Patients generally consider any unexpected event associated with braces to be an orthodontic emergency, especially if the event or occurrence causes discomfort. If any unexpected event occurs, patients are urged to call our office and make an appointment to be seen as soon as possible. However, many orthodontic emergencies are actually somewhat minor and can be attended to by patients while waiting to be seen. These actions by the patient can help to eliminate discomfort, but the orthodontist should still be seen later for a more permanent solution.

Orthodontic Emergencies

Protruding Arch Wire

A protruding arch wire can poke the cheeks and cause pain and irritation. An orthodontist should be contacted immediately if an arch wire is protruding, but if the patient cannot be seen, there are steps that can be taken to relieve discomfort and prevent further irritation. The arch wire should be pushed back with a pencil eraser until it is flush with the tooth to stop it from touching the cheeks. If the arch wire cannot be pushed back, relief wax should be applied to the wire to reduce irritation.

Loose Ligatures

The small wires that connect the arch wires to the brackets may come loose and cause irritation. If this occurs, the ligature should be put back in place or removed using sterile tweezers. Loose ligatures often cause a domino effect, so an orthodontist should be notified immediately to properly replace the ligatures as soon as possible.

Loose or Broken Brackets

Brackets may come loose or be broken during play or while eating foods that should be avoided while wearing braces. If a bracket is not centered on the tooth, it should be slid back into place using tweezers. If the bracket has rotated on the wire and the orthodontist cannot be seen immediately, it is possible to flip the bracket back to the proper side in between two teeth, and then carefully slide the bracket into place until help can be sought.

Mouth Sores

Mouth sores are very common when braces are new. An orthodontist should be notified of the sores, but actions can be taken to alleviate discomfort. Ora-Gel or another topical numbing agent can be applied to the areas of the mouth where the sores occur. Dental wax can be applied to the pieces of the braces that are causing irritation to prevent further damage. Most sores will go away as the body adjusts to the braces, but minor adjustments by the orthodontist may help to rectify some issues.