orthodontic emergencies

How to Resolve Common Concerns at Home

For Our Patients in Braces/Appliances

Patients typically wait six to eight weeks between orthodontic visits. More often than not, everything goes as planned, and patients will see us as scheduled for their next appointment. However, orthodontic emergencies may arise on rare occasions. While they may be uncommon, addressing emergencies is crucial to avoid disrupting your treatment plan.

It’s important to note that TRUE “orthodontic emergencies” are rare. Braces or Invisalign should not cause excessive concern or require medical treatment beyond a visit to the orthodontist. However, it is possible to experience a dental emergency during your orthodontic treatment if you sustain an unexpected injury or infection.

While you can resolve many common orthodontic concerns at home, dental emergencies require professional support. That’s why we want to define what is and is not an emergency and explore proper ways to resolve common issues at home. By staying informed, you can avoid unnecessary trips to the orthodontist and ensure your treatment stays on track!

Not every ache or sore constitutes an orthodontic emergency. However, if you notice any of these listed items, you may be experiencing an emergency and should contact your orthodontist or visit an emergency room as soon as possible (including but not limited to the following examples):

  • Intense or unmanageable pain
  • An injury to the mouth or face
  • Fractured teeth
  • Oral infections or swelling

How to Assess an Orthodontic Emergency

If you experience pain or discomfort during your orthodontic treatment, there are a few steps you can take to find a solution. They are as follows:

Evaluate the severity of your pain.
Do any of the previously mentioned concerns apply? If so, please see your orthodontist or visit the emergency room. If not, continue reading below.

Identify the problem. Do you have a wire poking your mouth or a bracket rubbing against your cheek? Open wide and pinpoint the source of your child’s pain.

Try fixing the issue at home. Keep reading to explore our at-home recommendations. However, please contact your orthodontist if the following tips are unsuccessful.

One of the most common concerns orthodontic patients face is tooth soreness. This pain is normal, minimal, and subsides within one to three days. In fact, it is often a sign that your teeth are making their way into the desired position! Here are a few simple ways to alleviate the soreness at home:

  • Stick to a soft diet. Chewing hard or crunchy foods may feel uncomfortable on days when your teeth are shifting a lot. Yogurt, apple sauce, and smoothies are all excellent snack options.
  • Use a soft-bristled toothbrush. Make sure to give your mouth a little extra TLC when your teeth start to ache. Soft-bristled toothbrushes will ensure you’re not too abrasive on the sensitive area.
  • Take over-the-counter pain relievers. Common household pain relievers can help take your mind off the pain following an adjustment. Please be sure to follow the instructions provided with over-the-counter pain relievers, especially pertaining to dosage.

Braces can commonly rub the inside of your mouth and cause small sores or ulcers. Although uncomfortable, they are a normal part of the adjustment process, usually heal quickly, and your mouth will get used to the braces in no time. However, you can alleviate the immediate discomfort by taking over-the-counter pain medication as instructed, applying orthodontic wax to the affected areas, and/or using topical gels such as Orajel. It is also important to avoid touching the affected spot or consuming anything acidic or spicy while it heals.

You may experience discomfort when the wire at the end of your braces pokes out and irritates your gums or cheeks. However, there are some simple at-home solutions to this issue.

  • Utilize orthodontic wax. If the wire is only slightly protruding, you can use wax to create a soft barrier between your mouth and the metal. It will help to make sure the metal part is dry. Otherwise, the wax will fall off.
  • Use a pencil eraser. You can also use a disinfected pencil eraser to gently push the wire back into place or away from the irritated area. Your orthodontist can then properly reposition the wire at your next appointment.

Usually, small mouth sores caused by wires will heal quickly. However, to clean the affected area and prevent infection, we suggest rinsing your mouth with warm salt water daily until it heals.

We strongly advise against cutting the wire unless it’s absolutely necessary, as there is a risk of accidentally swallowing the wire fragment. If you are the parent of a very young orthodontic patient or feel uncertain about this solution, we recommend seeking professional guidance from your orthodontist.

Wires can occasionally slip away from multiple brackets. If this happens, you can carefully place the wire back into position using disinfected tweezers. However, we recommend visiting your orthodontist to avoid compromising your treatment if the wire does not fit back into place.

When a bracket separates from the tooth, it will remain stuck on the wire and spin around the bracket. Fortunately, this problem doesn’t require immediate professional attention and can be addressed at your next scheduled visit.

If the broken bracket is at the last tooth in your mouth, you can slide the bracket off or cut the wire to release it (only if you are comfortable doing so). When you cut the wire, it’s best to cut it close to the adjacent bonded bracket. Then, use orthodontic wax to ensure the exposed wire does not poke your cheek. However, if the loose bracket is between several others, use a pair of tweezers to remove the rubber band. This will release the bracket from the wire, and your orthodontist will replace it at your next appointment.

If you notice a color elastic has come off, you can reattach it around the bracket at home using a sanitized tweezer. Alternatively, you may choose to leave it off until your next appointment. If the bracket becomes loose, gently push it back into place using clean tweezers.
Orthodontic treatments sometimes require coil springs. If the spring becomes slightly out of place, you can reposition it using tweezers or cover it with orthodontic wax until your next appointment. However, if a large portion of the wire becomes displaced, visit your orthodontist as soon as possible to resolve the issue.

If your braces have steel ligatures (they look like steel pigtails), there is a chance that they may come loose and cause discomfort by poking areas inside your mouth. In such cases, you can gently readjust/bend the ligature using the clean end of a pencil eraser and tuck it under the bracket towards the tooth. Alternatively, patients can apply wax to shield the wire for temporary relief until their next appointment.

Do not wear your retainer if it breaks, and contact your orthodontist for a replacement as soon as possible. Not wearing a retainer will result in shifting of teeth. Therefore, addressing a broken retainer promptly to avoid setbacks in your orthodontic progress is essential!

For Our Patients in Invisalign

Thankfully, when you choose Invisalign, you do not need to worry about poky wires, broken brackets, or anything falling out of place. However, you might find yourself in a situation where you break or lose a tray. If this happens, you can move up to the next set of Invisalign aligners. If you do not have another tray to move up to, you may go back to the previous tray until your next visit.

If you notice that an attachment is missing, please call us and let us know which tooth is missing the attachment. Sometimes, you can wait until the next visit for repair. Other times, you may need it repaired sooner than later. This will be at the orthodontist’s discretion.
If you have a broken button that was bonded for elastic wear in addition to the aligners, please discontinue the elastics but continue to move up in your aligners until you can schedule a visit to repair the buttons.
If you have an aligner that doesn’t fit well, there are several options depending on your case.

If your aligner is loose, move up to the next tray and wear it for the duration you were instructed plus additional days you missed from the loose tray. If the next tray does not provide a better fit, please call for an appointment for an evaluation by your orthodontist.

If your aligner doesn’t fit due to erupting permanent teeth, it may be
time for a new scan. Please call to make an appointment.

Contact Us For More Information

If you are unsure of the proper course of action after reading our recommendations, please don’t hesitate to contact our orthodontic line. We will assist you in identifying the best course of action to resolve any of your orthodontic concerns.

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