Keep Your Cool and Know What to Do
You probably won’t experience a true orthodontic emergency because they’re rare. But since they do happen from time to time, you need to know how to handle them.
About Orthodontic Emergencies
The following orthodontic emergencies and their treatments are listed in the order from least severe to most severe. Only the most severe emergencies may require immediate attention by Dr. Krieger.
This is not an emergency, but it can be uncomfortable or embarrassing. You can fix it easily with a piece of dental floss.
Try tying a small knot in the middle of the floss to help remove the food, or use an interproximal brush or toothpick to dislodge food caught between your teeth and your braces.
Tiny rubber bands or small, fine wires, known as ligatures, hold the wire to the bracket. If a rubber ligature comes 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 your wire ligature is sticking out into the lip but is not loose, you can bend it back down with a Q-tip or pencil eraser so it doesn’t irritate your lip. Of course, when one ligature pops off or breaks, others may follow.
Be sure to examine all ligatures. Missing or broken ligatures should be brought to the attention of Dr. Krieger. If a rubber or wire ligature is lost, tell Dr. Krieger so he can advise whether you should be seen.
It’s normal for you to have discomfort for a day or two after braces or retainers are adjusted, but it can make eating uncomfortable.
This discomfort is very normal and only for a short time.
Try eating soft foods and rinse the mouth with warm saltwater.
You may be susceptible to mouth sores. While your braces don’t cause sores, they can make sores worse by irritating your mouth.
One or several patches of sores may appear on your cheeks, lips or tongue. This is not an emergency, but may be very uncomfortable for you.
Get quick relief by applying a small amount of topical anesthetic (such as Orabase or Ora-Gel) directly to the area with sores using a cotton swab.
You can reapply as needed.
Sometimes new braces can irritate your mouth, especially when you're eating. A small amount of non-medicinal relief wax makes an excellent buffer between the metal and your mouth.
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 irritated area.
Then, you can eat more comfortably. If you accidentally swallow the wax, it’s not a problem. The wax is harmless.
Occasionally, the end of a wire will work itself out of place and irritate your 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 moved into a comfortable position, cover it with relief wax. (See Irritated of Lips or Cheeks above for instructions on applying relief wax.)
You'll need to make Dr. Krieger aware of the problem.
In a situation where the wire is extremely bothersome, and you can't see Dr. Krieger anytime soon, you may, as a last resort, clip the wire.
Reduce the possibility swallowing the snipped piece of wire by using folded tissue or gauze around the area.
Use a pair of sharp clippers and snip off the protruding wire. Relief wax may still be necessary to comfort to the irritated area.
If your braces come loose in any way, call Dr. Krieger to determine the next steps.
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 if you've eaten one of those hard or crunchy foods you are instructed to avoid, or if the mouth is struck while at play.
We encourage all patients, especially those with braces, to wear a protective mouthguard while playing sports.
If the bracket is off-center, the adhesive may have failed. In this instance, it is best to immediately notify Dr. Krieger, who will determine the course of action.
If the loose bracket has rotated on the wire and is sticking out and you can't come to our office immediately, you can do a temporary fix to alleviate discomfort and prevent further damage, but take care to prevent swallowing or another injury.
To put the bracket back in place, use sterile tweezers to slide the bracket along the wire until it is between two teeth.
This is rare, but when it does happen, it can be alarming but stay calm.
If you're coughing excessively or having difficulty breathing, you may have inhaled the piece into your airways or lungs.
If you can see the piece, you may carefully attempt to remove it.
DO NOT attempt it if you could cause harm.
If appropriate under the circumstances, examine your braces for problems that may result from the missing piece, such as looseness or irritation, and treat as specified above.
If you are unable to see the piece and believe it may have been inhaled, call Dr. Krieger immediately.