Emergency Ortho Care


True orthodontic emergencies are very rare, but when they do occur we are available to help you. As a general rule, you should call the office when you experience severe pain or when you have a painful appliance problem that you can't take care of yourself. We'd be happy to schedule an appointment to resolve the problem.

You might be surprised to learn that you may be able to temporarily solve many problems yourself until you schedule an appointment with our office. If you need to call the office with an emergency or problem, it will be helpful to know the names of the parts of your appliances so you can identify what part is broken or out of place. See the Parts of Braces as well as the Braces Diagram.

Tooth Soreness

Teeth will be tender to biting pressures at times during orthodontic treatment. This is normal after braces are placed and following adjustments. The tenderness will significantly diminish within 3 or 4 days. Soreness can be relieved by rinsing your mouth with a warm salt water mouthwash. Dissolve one teaspoonful of salt in 8 ounces of warm water, and rinse your mouth vigorously. Eat soft foods for the first few days. Eating warm soup or drinking hot liquids after an adjustment will also help reduce tooth soreness. Take Tylenol, Advil or whatever you would take for a headache to help alleviate any discomfort.

Irritated Cheeks, Lips, or Tongue

Brackets may irritate soft tissues initially until the tissues toughen (like your feet if you start to walk barefoot). We provide wax, which can be placed onto the braces until the adjacent cheek or lip area heals. Pinch off a small piece of wax, roll it between your fingers to warm it and soften it, then place it directly over the sharp wire, bracket, or band. If you have no wax, place a small piece of a cotton ball over the sharp part of your braces. We do not recommend chewing gum while wearing braces, but in a pinch, a piece of sugarless gum can be carefully chewed to soften it, then placed over the offending wire, if wax or cotton do not work. Orabase topical anesthetic gel can be applied directly on the sore spot on the cheek, lip or tongue to numb it and make it feel better. Rinsing with warm salt water can also help relieve some of the discomfort.

Loose Bracket or Band

Generally, loose brackets or bands do not require immediate reattachment, but should be repaired within several days. Simply leave us a voice mail message, and we will return your call when the office is open to schedule the repair. It is also OK to wait for regular office hours to call our office to plan the repair, unless you are experiencing pain. If your band or bracket comes completely off, keep it in a safe place and bring it with you to the office. If you are wearing headgear or elastics attached to a loose band or bracket, stop wearing them until we perform the repair. If a band or bracket comes loose, please call us to let us know, even if you notice something is broken the day of your appointment, as it is not always possible to repair appliances at your regular appointment without prior warning. This is because additional time is needed in the schedule to reattach the loose portion of your braces. Please do not arrive for an appointment with a loose bracket or band without having called us in advance to inform us. We appreciate your cooperation and understanding.

We reward our patients by taking good care of their braces by not having broken brackets at their appointments. Please see our Patient Rewards page for details on how you can earn wooden nickels and turn them in for fun prizes!

Broken or Poking Archwire

If a broken wire can be removed easily, remove the broken piece. If a wire slips out of its tube, replace the wire back in the tube or under the tube hook by using tweezers. If the wire still pokes, slide it to the opposite side, or cover the wire with wax, a cotton ball or gauze. Call our office for an appointment before additional problems develop.

Poking Ligature Wire

Tuck the poking wire under with a pencil eraser. If this is not possible, cover it with wax, cotton ball or gauze and call for an appointment.

Lost Separator

If you are unable to place the separator back in yourself, give the office a call and we will replace it. If a separator comes out over the weekend, it is OK to wait to call the office on Monday for replacement then. A lost separator would not require an emergency visit to the office if the office is closed.

Loose Teeth

Loose teeth are to be expected throughout treatment. Don't worry! It's normal. Teeth must loosen first so they can be moved. The teeth will again become firm in their new, corrected positions.

Soft Tissue Impingement

Call our office for an appointment to relieve the offending portion of the appliance. You may be able to pull a hook or loop out (or push it in) to relieve discomfort.

Gums Bleed When Brushing

Inadequate tooth brushing causes your gums to swell up and bleed, an infection called gingivitis. Bleeding means you need to brush more effectively and to floss as well. After the gums regain their health, they will no longer be sore or bleed. Refer to Tooth brushing with Braces for detailed instructions. Be sure to continue to see your family dentist at least every 6 months (or more frequently as your dentist recommends) for regular cleanings, examinations and fluoride treatments.

Removable Appliance or Retainer Does Not Fit

If these appliances are not worn regularly as prescribed, they will not fit properly and your teeth could move in the wrong direction. If you are unable to wear your appliance, treatment length will be extended, as you will not be making the progress you should. Call for an appointment right away for adjustment.

Staining of Clear Brackets or Power Chain

Avoid coffee, tea, mustard, curry, spaghetti sauce, dill pickle juice, and all tobacco products. Our clear ceramic brackets themselves will not stain, but the power chain can discolor. Don't worry, the power chain will be replaced at your next appointment.

Trouble Turning Expander

We should see you if you are unsure about turning or if you are having trouble turning your expander. We want to be certain that you are turning it correctly and that the appliance is working properly. Please call us.

Loose Expander

If your expander seems loose and not well attached to all the teeth, stop turning the expander until we can recement it. Call right away for an appointment.

Traumatic Accidents

Use ice immediately to reduce swelling. If the teeth are displaced and don't fit together properly, archwires are bent, or soft tissue is impaled on the braces, schedule an appointment immediately in our office, with your general dentist, or oral surgeon. If a tooth is knocked completely out of your mouth, do not scrub the root. Simply rinse any dirt off the tooth with fresh water and replace it back in the tooth socket as soon as possible. Call immediately for an emergency appointment with your dentist.