The following outline describes how dental emergencies are handled with patients in orthodontic appliances. Dental emergencies while wearing braces or other orthodontic appliances fall into two categories: 1) Direct injuries to the mouth or teeth or 2) Problems related to orthodontic appliances.

Direct Injuries to the Mouth

Following a direct injury to your mouth or teeth, whether undergoing orthodontic care or not, you should be seen by your regular dentist as soon as possible. Usually a radiograph of the involved tooth, or teeth, is needed to ascertain the extent of injury. If a tooth has been knocked out, severely displaced, or fractured, it is best to contact your family dentist first, since we may not have the necessary materials needed to treat these injuries. If the orthodontic appliances are dislodged or displaced, we will need to replace or adjust them as soon as possible.

Please call our office immediately after seeing your family dentist. If you are unable to reach your family dentist or an alternate emergency facility, call this office and we will assist you in locating someone to care for the injury. Please discuss emergency procedures with your family dentist at your next visit to his or her office.

Problems Related to Orthodontic Appliances

Broken or disturbed appliances are likely to occur from time to time with your orthodontic care. If there is any disturbance, such as loose bands or broken or poking wires, call our office as soon as possible so we can evaluate the urgency of the problem and schedule you to be seen accordingly.

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. When working with your appliances, you need to know the names of the parts of your appliances so you are able to 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 in your treatment plan.

The following solutions may help you relieve your discomfort:

Poking Wire
Using a pencil eraser, push the poking wire down or place wax on it to alleviate the discomfort.

Loose Bracket or Band
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.

Loose Wire
Using tweezers, try to place your wire back into place. If doing this and using wax does not 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.

Loose Appliance
If your appliance is poking you, place wax on the offending part of your appliance.

Headgear Does Not Fit
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. Surprisingly, the headgear may hurt less if it’s worn more, so be sure you’re getting in the prescribed hours.

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 8 ounces of warm water and rinse your mouth vigorously. Placing Orabase on the affected area may help; this can be found in your local pharmacy. If the tenderness is severe, take ibuprofen 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!

After Office Hours

Our office is generally open Monday through Thursday and emergency time is held open during each day so that we may schedule you as soon as possible during normal clinic hours. If contacting our office, your message will be recorded by an answering system, and you will be contacted the next business day by our staff. If you have an orthodontic emergency, Dr. Carlson can be contacted by following the information on the message.

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