Emergency Care

You probably won’t experience a true orthodontic emergency because they’re rare. But since they do happen from time to time, it’s important for you to know how to handle them.

The following orthodontic emergencies and their treatments are listed in the order from least serious to most severe. Only the most severe emergencies may require immediate attention by Dr. Frank.

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Ligatures Coming Off

Tiny rubber bands or small, fine wires, known 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 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. If a rubber or wire ligature is broken or lost, tell Dr. Frank so she can decide whether or not you need to schedule an appointment.

Food Caught Between Your Teeth

This is not an emergency, but it can be uncomfortable or embarrassing. It’s 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 your teeth and your braces.

Mouth Sores

Braces don’t cause mouth sores, but if you’re already prone to them, your braces may irritate your mouth and make them worse.

One or several areas 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.

Discomfort

It’s normal for you to have some 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 your mouth with warm salt water.

boy wearing metal braces

Protruding Wire

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 tell Dr. Frank about the problem.

In a situation where the wire is extremely bothersome and you can't see Dr. Frank 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. You may still need to use relief wax to make the area more comfortable.

Irritated Lips or Cheeks

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 area of the braces that is causing your irritation.

Then, you can eat more comfortably. If you accidentally swallow the wax, it’s no big deal. The wax is harmless.

Orthodontic patients smiling

Loose Brackets, Wires, or Bands

If your braces come loose in any way, call Dr. Frank to figure out what to do next.

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’re told to avoid, or if your mouth is hit while at play.

We encourage all patients, especially those with braces, to wear a protective mouth guard while playing sports.

If the bracket is off center, the adhesive may have failed. In this instance, it is best to immediately notify Dr. Frank, 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 make it more comfortable 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.

You Swallow a Piece of Your Appliance

This is rare, but when it does happen, it can be alarming.  It’s important to stay calm.

If you're coughing excessively or having difficulty breathing, you may have inhaled the piece into your airways or lungs.

If you are able to see the piece, you may carefully attempt to remove it.

DO NOT make the attempt 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 be have been inhaled, call Dr. Frank immediately.