Orthodontic Emergencies…What To Do.

emergency-careMajor orthodontic emergencies are fairly rare; however, when they do occur it is very important to seek immediate attention by an orthodontist. As a general rule, you should call our Sioux Falls, SD office when you experience severe pain or have a painful appliance problem you can’t take care of yourself. We’ll be able to schedule an appointment to resolve the problem. By comparison, a minor orthodontic issue is something you can usually take care of yourself temporarily, or wait until your next scheduled appointment for care.

If there is a loose piece that you can remove, put it in a plastic bag or envelope and bring it with you to your next appointment. If your braces are poking you, put soft wax on the piece that’s sticking out. If the wire has slid to one side, you can pull it back to the other side with needle-nosed pliers, replacing it in the tube on the back tooth.

After alleviating your discomfort, it is very important that you call our office as soon as possible to schedule a time to repair the problem. Allowing your orthodontic appliance to remain damaged for any length of time could result in disruptions to your treatment plan.

Here are some more specific guidelines to help you understand the difference between a true orthodontic emergency and a minor orthodontic issue.

Orthodontic Emergencies

Acute, Direct Injury to the Mouth, Jaw, or Teeth. Whether or not you are undergoing orthodontic care, if you suffer an injury to your mouth, jaw, or teeth, you should see a doctor or dentist immediately. You may need an X-ray to determine the extent of your injury. If the injury affects the orthodontic appliances, they will need an adjustment or possibly replacement, depending upon the extent of the injury.

Infected Teeth. It is possible for teeth to become infected following orthodontic treatment. This may or may not be related to your orthodontic appliances. If you experience pain or swelling around a tooth that gets progressively worse, seek professional care as soon as possible.

Minor Orthodontic Issues

While true orthodontic emergencies are rare, minor issues are much more common. The following are some examples of minor orthodontic issues that can be remedied by you and/or fixed at your next office visit:

  • Loose bracket
  • Loose elastic band
  • Loose wire
  • Loose appliance
  • Poking wire
  • Headgear does not fit
  • Lost or broken elastic band
  • General soreness or discomfort

Any of these issues can occur as a result of normal every day usage, shifting, and wear of your braces. Eating really hard or sticky, gummy foods can cause or aggravate these problems. Vigorous brushing of the teeth can also be a factor. None of these issues are considered to be orthodontic emergencies unless they are accompanied by acute or prolonged pain or discomfort.

As for on-the-spot remedies, covering a loose bracket or wire with wax can be a quick fix to ease any discomfort until your next visit to us here at Horner Barrow Orthodontics. Poking or protruding wires can be moved with a cotton swab or tweezers, or trimmed down with nail clippers. Just remember to always sterilize the tweezers or clippers in alcohol first. Cover any clipped wire ends with a small ball of wax.

Loose Bracket. If your bracket or band is still attached to the wire, you should leave it in place and put wax on it if needed for comfort. If the bracket or band can be removed easily, place it in an envelope and save it to bring to your next appointment.

Loose Wire. Using a pair of tweezers or needle-nosed pliers, try to put your wire back into place. It is okay to use a piece of floss to tie the wire into place: tie the floss around the bracket in place of the missing colored o-ring. If you cannot put the wire into a comfortable position, and covering the end with wax doesn’t help, as a last resort use a small fingernail clipper to clip the wire behind the last tooth to which it is securely fastened. If the end of the wire is still sharp, you can place wax on it.

Poking Wire. Using a pencil eraser, push the poking wire down or place wax on it so that it is no longer poking your mouth.

General Soreness. When you get your braces on, you may feel general soreness in your mouth, and teeth may be tender to biting pressures for three to five days. Some soreness or small abrasions in the mouth are normal, especially with recent orthodontic work. Stick to a soft diet until your teeth do not hurt to chewing. Irritated gums and other sore spots can be relieved by rinsing your mouth with a warm salt-water mouthwash. Dissolve one teaspoonful of salt in eight ounces of warm water, and rinse your mouth thoroughly. If the tenderness is severe, take acetaminophen (Tylenol) or whatever you would normally take for headache or similar pain. Please note: aspirin, ibuprofen (Motrin, Advil) and naproxen sodium (Naprosyn, Anaprox) actually slow the tooth movement, so it is not advisable to use them frequently while wearing braces.

The lips, cheeks, and tongue may become irritated for one to two weeks as they learn a new posture and become accustomed to the surface of the braces. You can put wax on the braces to lessen this. We’ll show you how!

Sometimes discomfort can be caused by not wearing the headgear as instructed. Please refer to the instructions provided by the Horner Barrow Orthodontics team. If the facebow (metal piece) is bent, please call our office for assistance. The headgear should hurt less the more it’s worn, so be sure you get in the prescribed number of hours.

When in doubt whether it’s a true emergency or something that can wait until your next appointment, be sure to contact our office with any questions you might have. At Horner Barrow Orthodontics, we’re here to help!