Emergencies

 

Avoiding Problems and Convenient Solutions

 

Things to Keep In Mind

Most concerns can be remedied at home. However, if you have a situation that you are not able to resolve on your own, please call our office so we can schedule you a comfort care or repair appointment.

By becoming familiar with the appliances in your mouth and how to handle small problems that may occur during treatment, you can help make your experience with braces a pleasant one.

Common concerns that may arise along with some helpful suggestions:

 

Separator Falls Out

If a separator falls out, and your next appointment is within the next two days, you do not have to come back to our office to have the separator replaced. However, if the separator falls out within a day or two of being placed, you should call our office to schedule a quick appointment to have the separator replaced.

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Elastic Tie Falls off

Tiny rubber bands 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. In either case, this is not an emergency, and the patient can wait until their next visit to replace the tie.

   

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Elastic chain breaks

If the elastic chain breaks, this is not an orthodontic emergency. Please call our office during regular hours to schedule an appointment.

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Wire poking the cheeks

There are several possible scenarios when a wire is poking:
  1. A ligature wire may be poking
  2. The main archwire may have come out of the tube
  3. The main archwire may be protruding out the back of the molar tube

Ligature wire poking
Try tucking the ligature wire away from the area by using the eraser end of a pencil or a Q-tip. If the ligature wire cannot be tucked in, cover the end of the wire with a small piece of wax, a cotton ball or a piece of sugarless gum. Cutting the wire should only be done as a last resort. If you cannot tuck the wire into a comfortable position, please call our office for an appointment.

 


Main Archwire out of tube
You may attempt to reinsert the wire with a pair of needle nose pliers or tweezers. If you are not successful in placing the wire back into the tube, place a piece of wax over the area. If the archwire is long and poking you, apply wax to the area. If wax does not help, the wire can be cut with wire cutter or nail clipper close to the back of the brace. Cutting the wire should be done as a last resort.

 


Protruding Archwire
If the main archwire is long and poking you, we recommend you cover the area with wax until you can get in to see us for a comfort appointment. If you are unable to get relief from that you may wish to try and trim the wire with nail clippers or small wire cutters, if you have them. Do this as a last resort.

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Loose Bracket

If a bracket (the small rectangular brace) is loose, call our office to schedule a REPAIR 2 appointment. In most cases, the bracket will remain attached to the main archwire. A loose bracket can be left in place until you are seen for your repair appointment. You may use a pair of eyebrow tweezers to reposition the brace if it flips around the wire and becomes a source of irritation.

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Loose Band

If a band (the ring around the back molar) is loose, call our office to schedule an appointment to have the band re-cemented.

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Irritation of Lips or Cheeks

Sometimes new braces can be irritating to the mouth, especially when the patient is eating. Usually the tissues toughen, but in the meanwhile, soft wax placed over the offending hardware will smooth it out. Simply pinch off a small piece and roll it into a ball the size of a small pea. Flatten the ball and place it completely over the area of the braces causing irritation.

Warm salt water also helps (1 tsp salt in 8 oz. warm water) Over-the-counter ointments like Orabase or Oragel provide comfort and help with healing.

Sometimes archwires bow out into the cheeks and irritate the soft tissue. A ball of cotton over the wire, at least during sleep, relieves the cheek from this pressure.

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Mouth Sores

Some patients are susceptible to episodes of mouth sores which may be precipitated or exacerbated by an irritation from braces. One or several areas of ulceration of the cheeks, lips or tongue may appear. This is not an emergency, but may be very uncomfortable for the patient. Placing wax over the bracket(s) in the area of irritation may also bring relief, and allow the irritated area to recover.

Mouth sores generally last 10 to 14 days, even if you don't do anything. They sometimes last up to 6 weeks. The following steps can make you feel better:

  • Avoid hot beverages and foods, spicy and salty foods, and citrus.
  • Take pain relievers like acetaminophen.

For canker sores

  • Rinse twice daily with salt water. (1 tsp salt with 8 oz of warm water)
  • Mix 1 part hydrogen peroxide with 1 part water and apply this mixture to the lesions using a cotton swab.
  • For more severe sores, prompt relief may be achieved by applying a small amount of topical anesthetic (such as Orabase or Orajel) directly to the ulcerated surface using cotton swab.
    • These medicated gels contain anesthetic that forms a smooth flexible protective film over the affected area which can last up to 6 hours, allowing pain-free eating and drinking.

Two other excellent products for general mouth soreness include Rincinol and Peroxyl.

Rincinol gently forms a micro-thin, invisible, bioadhesive protective barrier over sores which promotes healing and prevents air, liquid, and food from irritating the sensitive nerve endings. This soothing oral bandage provides up to 6 hours of pain relief. In contrast to Orabase and Oragel, Rincinol is a rinse that brings relief to the entire mouth.

 

 

Colgate Peroxyl Antiseptic Dental Rinse
Peroxyl is an oral debriding agent/oral wound cleanser for minor wounds or minor gum inflammation resulting from orthodontic appliances irritations. The active ingredient in Peroxyl is hydrogen peroxide.

 

 

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Bent appliance

If any appliance gets bent, or is not fitting well it should not be worn until it can be properly adjusted in our office. Please call our office to schedule a repair appointment.

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Loose or broken appliance or retainer

If you lose or break your appliance or retainer, bring all the pieces in with you for repair. There may be a fee for the repair of the appliance or retainer. Please call our office to schedule an appointment.

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Sore Teeth

If your teeth are sore after a visit, take aspirin, Tylenol or ibuprofen unless you are allergic to them. If your teeth suddenly get sore, please call our office to schedule a COMFORT CARE appointment. It is unusual for teeth to get sore several weeks after your last office visit.

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Food Stuck between teeth

If food becomes stuck between your teeth, use dental floss or a proxy brush to dislodge the food. It sometimes helps to tie a small knot in the middle of the floss and then slide the floss back and forth through the food mass.

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Loose Teeth

If a permanent tooth feels loose, a little movement is normal when wearing braces.

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