Instructions for Handling Problems
Wherever you currently find yourself in your orthodontic journey, it’s helpful to know about the minor issues that can sometimes occur when wearing braces.
True orthodontic emergencies are rare, but they do happen from time to time, and it’s important to know how to handle them if they do.
The following orthodontic emergencies and their treatments are listed in the order from least severe to most severe.
Only the most severe emergencies may require immediate attention by Dr. Demas.
For major orthodontic emergencies, don’t hesitate to call 860-276-0333.
However, most orthodontic emergencies are easily treated at home with a follow-up appointment with us.
Common Orthodontic Issues
Ligatures Coming Off
Tiny rubber bands or small, fine wires, known as ligatures, 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. If a wire ligature comes loose, simply remove it with sterile 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. Missing or broken ligatures should be brought to the attention of Dr. Demas. If a rubber or wire ligature is lost, tell Dr. Demas so he can advise whether you should be seen.
Food Caught Between Teeth
This is not an emergency, but can be a little uncomfortable or embarrassing for the braces-wearing patient.
It’s easily fixed 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.
It’s normal for you to have discomfort for a day or two after braces or retainers are adjusted, but it can make eating uncomfortable.
This discomfort is very normal and only for a short time.
Try eating soft foods and rinse the mouth with warm salt water.
Some patients are susceptible to episodes of mouth sores. While braces do not cause them, they may be precipitated or exacerbated by 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 you.
Get prompt relief 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 as needed.
Irritated Lips or Cheeks
Sometimes new braces can be irritating to the mouth, especially when you’re eating. A small amount of non-medicinal relief wax makes an excellent buffer between metal and mouth.
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.
Then, you can eat more comfortably. If you accidentally swallow the wax, it’s not a problem. The wax is harmless.
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. (See Irritation of Lips or Cheeks above for instructions on applying relief wax.)
You’ll need to make Dr. Demas aware of the problem.
In a situation where the wire is extremely bothersome and you can’t see Dr. Demas anytime soon, you may, as a last resort, clip the wire.
Reduce the possibility 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, call Dr. Demas 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’ve eaten one of those hard or crunchy foods orthodontic patients are instructed to avoid, or if the mouth is struck while at play. (We encourage all patients, especially those with braces, to wear a protective mouth guard while playing sports.)
If the bracket is off center, the adhesive may have failed. In this instance, it is best to immediately notify Dr. Demas, who will determine the course of action.
If the loose bracket has rotated on the wire and is sticking out and you can’t come to our office immediately, you can do a temporary fix to alleviate discomfort and prevent further damage, but take care to prevent swallowing or other injury.
To put the bracket back in place, use sterile tweezers to slide the bracket along the wire until it is between two teeth.
If You Swallow a Piece of Appliance
This is rare, but when it does happen, it can be alarming but stay calm.
If you’re coughing excessively or having difficulty breathing, the piece could have been aspirated.
If you are able to see the piece, you may carefully attempt to remove it.
DO NOT make the attempt if you could cause harm.
If appropriate under the circumstances, examine your braces for problems that may result from the missing piece, such as looseness or irritation, and treat as specified above.
If you are unable to see the piece and believe it may be have been aspirated, call Dr. Demas immediately.