Emergency Care

While you are getting used to your appliance or your teeth begin to shift into place for your perfect smile, you may feel some pain or discomfort as you adjust. This is completely normal and generally doesn’t last very long. We encourage soft foods if eating is uncomfortable. That being said, we don’t want you to feel uncomfortable for a prolonged period of time. If the soreness doesn’t go away quickly, we suggest taking any over-the-counter pain medicine. Other helpful remedies include gargling salt water or holding a warm washcloth to your jaws to soothe the pain.

Some patients are susceptible to episodes of mouth sores. While braces do not cause them, they may be triggered by an irritation from braces. One or several areas of ulceration of the cheeks, lips or tongue may appear. Prompt relief may be achieved by applying a small amount of topical anesthetic (such as Orabase or Ora-Gel at your local pharmacy) directly to the ulcerated surface using a cotton swab.

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 the braces and mouth. Simply pinch off a small piece and roll it into a ball the size of a small pea. DRY THE BRACE AND THE WIRE. Flatten the ball and place it completely over the area of the braces causing irritation. You may now eat more comfortably. If the wax is accidentally ingested, it’s not a problem. The wax is harmless.

Small round 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 rubber or 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 with a Q-tip or pencil eraser to eliminate the irritation. Be sure to examine all ligatures.

Spacers are small rubber rings between your teeth to make space for bands to fit around your teeth or to help move teeth. They are usually left in place for a few days before placing braces on your teeth. If your spacers move out of position or fall out entirely, no need to worry! It means you have enough space and that’s a good thing.

If the loose bracket has rotated on the wire and is sticking out use sterile tweezers to slide or rotate the bracket along the wire until it is comfortable. Cover the area with orthodontic wax.

Occasionally, the end of a wire will work itself out of place and irritate the patient’s mouth. Use a Q-tip or pencil eraser to gently nudge 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 Lips or Cheeks above for instructions on applying wax). In a situation where the wire is very bothersome you may clip the wire. Use a folded tissue or gauze around the area. Use a pair alcohol sterilized sharp clippers (cuticle cutters or nail clipper) and snip off the protruding wire and grab with paper/gauze. Relief wax may still be necessary.

If the bracket broke off and the bracket can be easily removed, bring it to your orthodontist in a plastic baggie.

Bands are the metal rings that fully surround your back teeth. If you feel a band has come loose and is still attached to the wire try to chew on the other side until you see your orthodontist.

If the spring of a Forsus Distalizer or Herbst appliance comes loose save all the parts on a plastic baggie.

Stay calm and go to the Local Emergency Room. Get a written report and x-rays and bring to your Orthodontist.