Handling Orthodontic Emergencies
What to do In case of Emergency
Please call our office as soon as possible if you break or loosen any of your appliances. Even if you have a regular appointment scheduled, please call to notify us as soon as possible so that we can make appropriate time during your scheduled appointment.
If your emergency is afterhours, many situations can be handled at home. Please review these situations and if necessary call the office for Dr. Cancelli's after hours information.
Food Caught Between Teeth
This is not an emergency, but can be a little uncomfortable or embarrassing.. 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.
Lost Wire or Ligature
Tiny rubber bands or small, fine wires, known as ligatures, hold the wire to the bracket. If a rubber or wire ligature is lost call the office on the next business day. Often this can wait until your next appointment.
It's normal for a patient to have discomfort for a day or two after braces or retainers are adjusted. But it can make eating uncomfortable. This is both normal and temporary. Encourage soft foods. Rinse with warm salt water. If you or your child is allowed to have over-the-counter pain relievers, acetaminophen or ibuprofen may be effective.
Some patients are susceptible to episodes of mouth sores. While braces do not cause them, they may be precipitated or exacerbated by an irritation from braces. One or several areas of ulceration of the cheeks, lips or tongue may appear. This is not an emergency, but may be very uncomfortable. Prompt relief may be achieved by applying a small amount of topical anesthetic (such as Orabase or Ora-Gel) directly to the ulcerated surface using a cotton swab.
Irritation in Mouth
Sometimes new braces can be irritating to the mouth, especially when the 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 .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 the 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 Irritation of Cheeks or Lips above for instructions on applying relief wax.) Call the office to make an appointment to have the wire fixed.
In a situation where the wire is extremely bothersome and the patient will not be able to see the orthodontist anytime soon, as a last resort, you may clip the wire.Reduce the possibility of the child or yourself swallowing the snipped piece of wire by using folded tissue or gauze around the area. Use a pair of washed sharp clippers and snip off the protruding wire. Relief wax may still be necessary to provide comfort to the irritated area.
Loose Wires, Brackets or Bands
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 or become loose if you or your child has eaten one of those hard or crunchy foods orthodontic patients are instructed to avoid, or if the mouth is struck while at play. Or the adhesive may have failed. Call the office to schedule an appointment to reposition the bracket or band.
If the loose bracket has rotated on the wire and is sticking out, and the patient cannot immediately be taken to the orthodontist, you can do a temporary fix to alleviate discomfort and prevent further damage. But take care to prevent swallowing or other injury.
To put the 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.
Lost or Broken Retainer
If you have lost or broken your retainer it is important to call the office as soon as possible to schedule an appointment for a replacement. If you have two retainers, one for day and one for night you can interchange those until a replacement is made. If your retainer is broken or lost and it is on a weekend or evening, it is not an emergency. Just call on the next business day.