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Orthodontic Emergencies – Braces Problems
By Matthew Freeman, DDS, MS
Board Certified Orthodontist
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Although there are very few true orthodontic emergencies, during the course of treatment you may discover that you have loose or broken braces. You may also discover that the orthodontic wires may shift and begin irritating your lips or cheeks. Below is a list of common braces problems and how they may be remedied at home. If you have a problem that you cannot resolve on your own, call your orthodontist’s office. Your orthodontic team will be able to give you advice on how to solve the problem yourself or schedule you the appropriate appointment so that your braces problem can be fixed. If you are out of town, use our orthodontist directory to find the nearest orthodontist. You can also view our braces problems video for more information about how to handle problems with your braces.

Loose or Broken Braces
Loose Band
Long Poking Archwire
Tooth Discomfort or Soreness
Sores or Ulcerations Inside the Mouth
Wire Out of Tube or Slot
Poking Metal Tie
Lost Elastic Tie
Headgear or Other Orthodontic Appliance Does Not Fit
Accidents Involving the Teeth
Loose or Broken Braces
loose orthodontic bracket or broken braces

You may discover that you have loose or broken braces.  This is usually caused by playing with your braces or eating hard or sticky foods.  This is generally not an emergency unless it is associated with pain or discomfort.  If the bracket is attached to the wire, leave it in place and cover it with wax as needed for comfort.  If the bracket comes out completely, bring it with you to your next appointment.  Avoid connecting elastics or a headgear appliance to any loose brackets.  Call the office to schedule an appointment to repair the bracket. Be careful not to break too many brackets during your orthodontic treatment.  You may be charged an extra fee to repair broken braces which may increase your overall braces cost.

Loose Band
loose broken orthodontic band or braces

Eating hard or sticky foods or playing with your orthodontic braces can loosen a band.  This is generally not an emergency unless it is associated with pain or discomfort.  Avoid connecting elastics or a headgear appliance to any loose bands.  If the band is still attached to the wire, it will usually wobble slightly.  You can call the office to see if you need a special appointment to have the band recemented or if it can be done at your regularly scheduled appointment time.  If the band comes off your tooth, the space needed to recement the band may close in a few days so call your orthodontics office to schedule an appointment to have the band recemented.  If no recementation appointment is available within a few days of the band coming off, the office can usually have you in for a quick appointment to place separators so the band space does not close.  Remember to bring the band with you to your appointment.

Long Poking Archwire
orthodontics poking protruding wire out of braces

Sometimes as your teeth shift, the ends of the wire will start poking out the back of the molar tubes and begin irritating the cheeks.  This problem may be resolved by moving the wire away from the irritated area using a cotton swab or pencil eraser.  If the wire does not move, cover it with a small pea-sized amount of wax or cotton.  You may also try cutting the wire with nail clippers that have been washed and sterilized in alcohol.  Call the office for an appointment if you cannot resolve the problem.

Tooth Discomfort or Soreness
Discomfort soreness, sore tooth pain, painful teeth from braces or orthodontics

Teeth may become sore or achy following an orthodontic activation appointment.  Usually the teeth are most sore during the first 24-72 hours.  After 72 hours, the teeth usually start feeling better.  Maintain a soft food diet as needed.  If necessary, take the pain reliever you would use for a headache. 

Sores or Ulcerations Inside the Mouth
Canker sore, cut, ulcer on lips cheeks from braces or orthodontics

During the first week of treatment, you may notice sores or ulcerations inside your mouth.  This can happen because your lips and cheeks are not yet used to rubbing against your orthodontic braces.  Over time, your skin on the inside of your mouth will get tougher and you will not have sores anymore.  To provide some relief for your lips and cheeks rubbing against your rough braces, you can place a small pea-sized amount of wax or cotton on the area of the braces that is causing the sore or ulceration.  The sore should improve within a couple of days and completely heal within a week.  If the sore or ulceration does not improve or gets worse, call your orthodontist to have it examined.

Wire Out of Tube or Slot
orthodontic wire fell out of braces band tube

During treatment, flexible wires may slip out of the bracket slots of the back teeth.  This may be avoided by eating the appropriate foods your orthodontist recommends.  If the wire comes out of the tube, try placing the wire back in the tube using tweezers.  If necessary, cover the loose wire with wax and call the office for an appointment.

Poking Metal Tie
orthodontic metal tie wire poking lip cheek

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 by your orthodontist to have it fixed.

Lost Elastic Tie
lost elastic rubber tie on bracket or braces

If an elastic tie falls off, call your orthodontist’s office.  Sometimes, you can wait until your next appointment to have it replaced.  Other times, your orthodontist will want to see you for a quick visit to put the elastic tie back on.

Headgear or Other Orthodontic Appliance Does Not Fit
broken orthodontic appliance or headgear does not fit

Call the office for an appointment to have the orthodontic appliance or headgear adjusted.

Accidents Involving the Teeth
accident emergency when have braces

If an accident occurs during treatment involving the teeth, call your dentist or orthodontist immediately. 

 
Brushing With Braces
Braces Problems Video
 
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