If wax can not be located it can be purchase in most pharmacy stores. 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. The patient may then eat more comfortably. If the wax is accidentally ingested, it’s not a problem, the wax is harmless.
Occasionally, the end of a wire will work itself out of place and irritate the patient’s 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 move into a comfortable position, cover it with relief wax. (See Irritation of Lips of Cheeks above for instructions on applying relief wax.) Make sure that you make the orthodontist aware of the problem so we can schedule an appointment. In a situation where the wire is extremely bothersome and the patient will not be able to see the orthodontist anytime soon, you may clip the wire. Reduce the possibility of the patient swallowing the snipped piece of wire by using folded tissue of 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.
Loose Brackets, Wires or Bands
If the braces have come loose in any way please notify the office when possible to schedule an appointment for a repair. 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 it the patient has eaten one of those hard or crunchy foods orthodontic patients are instructed to avoid, or if the mouth is struck while at play. If the bracket is off center, the adhesive may have failed. If the loose bracket has rotated on the wire and is sticking out you can temporarily put protective wax to alleviate discomfort. To put the bracket back in place, use sterile tweezers to slide the bracket along the wire until it is between two teeth. Rotate the bracket back to the proper position, then slide it back to the center of the tooth.