Handling Orthodontic Dental Emergencies

At Stellar Smiles Ortho, we want to be there for you every step of your treatment so you can be as comfortable as possible while achieving the smile of your dreams. We understand that you may have a few accidents or emergencies on the journey to your stellar smile. Generally, there aren’t many times where an orthodontic issue is truly an emergency, and they can typically be taken care of at home.

Whenever one of these situations happens, there is no need to worry. Our team is ready to help you and ensure that your treatment carries on without any issues. While we are happy to tend to these emergency situations as quickly as we are able, we know there is often some discomfort in the moment. There are a few tips and tricks you can use to feel more comfortable in the face of an accident so that you don’t have to deal with any pain leading up to an emergency appointment. Depending on the area of your mouth affected, you can use a combination of these methods to temporarily address the issues.

Emergency Care Diagram

3 Categories of Scheduling

  • This is NOT and emergency and you can be seen at your regular visit.
  • Schedule for COMFORT visit at designated times within a week.
  • Schedule for COMFORT visit at designated times asap.

(Color) Ligatures Came Off

Small round 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 rubber or 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. Be sure to examine all ligatures.

  • This is NOT and emergency and you can be seen at your regular visit.

General Soreness (Discomfort) or Toothache

While you are getting used to your appliance or your teeth begin to shift into place for your perfect smile, you may feel some pain or discomfort as you adjust. This is completely normal and generally doesn’t last very long. We encourage soft foods if eating is uncomfortable. That being said, we don’t want you to feel uncomfortable for a prolonged period of time. If the soreness doesn’t go away quickly, we suggest taking any over-the-counter pain medicine. Other helpful remedies include gargling salt water or holding a warm washcloth to your jaws to soothe the pain.

  • This is NOT and emergency and you can be seen at your regular visit.

Mouth Sores

Some patients are susceptible to episodes of mouth sores. While braces do not cause them, they may be triggered by an irritation from braces. One or several areas of ulceration of the cheeks, lips or tongue may appear. Prompt relief may be achieved by applying a small amount of topical anesthetic (such as Orabase or Ora-Gel at your local pharmacy) directly to the ulcerated surface using a cotton swab.

  • This is NOT and emergency and you can be seen at your regular visit.

Irritation of Lips or Cheeks

Sometimes new braces can be irritating to the mouth, especially when eating. A small amount of non-medicinal relief wax makes an excellent buffer between the braces and mouth. Simply pinch off a small piece and roll it into a ball the size of a small pea. DRY THE BRACE AND THE WIRE. Flatten the ball and place it completely over the area of the braces causing irritation. You may now eat more comfortably. If the wax is accidentally ingested, it’s not a problem. The wax is harmless.

  • This is NOT and emergency and you can be seen at your regular visit.

Loose Spacer (little blue rubber band)

Spacers are small rubber rings between your teeth to make space for bands to fit around your teeth or to help move teeth. They are usually left in place for a few days before placing braces on your teeth. If your spacers move out of position or fall out entirely, no need to worry! It means you have enough space and that’s a good thing.

  • This is NOT and emergency and you can be seen at your regular visit.

Loose Bracket (still attached to wire)

If the loose bracket has rotated on the wire and is sticking out use sterile tweezers to slide or rotate the bracket along the wire until it is comfortable. Cover the area with orthodontic wax.

  • Schedule for COMFORT visit at designated times within a week.

Protruding (Poking/Long) Wire

Occasionally, the end of a wire will work itself out of place and irritate the patient’s mouth. Use a Q-tip or pencil eraser to gently nudge 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 wax). In a situation where the wire is very bothersome you may clip the wire. Use a folded tissue or gauze around the area. Use a pair alcohol sterilized sharp clippers (cuticle cutters or nail clipper) and snip off the protruding wire and grab with paper/gauze. Relief wax may still be necessary.

  • Schedule for COMFORT visit at designated times within a week.

Loose Bracket (came off wire)

If the bracket broke off and the bracket can be easily removed, bring it to your orthodontist in a plastic baggie.

  • If NOT the front of mouth bracket and DOES NOT attach to rubber bands:
    • Schedule for COMFORT visit at designated times within a week.
  • If it is a bracket that attaches to a rubber band:
    • Schedule for COMFORT visit at designated times within a week.

  • If it is the front of mouth (Upper + Lower 4 front teeth) bracket:
    • Schedule for COMFORT visit at designated times asap.

Loose Band

Bands are the metal rings that fully surround your back teeth. If you feel a band has come loose and is still attached to the wire try to chew on the other side until you see your orthodontist.

  • If band DOES NOT attach to a rubber band and IS NOT part of an appliance:
    • Schedule for COMFORT visit at designated times within a week.
  • If band attaches to a rubber band:
    • Schedule for COMFORT visit at designated times within a week.
  • If band is part of an appliance:
    • Schedule for COMFORT visit at designated times asap.

Appliance Examples: (Hyrax Expander, Nance, Bite Plate, Herbst, Lower Space Maintainer, Lingual Holding Arch)

Loose Specialty Appliance – Forsus, Herbst

If the spring of a Forsus Distalizer or Herbst appliance comes loose save all the parts on a plastic baggie.

  • Schedule for COMFORT visit at designated times asap.

Brace/Appliance/Wire Swallowed

Stay calm and go to the Local Emergency Room. Get a written report and x-rays and bring to your Orthodontist.

  • Schedule for COMFORT visit at designated times within a week.