True orthodontic emergencies are rare, but when they occur we want you to know that we are available whenever you need us. Occasionally, minor orthodontic emergencies such as poking wires, loose brackets or bands, loose wires, or loose appliances can occur. If you have a broken appliance or are experiencing an abnormal amount of discomfort, please give us a call as soon as possible so that we can evaluate the urgency of the problem and schedule you to be seen accordingly.
You might be surprised to learn that you may be able to solve many problems yourself temporarily until you can get to our office. In the interim, you can take the temporary measures listed below. 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.
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. Stick to a soft diet until your teeth do not hurt to chewing. 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. If the tenderness is severe, take Acetaminophen (Tylenol) or whatever you normally take for headache or similar discomfort. 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. Prompt relief may be achieved by applying a small amount of topical anesthetic (such as Orabase or Ora-Gel) directly to the sore area. You can also put wax on the braces to lessen the temporary discomfort. We'll show you how!
Distorted or Broken Removable Appliance
A distorted or broken removable appliance should be adjusted or replaced as soon as possible and should not be worn until the adjustment or repair is made.
Irritation of Lips or Cheeks
Sometimes new braces can be irritating to the mouth, especially when eating. A small amount of non-medicinal relief wax makes an excellent buffer between the braces and your mouth. Simply pinch off a small piece and roll it into a ball the size of a small pean. Flatten the ball and place it completely over the area of the braces causing irritation.
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 needed for comfort. If the bracket or band can be removed easily, please don't discard it! Place it in an envelope and bring it to your emergency appointment for repair.
Loose or Protruding Wire
Occasionally, the end of a wire will work itself out of place and cause irritation of the gum. A broken archwire, or one that is irritating the gum or cheek, needs to be seen as soon as possible for replacement or adjustment. To temporarily relieve discomfort, 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. If the 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.
Images courtesy of American Association of Orthodontists.