Ace Orthodontic/Braces Emergencies

The following orthodontic emergencies and their treatments are listed in the order of the least severe to the most severe. Only the most severe emergencies may require immediate attention by Dr. Donna Chang. The majority of these are easily treated during a follow-up appointment.

Food Caught Between Teeth and/or Braces

This is not an emergency, but it can be a little uncomfortable or embarrassing when you wear braces. Try brushing first. If food is still stuck after brushing, you can easily fix it with a piece of dental floss. Try tying a small knot in the middle of the floss to help remove the food, or use an interproximal brush or toothpick to dislodge food caught between teeth and braces.

Ligatures/O-Ties or Power Chains Come Off

Tiny rubber bands or small, fine wires, known as ligatures, hold the wire to the bracket. Or sometimes they are linked together like a chain. If a rubber ligature should come off, you may be able to put it back in place using clean tweezers. If a wire ligature comes loose, simply remove it with clean tweezers. If the wire ligature is sticking out into the lip but is not loose, it may be bent back down with a Q-tip or pencil eraser to eliminate the irritation.

Of course, when one ligature pops off or breaks, others may follow. Be sure to examine all ligatures. You need to inform the office about missing or broken ligatures, and Dr. Donna Chang can then advise whether you should be seen before your next scheduled appointment for evaluation and replacement of ligatures.

Discomfort

It’s normal to have discomfort for a day or two after braces or retainers are adjusted.

But it can make eating uncomfortable. Discomfort during eating is both normal and temporary. Try to eat soft foods and rinse the mouth with warm salt water. You may take some over-the-counter pain medications, such as Advil or Tylenol, to decrease the discomfort.

Mouth Sores or Canker Sores

Some orthodontic patients are susceptible to episodes of mouth sores. While braces do not cause them, mouth sores 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 it may be very uncomfortable for you. Prompt relief may be achieved by applying a small amount of topical anesthetic (such as Orabase or Ora-Gel) directly to the ulcerated surface using a cotton swab. You can reapply topical anesthetic as needed.

Irritation of Lips or Cheeks

Sometimes new braces can be irritating to the mouth, especially when you eat. In that case, you can apply wax provided by Ace Orthodontics over the area of the braces causing irritation. Wax will make an excellent buffer between metal/porcelain braces and mouth. Furthermore, if you accidentally ingest the wax, it is not a problem. The small amount of wax is harmless.

Protruding Wire

Occasionally, the end of a wire will work itself out of place and irritate your mouth. Use a Q-tip or pencil eraser to push the wire so that it is flat against the tooth. If the wire cannot be moved into a comfortable position, cover it with relief wax provided by Ace Orthodontics (See Irritation of Lips or Cheeks above for instructions on applying relief wax.)

Then, you need to inform Dr. Donna Chang about the problem and we will schedule you to come in to cut the wire for you. In a situation where the wire is extremely bothersome and you will not be able to see Dr. Chang anytime soon, you may, as a last resort, clip the wire. Reduce the possibility of swallowing the snipped piece of wire by using folded tissue or gauze around the area. Use a pair of sharp clippers and snip off the protruding wire. Relief wax may still be necessary to provide comfort to the irritated area.

Loose Brackets, Wires, or Bands

If the braces have come loose in any way, you need to inform Dr. Chang to determine appropriate next steps. Brackets are the parts of braces attached to teeth with a special adhesive. They are generally positioned in the center of each tooth. The bracket can be knocked off if you have eaten one of those hard or crunchy foods that you need to avoid, or if the mouth is struck while at play (you need to wear a protective mouth guard while playing sports).

If the bracket is off center, the adhesive may have failed. In that case, you need to call our office and inform Dr. Chang, who will determine the course of action. If the loose bracket has rotated on the wire, if it is sticking out and you cannot see Dr. Chang right away, you can do a temporary fix to alleviate discomfort and prevent further damage. But be careful not to swallow the bracket or get injured in any other way.

To put the bracket back in place, use clean tweezers to slide the bracket along the wire until it is between two teeth. Rotate the bracket back to the proper position, and then slide it back to the center of the tooth.

Piece of Appliance is Swallowed

This is rare, but when it does happen, it can be fairly alarming to you. Try to stay calm. If you are coughing excessively or have difficulty breathing, you could have aspirated the piece. In that case, you need to inform Dr. Chang and go to the emergency room right away.

If you are able to see the piece, you may carefully attempt to remove it. However, do not make the attempt if you could cause harm. You can then call our office and Dr. Chang will examine you for problems that may result from the missing piece, such as looseness or irritation.

If you are unable to see the piece and believe it may be have been aspirated inform Dr. Chang immediately.