At Straight Orthodontics, we offer emergency orthodontics to patients in need.
You may experience soreness of the teeth, gums and jaws when the orthodontic appliances are first put on, and most patients experience minor aches as the teeth begin to move into new positions. It’s comforting to know that genuine orthodontic emergencies are rare.
If you think you may have an emergency, the first step is to determine the severity of the problem: Is it an urgent situation that requires immediate attention, or a minor problem that you can take care of yourself, until you can come in to our office?
Please understand that most emergencies will need to be seen during school, or office hours.
The following information is compiled by the Australian Society of Orthodontists and reproduced for the information of Straight Orthodontics patients. Orthodontic emergencies do occasionally occur and are often simple to treat. For some emergencies, you may need to contact your orthodontist to accurately describe your orthodontic emergency.
Brackets are bonded directly onto each tooth or attached to the tooth via a metal band.
The archwire is tied to all of the brackets and creates force to move teeth into proper alignment.
Ligatures (or “o-rings”) are tiny rubber rings used to tie the archwire to each bracket. Brackets with self-locking mechanisms do not require ligatures.
Metal bands are flat metal rings cemented around a tooth to provide a stronger means of attaching a bracket (or any other type of fitting).
Hooks & Rubber Bands
Hooks are used for the attachment of rubber bands (elastics) which help move teeth toward their final position.
Tools & Supplies
With these tools and supplies on hand (most of which you will already have), you will be prepared to handle the most common orthodontic emergencies.
- Non-medicated orthodontic relief wax
- Dental floss
- Sterile tweezers
- Small, sharp clipper
- Inter proximal brush
- Non-prescription pain reliever
- Topical Anaesthetic
The following orthodontic emergencies and their treatments are listed in the order of the least severe to the most severe. Only the most severe emergencies will require immediate attention by an orthodontist or medical doctor. The majority of these are easily treated with a follow-up by the patient’s orthodontist.
Food Caught Between Teeth
This is not an emergency but can be a little uncomfortable or embarrassing for the patient. Removing food caught between the teeth is quite simple, just use a piece on dental floss or a toothpick.
Lost Wire or Ligature
Tiny rubber bands or small, fine wires, known as ligatures, are used in some cases to hold the wire to the bracket. If a rubber or wire ligature is lost, notify the orthodontist who will advise whether the patient should be seen.
Ligatures Come Off
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 the wire ligature is sticking out into the lip but is not loose, it may be bent back down to eliminate the irritation.
Missing or broken ligatures should be brought to the attention of the orthodontist at your earliest convenience.
It is normal for a patient to have discomfort for a day or two after braces or retainers are adjusted. But it can make eating uncomfortable. The discomfort is both normal and temporary. Eating soft foods such as mashed potatoes, soups, or ice cream can ease the discomfort. Rinsing the mouth with warm salt water often helps with discomfort. Over-the-counter pain relievers can be effective at minimising any pain or discomfort.
Although braces do not cause mouth sores, the braces could irritate a mouth sore and cause slight pain. Mouth sores can appear on your tongue, lips or cheeks. This is not an emergency as mouth sores are common, but it may cause slight discomfort. The best way to relieve the pain is by applying a small amount of topical anaesthetic directly to the ulcerated surface using a cotton swab, and reapplying the anaesthetic as needed to reduce pain.
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 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 make it much more comfortable to eat, and if the wax is accidentally eaten, it isn’t a problem at all, the wax is harmless.
Occasionally the end of a wire will work itself out of place and irritate your mouth. Use a suitable implement 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.) The orthodontist should be notified of the problem.
In a situation where the wire is extremely bothersome, and you are not be able to see the orthodontist anytime soon, as a last resort, you may clip the wire if it is a light and flexible archwire, used in the first few months of orthodontic treatment. Carefully 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.
Loose Brackets, Wires or Bands
If the braces have come loose in any way, the orthodontist should be notified, at your earliest convenience, however it is not considered a dental “emergency”.
A Bracket is knocked off
Brackets are the parts of braces attached to teeth with a special adhesive. They are generally positioned in the centre of each tooth. The bracket can be knocked off if you have eaten a hard candy or foods orthodontic patients are instructed to avoid, or if the mouth is struck while at play and a mouth guard wasn’t worn to protect the teeth and braces. If the bracket is off centre and is movable, it has most likely been broken off. Notify the orthodontist, who will determine the course of action.
If the loose bracket has rotated on the wire and is sticking out, and you 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.
Your orthodontist will put the bracket back in place, using sterile tweezers to slide the bracket along the wire until it is between two teeth. Your orthodontist will then rotate the bracket back to the proper position, then slide it back to the centre of the tooth.
Even though this is not an “emergency” as such, we do ask that you call and let us know about the breakage ahead of your next appointment. This allows us to determine if we should make you a sooner appointment. It also allows us to be prepared and ready with the correct equipment required to repair the breakage when you come in.
Piece of the appliance is swallowed or aspirated
If a piece of the appliance is swallowed, there should be no coughing or difficulty in breathing. Usually the conservative approach is taken, and the piece is allowed to pass naturally. Notify your orthodontist and follow his or her advice.
Very rarely, a piece of the appliance can be aspirated (caught in the airway). If you are coughing excessively or having difficulty breathing, the piece could have been aspirated. When this happens, it can be fairly alarming but it is important to remain calm.
If you are able to see the piece, you may carefully attempt to remove it. But do not make the attempt if you would cause harm.
If you are unable to see the piece and believe it may have been aspirated, call the appropriate emergency number for your area, then notify your orthodontist immediately. The patient should be taken to an urgent care facility for an x-ray to determine the location of the piece. A physician will have to determine the best way to remove it.
Orthodontic Emergencies Mentone
If you find yourself in an orthodontic emergency, our team at Straight Orthodontics is just a phone call away. Contact us today.