Orthodontic Emergency

Food Caught Between Teeth

Food and debris that is lodged between teeth can cause discomfort and sometimes significant pain, but once it is removed the area will quickly recover. To remove the food it is recommended to use floss, interproximal brush or a toothpick. When using floss try tying a knot in the middle of the floss and sliding that knot through the area. Don’t be surprised if the gums bleed when the debris is removed initially but it will quickly stop and the area will feel sore but significantly better.

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Mouth Sores

Mouth sores can be common to some people and for those who are susceptible to getting them already, you may experience more than normal due to the irritation from braces. Sores can occur on the cheeks, lips, or tongue. For pain relief from mouth sores it is recommended to try a small amount of topical anesthetic. Topical anesthetics such as Orabase or Ora-Gel can be placed on the sore using a cotton tip and reapply when needed.

Loose Brackets, Wires or Bands

It is recommended to call the orthodontist if any part of the braces become loose. Parts of braces include: Brackets, Wires, Bands Brackets are adhered to the center of each tooth using a special adhesive. Brackets can become loose from eating hard crunchy foods, mouth being struck while at play, or the adhesive may have failed. If a bracket has turned or rotated and you cannot be seen immediately by the orthodontist you can put the bracket back in place temporarily. To do this use sterile tweezers to slide the bracket along the wire until it is back into the correct position. Rotate the bracket back into position if needed. Wires run through the brackets, and are held onto the teeth with the bracket. If a wire feels loose it could be due to a loose bracket or is the ligature to secure the wire has been lost. It’s advised to call your orthodontist if you feel like your wire is loose.

Bands are usually only on the back teeth and look like a silver ring around the tooth. Bands can become loose from crunchy foods or if the adhesive failed. You can push a loose band back into place and call your orthodontist.

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Irritation of Lips or Cheeks

It’s not uncommon to experience irritation with your lip and cheeks especially when new braces are placed. To help ease the discomfort from the irritation it is recommended to use a small amount of non-medicinal relief wax. The wax acts as a cushion between your braces and area of soft tissue irritation. All you need is a to roll a peas size ball of the wax and to squish the ball and put it over the part of the braces that is causing the discomfort. You can eat with the wax in place and the wax is completely safe if swallowed accidentally.

Ligatures Come Off

Ligatures are the small rubber bands or wires that hold the wire to bracket. If the rubber ligature comes off, it’s possible to put it back on using sterile tweezers. If a wire ligature comes loose, you can either remove it with sterile tweezers or bend it down with a Q-tip or pencil eraser. If a ligature is missing you could contact your orthodontist to see if there is a need for the patient to be seen.

Discomfort

Unfortunately, it’s normal for a patient to experience discomfort with braces. Discomfort can come from having braces on for the first time or from having adjustments made to the braces. It’s important to understand that this type of discomfort is temporary. Soft foods are recommended during this time of discomfort and rinsing with warm salt water can be helpful.

Protruding Wire

Sometimes the end of a wire can come out of place and cause irritation to the soft tissue in the mouth.

To alleviate the discomfort you could try:

  • contact your orthodontist
  • using a Q-tip or pencil eraser to push the wire back in place
  • use relief wax to cover it
  • last resort: to clip the wire using sterile sharp clippers to snip off the extended wire, placing gauze or tissue under the wire to catch the piece of wire being snipped off.

Piece of Appliance is Swallowed

Sometimes a piece of appliance can be swallowed accidentally, it’s a rare occurrence and if it does occur the first thing to remember is to remain calm.  Assess the situation and determine if the piece could have been aspirated.

  • Excessive coughing and having difficulty with breathing is a sign that a piece could have been aspirated. Look inside their mouth to see if the piece is visible. If something is visible carefully try to remove the item, but being carefully not to try and do something that would cause them harm.
  • Aspirated: If you believe a piece has been aspirated notify your orthodontist immediately.

Reference: American Association of Orthodontist. Handling Orthodontic Emergencies. My Life. My Smile. My Orthodontist.Updated 2017 https://mylifemysmile.org.

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