Not all orthodontic emergencies require immediate attention by one of our orthodontists or hygienists.
Listed below, in order of least severe to the most severe, are some helpful tips on how to handle an orthodontic emergency.
Food Caught Between Teeth
Getting food caught between the teeth can be a little embarrassing or uncomfortable for a braces patient, but can be easily fixed with a piece of dental floss. Tying a small knot in the middle of the floss may help; otherwise an interproximal brush (Pikster) or toothpick may assist to dislodge the food stuck between the teeth and braces.
Ligatures Come Off
The tiny elastics that hold the wire to the braces are called ligatures. If one comes off you may be able to put it back into place with some sterile tweezers. Sometimes, when one ligature pops off, then others may follow, so just be sure to examine all ligatures. Missing or broken ligatures should be brought to our attention so that we can advise whether it is necessary for you to be seen sooner.
It is normal for a patient to experience some discomfort for a day or two after braces are adjusted or aligners are changed. Feel reassured that the discomfort is normal and temporary. We recommend eating soft foods and rinsing your mouth with warm salt water.
Some patients are susceptible to mouth sores. Although braces do not cause them, they may be exacerbated by an irritation from braces. This may cause one or several areas of ulceration of the cheeks, lips or tongue. While mouth sores are not an emergency, they can be very uncomfortable for the patient. Applying a small amount of topical anaesthetic to the ulcerated surface using a cotton bud can provide some fast relief. Reapply as needed.
Irritation of Lips or Cheeks
It can take a week or so for the mouth to adjust to new braces and it is normal for a patient to experience some irritation. If new braces are irritating your mouth, a small amount of wax makes an excellent buffer between the braces and the mouth. Simply pinch a small amount of wax, roll into a ball the size of a small pea and flatten the ball completely over the area of braces that is causing the irritation. Don’t stress if you accidently ingest the wax, as it is harmless.
Occasionally, the end of a wire will poke into the side of the mouth and cause irritation. Use a cotton bud or a pencil to gently push the wire so that it is flat against the tooth; otherwise cover it with wax for immediate relief. In extremely bothersome cases it may be necessary to contact us so that we can arrange for an earlier appointment to have the wire clipped.
Loose Brackets, Wires or Bands
If your braces have come loose in any way, please contact us so we can determine the appropriate next steps. The brackets are attached to the teeth with a fluoride-releasing adhesive and are generally positioned in the centre of each tooth. We encourage wearing a mouthguard for contact sports/activities and to avoid hard, crunchy foods as these can knock the brackets off the teeth.
If a bracket is knocked off the tooth, please contact us to determine the course of action. If the loose bracket has rotated on the wire and is sticking out and you cannot be immediately seen by the orthodontist, you can fix it temporarily to alleviate discomfort and prevent further damage. However, take care to prevent swallowing it or causing other injury. Use sterile tweezers to slide the bracket along the wire until it is between two teeth. Rotate the bracket back to its proper position and then slide it back to the centre of the tooth.
Piece of Appliance is Swallowed
It is extremely rare for a patient to swallow a piece of appliance. However, when it does happen, it can be fairly alarming. Try to remain calm. If the patient is coughing excessively or having difficulty breathing, the piece could have been aspirated. If you can see the piece, take care to remove it. However, do not attempt to remove it if you could cause further harm. If appropriate under the circumstances, examine the braces for problems that could have resulted 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 have been aspirated, please contact us immediately.