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Emergency Care

emergency care

 

 

 

True orthodontic emergencies are rare, but when they occur we are available to you. As a general rule, you should call the 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.

You might be surprised to learn that you may be able to solve many problems yourself temporarily until you can get to our office. When working with your appliances, you need to know the names of their parts so you can identify what part is broken or out of place.

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


  • 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. This 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 vigorously. Placing Orabase on the affected area may help; this can be found in a pharmacy. If the tenderness is severe, take aspirin or whatever you normally take for headache or similar pain.

    The lips, cheeks and tongue may also become irritated for one to two weeks as they toughen and become accustomed to the surface of the braces. You can put wax on the braces to lessen this. We'll show you how!
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  • Headgear

     

    Sometimes headgear discomfort is caused by not wearing the headgear as instructed by your orthodontist. Please refer to the instructions provided by your orthodontist. If the facebow is bent, please call our office for assistance. The headgear should hurt less the more it’s worn, so be sure you’re getting in the prescribed number of hours.
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  • Loose appliance

     

    If your appliance is poking you, place wax on the offending part.
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  • 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 the wire comes out entirely, wrap the bracket with a tissue.
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  • Loose wire

     

    Using a pair of tweezers, try to put your wire back into place. If doing this and using 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 your discomfort continues, place wax on it.
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  • Poking wire

     

    Using a pencil eraser, push the poking wire down or place wax on it to alleviate the discomfort.
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The following is intended to provide general information regarding some of the more common orthodontic emergencies. Emergencies for patients in braces tend to be relatively infrequent and fortunately are not usually severely debilitating. Nevertheless, discomfort from a problem with the braces can occur. Listed below are some of the more common problems and some possible solutions to deal with the situation on a temporary basis. If you have concerns after attempting these repairs, please feel free to contact our office for further instructions.

  • Broken Braces

 

Broken or loose braces are generally not considered an urgent problem in most cases. There are times when a loose brace may cause some problems, however, so it is best to call our office when the problem occurs. When a bracket comes off of a tooth, it is still normally attached to the wire with an elastics tie.

This will prevent the bracket from being swallowed, but it may move or spin around on the wire. If this is a problem for the patient, a little wax pressed against the bracket will keep it from moving around.

  • Loose Band

 

When a band (ring around the back teeth) comes loose, the patient is in no immediate harm. However, the band is normally cemented on the tooth with an adhesive that seals the inner portion of the band from saliva and plaque. If the band is left loose for a period of time (3-4 weeks), saliva and bacteria may enter into the crevice between the tooth and the band. The result could be a decalcification (white spot) on the tooth surface. It can form rather quickly, causing damage to the enamel, so a phone call to our office is recommended.

  • Poking Wire

 

Many times as the teeth move in the early phase of treatment, the wire used to straighten the teeth has no place to go except out the back of the molar band area. Also, if spaces are being closed or if the bite is being corrected, the wire will begin to get longer at the back of the braces. Fortunately, most times this can be handled at home very simply with some orthodontic wax. It is important to try and dry the area first (with a paper towel), then roll up a piece of wax into a ball. Place the ball of wax into the area of the poking wire. The wax will smooth the area and keep the tissue from getting caught on the end. If wax does not resolve the pain, please contact our office.

Orthodontic pain and discomfort

Pain and discomfort is a normal part of orthodontic treatment. The pain tends to occur about 4-6 hours after the braces are placed or after an adjustment appointment. Over the next day or two, the pain will progressively become worse. Then, after days 3-5, the pain will begin to subside. We recommend over the counter pain medication (preferably Tylenol) just prior to and after the adjustment appointments. This allows the medication to already be in the system before the pain begins, improving the effectiveness.

  • Injuries

Significant dental injuries while in braces can be traumatic to the patient. Immediate care should be sought from an emergency physician and dentist in these cases. Often the braces have been known to actually prevent loss of teeth, since the braces and wires had provided stability.

  • Lost/Broken Retainers

 

There are a number of variables that determine whether this is an urgent situation or not. For example, if the braces had recently been removed, there is a greater chance that the teeth will shift and move if a retainer is not replaced relatively quickly. However, every patient may differ with the potential amount of relapse. If a patient has been out of braces for a long period of time, and the teeth are in a relatively stable position, the chance of significant shifting may be low. Please call our office if your retainer is lost or broken to discuss your options.

  • Poking metal tie

 

Occasionally, metal wires are used to tie the archwire to the brackets or bands. Sometimes during eating or brushing, this metal wire tie can accidentally be redirected and start to cause irritation to your lips or cheeks. You can try to push the poky wire back into place by using the end of a pencil eraser.

If that is not possible, you can place wax on the area causing the irritation until you can be seen at our office.

  • Mouth Sores

The braces have a tendency to feel rough against the cheeks, lips, and tongue, especially soon after the braces are placed. This will sometimes lead to soreness and cause discomfort. The tissues will develop a callous over time, so this becomes less of a problem while treatment progresses. In the initial stages of treatment, wax can be used in areas that are particularly painful. However, limiting the use of wax will help the patient build up the callous tissues. Temporary pain relief can also be obtained with topical anesthetics (i.e. Orabase®).

 
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