Emergency care

Whether you are in braces or not, in case of direct trauma to the teeth and/or mouth, you will need to contact your family dentist right away. He/she will typically examine the area, take x-rays as needed, and restore the tooth if fractured or damaged. If the trauma is extensive, you may need to be referred to a specialist such as an oral surgeon or endodontist (root specialist). If orthodontic appliances are broken or loose as a result, please contact our office to repair or replace them once your dentist has released you.

If your bracket is no longer attached to the tooth (ie will slide on the wire or flip around), you should assess the situation as follows:

• If it is not bothering you, leave it alone. Call the office during the next business hours for an appointment.
• If it is bothering you, try to secure it in place with a small piece of wax over the loose and adjacent brackets.
• If it is the last bracket in the back, slide it off the wire, put it into a baggie, and bring it with you to the repair appointment. If the end of the wire is poking, you can either place wax over it or clip it with nail clippers that have been sterilized in alcohol. Be sure to secure the loose piece of wire so it is not swallowed.
• Do not wear elastics on loose brackets.

Even if you have a regular appointment scheduled soon, please call us so that we can plan for the additional procedure or schedule a new appointment as needed.

Once the wire is placed into your braces, your teeth are going to move and will be sore for 3-5 days. We suggest taking an over-the-counter pain medication such as Tylenol, Motrin, or Advil according to the bottles’ instructions. Be sure to take the medication around the clock as prescribed to get effective relief. This should be more than enough to relieve most discomfort.

If your gums are swollen you need to brush your gums while you brush your teeth 3-4 times a day. Flossing will also help shrink the gums and create a healthier environment for the teeth to move. Any over-the-counter peroxide mouth rinse (such as Peroxyl) or Listerine will also help.

Do not worry about losing a separator, but call our office to see if it needs to be replaced.

• Poking wire: If your wire is poking in the back and you cannot wait until the next business day to come and see us, then you can either place wax over the end of it or you may cut the wire with fingernail clippers or cuticle cutters that have been washed and sterilized in alcohol. Be sure to secure the end of the wire so it is not swallowed. Please call the office the next business day for an appointment.
• Wire out of tube: If your wire has slipped out of the back molar tube you can attempt to reinsert it with tweezers. If not possible, it is bothering you, and you cannot wait until the next business day to come and see us, then you can either place wax over the end of it or you may cut the wire with fingernail clippers or cuticle cutters that have been washed and sterilized in alcohol. Be sure to secure the end of the wire so it is not swallowed. Please call the office the next business day for an appointment.
• Poking elastic hook: These are flexible hooks and certain foods or vigorous brushing can bend them. If your twisted elastic hook is bent away from the bracket and tooth, use the eraser end of a pencil to tuck it back towards the tooth surface.
• Poking twisted steel tie: These are flexible wires and certain foods or vigorous brushing can bend them. If your twisted elastic hook is bent away from the bracket and tooth, use the eraser end of a pencil to tuck it back towards the tooth surface.
• Poking or loose steel tie: You can cut the loose pieces (with fingernail clippers or cuticle cutters that have been washed and sterilized in alcohol) to make it comfortable. Use the eraser end of a pencil to tuck the ends back toward the tooth surface. You can also place wax over the ends as needed. Please call the office the next business day for an appointment.
• Poking molar hook or cleat (tongue attachment): Unfortunately, these hooks are not bendable and you just have to get used to them. You may use orthodontic wax on it. You may also use numbing agents such as Orajel, Anbesol, and Zilactin B to numb the tissues while healing and callusing. Any over-the-counter peroxide mouth rinse (such as Peroxyl) or a mild salt water rinse (one teaspoon of salt in 8 ounces of warm water, 3-4 times a day) will also help the healing.

If the hole is not exposed for you to insert the key, then the last turn was not done all the way back to expose the next hole or during the removal of the key you backed up the screw a bit. Try to find the last hole and complete the turn to expose the next hole. If not possible, call the office the next business day for an appointment.

If the bands on the expander are irritating the cheeks, you may use orthodontic wax on them. You may also use numbing agents such as Orajel, Anbesol, and Zilactin B to numb the tissues while healing and callusing. Any over-the-counter peroxide mouth rinse (such as Peroxyl) or a mild salt water rinse (one teaspoon of salt in 8 ounces of warm water, 3-4 times a day) will also help the healing.

If a band has come loose off of a molar tooth, push the band back onto the tooth and avoid chewing on that side. Please call the office the next business day for an appointment.

It is normal for a space to open up between the upper front teeth (it will soon close up). You will adjust to eating, swallowing, and speaking in a week or two.

If the bars have come apart, open as wide as you can, line up the rod attached to the lower jaw with the spring/sleeve attached to the upper jaw and slide the rod into the spring/sleeve.

If the clip on the upper spring has come off the molar tube, you can try to reclip it back to the metal tube on the upper molar band. If not successful, place it in a zip lock bag and bring it with you to the repair appointment. Allow the lower rod to rest next to the lower teeth. Please call the office the next business day for an appointment.

If the metal bar behind the lower teeth has come off the molar band (silver ring) on one side and it feels okay, then leave it alone and call the office the next business day for an appointment.

If it is bothering you and you cannot close down, then move it up and down until the metal solder joint on other side breaks off the molar band (silver ring) also. Use wax as needed to keep comfortable and call the office the next business day for an appointment.