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First Aid
True orthodontic emergencies are very rare, but when they do occur we are available to you. As a general rule you should call the office when you experience severe pain or when you have a painful appliance problem that you can't take care of yourself. A special visit can be accommodated the same day you call, or the next business day. In addition, every effort will be made to repair broken appliances at this time as well. Every now and then, there may be a need to re-schedule a repair visit depending on the extent of the damage and the time and technique required to fix it.
It is important to know the names of the parts of your appliances (refer to the "Emergencies" section of the patient care video on our website, or to our braces diagram). Knowledge about your braces will help when you phone the office. ALWAYS tell the receptionist when there is something broken or bothering you and what it is. In that way, time can be saved for repair when available and potentially save you an extra trip to the office.
Below, we have listed a few helpful tips that might answer some of the questions and concerns that you might have. You might be surprised to learn that you may be able to temporarily solve many problems yourself until you can come in for an appointment at our office.
If You Experience Trauma to the Mouth
Contact your dentist immediately, within MINUTES! Usually an X-ray is needed to determine the extent of the injury. If a tooth has been knocked out or fractured, it is best to contact your family dentist, since we may not have the necessary materials to treat these injuries. After seeing your family dentist, please call our office so that we can take care of dislodged or displaced teeth, or damage to orthodontic appliances. If you are unable to reach your family dentist, call our office and we will be happy to assist you in locating someone to care for the injury. If the office is closed, please follow the instructions on the message machine to reach the doctor.
If Your Teeth are Sore and Cheeks and Lips are Irritated
Discomfort during the first few days is common. It's caused from the new pressure being placed on the teeth and will dissipate within a week. Whatever you would normally take for a headache will help considerably — ibuprofen (such as Advil) is best. If possible, begin the pain reliever before the soreness begins and continue it every few hours (per the manufacturer's recommendations). Rinsing several times a day with salt water is the best way to prevent and relieve the soreness. Use warm water and as much salt as you can tolerate.
The lips, cheeks and tongue may also become irritated for one or two weeks as they toughen and become accustomed to the surface of new braces. You can put wax on the braces to lessen this, but use it minimally so cheeks and lips can toughen. If the cheek or lip is accidentally cut, you may use over-the-counter medications found at the drug store to keep you more comfortable while the area heals. If a problem persists, please call us!
If a Wire Causes Irritation
Push the wire away from the area using the eraser end of a pencil, handle of a spoon or a cotton swab. Do this looking in a mirror. Poking with a finger without looking almost never helps and sometimes makes things worse.
If the wire cannot be tucked away, cover the end of the wire with a small amount of wax or silicone ear plug. Both materials are available at any drug store. Then give us a call (or leave a message on our message machine) to set up an appointment.
If You Have a Loose Wire
Utilize wax over the wire temporarily. As a last resort (if you're unable to visit the office) use a small fingernail clipper to carefully clip the wire behind the last tooth to which it is securely fastened. Make sure to hold and remove any loose piece to avoid it being swallowed or pushed into the gums.
If it comes out from the back molar tube, attempt to reinsert the wire with a pair of needle nose pliers or tweezers. If the wire is poking you, place a piece of wax over the area. Then call us for a special repair appointment.
If a Bracket or Band Comes Loose From a Tooth
If your loose bracket or band is still attached to the wire, you should leave it in place and put wax on it if it is hurting you. If the appliance loosens completely, place the broken piece in a plastic bag and bring it to the repair appointment. Call us even if you have an upcoming appointment since repairs of this nature usually take additional time and we want to be sure we have everything ready when you arrive.
If You Notice Small Spaces Developing Between Your Teeth
Don't panic! This is usually normal and expected as teeth move into different positions, particularly in the early stages of treatment. They will be closed later in treatment.
If a Part of Your Braces or Your Retainer Breaks
Save the pieces and call to set up a repair visit.
If a Separator Comes Out
Contact our office and we'll let you know whether you need an appointment to have a new separator placed.
If You Have a Loose Expander
Call immediately to re-cement it.
If Headgear Does Not Fit
Sometimes headgear discomfort is caused by not wearing the headgear as instructed. Please refer to the instructions included in the pamphlet we have given you. If the headgear is not stored properly, it can be bent. Please call our office for any concerns or adjustments. Surprisingly, the headgear will hurt less if it's worn more, so be sure you're getting in the prescribed hours (usually at least twelve hours per day.)
If You Have Difficulty with Your Rubber Bands
Change your rubber bands after every meal as the elasticity wears out from use.
If your supply is low, call the office and we will mail you an additional supply.
If you forget to wear your elastics one day, don't double up the next day — just follow your regular instructions.
If your elastics break frequently, a wire or band loosens, or a hook breaks off call our office immediately.
If You Need Suggestions Regarding Your Retainer
Call us.
LOST or BROKEN RETAINERS should be replaced as soon as possible to avoid any movement of your teeth. Avoid flipping your retainer with your tongue. This can cause damage to your teeth or breakage of the retainer. Clean your retainer by brushing it daily with toothpaste. Denture cleaner (Efferdent or Polident) can be used in addition to brushing, for a more thorough cleaning. Take your retainer to your dentist when you have your teeth cleaned so the hygienist can clean it with a special solution.
If you are wearing a bonded wire retainer behind your teeth, be extra careful to clean the wire and the area around it. Flossing should be done every day, gently, with floss threaders. If it becomes loose, it may be re-cemented, or removed and replaced by a removable retainer worn at night.
Never wrap your retainer in a paper napkin or tissue and set it down on the table. You or someone else may throw it away. Don't put it in your pocket when playing or you may break or lose it. Whenever it is not in your mouth it should be in its plastic case.
Keep your retainer away from dogs and cats — they love to chew on them! Avoid storing them near any source of heat. And don't boil your retainer to sterilize it.
Not Sure?
Call our office and we will be happy to consult with you.
Loose brackets or bands and broken or poking wires are not considered orthodontic emergencies, and therefore do not require you to be seen in our office outside of our regular business hours. However, it is necessary that you call us as soon as possible so we can evaluate the urgency and schedule you accordingly. In the rare instance where you are not able to reach us for an emergency, call your general or pediatric dentist.
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