It is extremely rare to see a true orthodontic “emergency.” But minor problems and irritations are common. Here’s everything you need to know:
With the following tools and supplies on hand in your home (most of which you already have), you’ll be prepared to handle the most common orthodontic issues.
This is mostly an annoying, uncomfortable, and/or embarrassing experience for the person wearing braces. It is easily fixed 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 teeth and braces.
Tiny rubber bands or small, fine wires, known as ligatures, are what hold the wire to your braces’ bracket. If you lose a rubber band or wire ligature, notify the orthodontist. He will determine whether you need to come into the office.
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 the wire ligature is sticking out into the lip but is not loose, you can try to bend it 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. Missing or broken ligatures should be brought to the attention of the orthodontist.
Brackets are the parts of your braces that attach to your teeth with special adhesive. They are generally positioned in the center of each tooth. A bracket can be knocked off if you eat hard or crunchy foods or you get struck in the mouth while at play. (We encourage all athletes, especially those with braces, to wear a protective mouth guard while playing sports.)
If a bracket is off center, it may be because the adhesive has failed. Call the orthodontist immediately and notify him of the situation. He will tell you if you need to come in to the office.
If a loose bracket has rotated on the wire and is sticking out, and the patient cannot immediately see the orthodontist, you can do a temporary fix to alleviate discomfort and prevent further damage. Take care to avoid swallowing the bracket or causing another injury.
To put a 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.
If your braces have come loose in any way, you should call the orthodontist to determine the appropriate next steps.
It’s normal to have discomfort for a day or two after your braces or retainers are adjusted. This can make eating uncomfortable. Be assured that such discomfort is both normal and temporary. Eat soft foods. Rinse your mouth with warm salt water. Over-the-counter pain relievers such as acetaminophen or ibuprofen can also help.
Some patients are susceptible to episodes of mouth sores (i.e., ulcers or canker sores). This ulceration can occur on the inside of the cheeks, on the lips or tongue. While braces do not cause these sores, they may be precipitated or exacerbated by irritations from braces.
This is not an emergency, but the condition can be very uncomfortable. If this happens to you, you can get prompt relief by applying a small amount of topical anesthetic (e.g., Orabase or Ora-Gel) directly to the ulcerated surface using a cotton swab. Reapply as needed.
Sometimes new braces can be irritating to the mouth, especially when a patient is eating. A small amount of non-medicinal relief wax makes an excellent buffer between metal and 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 area of the braces causing irritation. This will allow you to 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 a patient’s mouth. If this happens to you, use a Q-tip or pencil eraser to push the wire so that it is flat against your tooth. If you can’t move the wire into a comfortable position, cover it with relief wax. (See above–”If your lips or cheeks get irritated”–for instructions on applying relief wax.) Make the orthodontist aware of the problem.
In a situation where the wire is extremely bothersome and you’re unable to see the orthodontist anytime soon, as a last resort, you may clip the wire.
Reduce the possibility of accidentally 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 provide comfort to the irritated area.