Caring for Orthodontic Emergencies
Life happens…and so do orthodontic accidents. We call them emergencies not because they are life-or-death (they’re not), but because they need our review and input to resolve quickly so you don’t lose the progress you’ve made. We’re pretty sure most patients don’t want their treatment to take longer or cost more!
The good news is that nearly all orthodontic emergencies can be managed at home with some simple self-care steps until we can connect with you. Follow the tips below for your specific situation, then call us (570) 387-1243 so we can assist via phone or make an appointment for you to be seen in the office.
Topics on This Page:
Dealing with General Soreness
Orthodontic treatment may cause general soreness in your mouth. Here are some general soreness self-care tips:
- If your teeth are sensitive to biting pressure, eat a soft foods diet.
- Irritated gums and other sore spots inside your mouth can be relieved by rinsing with a warm salt-water mouthwash. Dissolve 1 teaspoonful of salt in 6-8 ounces of warm water and swish vigorously for 30 seconds.
- The lips, cheeks, and tongue may become irritated for a short time as they learn a new posture and become accustomed to the surface of the braces. Apply the provided dental wax on the braces as needed.
- If the tenderness or discomfort is severe, take your normal over-the-counter pain reliever. It is not recommended to frequently use aspirin, ibuprofen or naproxen sodium during your orthodontic treatment as they actually slow tooth movement.
- And, don’t forget about cold drinks and treats. Sometimes an ice-cold smoothie or some ice cream can do the trick!
Wires that poke out from your braces can cause discomfort.
Try moving the offending wire away from your cheek with a cotton swab or pencil eraser. Dry the wire (a cotton swab, a piece of cotton or a tissue can work), then rub some dental wax on it. If the wire is particularly long and not resolved through the above step, it is most likely due to a loose bracket and may need to be clipped prior to your next appointment. Simply wash a pair of nail clippers in soap and water, then dip in or rub with rubbing alcohol or hydrogen peroxide to sterilize. Then, carefully snip the wire with the clippers; snip the wire behind the last tooth to which it is securely fastened. You may feel more comfortable tipping your head forward so the snipped wire naturally falls forward toward your open mouth. If the snipped end is still sharp, apply dental wax. We will assess it at your next appointment.
If a wire is still attached, but loose, try gently pushing it back into place with a pair of tweezers or needle nose pliers. Apply dental wax if the loose wire is causing irritation. We will assess it at your next appointment.
If a bracket or band is loose but still attached to the wire, simply leave it in place until your next appointment. If it is causing irritation, apply dental wax. Eat a soft foods diet until your appointment.
If a bracket falls out, place it in a clean resealable plastic baggie and bring it with you to your next appointment. We’ll determine if we can reattach it or if we need to apply a new one.
Braces may be uncomfortable for short periods of time, but they should never cause pain that can’t be relieved through self-care methods. If you have intense pain that doesn’t respond to the self-care methods we recommend, call our office.
Palatal Expander Emergencies
A broken palatal expander can cause painful cuts or lacerations due to sharp broken edges. Carefully remove the device from the mouth. Place the broken device in a resealable plastic baggie and bring it with you to your appointment so we can confirm it is truly broken. If we cannot fix the broken expander, we may have to make a new one. If it’s not broken, we can re-cement it.
Palatal expanders can become loose on just one side or on both sides. If it’s loose on just one side, push the expander back into position and ensure a soft-food diet until you can be seen for an emergency appointment. An expander that is loose on both sides is a choking hazard and should be removed completely from the child’s mouth; place the device in a resealable plastic baggie and bring it with you to your appointment so we can re-cement it.
A palate expander can cause discomfort, especially after it’s been placed or after an adjustment. However, palatal expander discomfort should be relieved through over-the-counter pain medicine and other self-care methods. If you have intense pain that doesn’t respond to the self-care methods we recommend, call our office.
Invisalign and Clear Aligner Emergencies
If you’ve lost your Invisalign or clear aligner tray, call our office for further instructions. If your tray is damaged and will not fit onto or stay on your teeth, call our office for further instructions. Depending on your situation, we may recommend wearing a previous set of aligners, advancing early to your next set of aligners or ordering replacements aligners for your current set.
For a cracked Invisalign or clear aligner tray, you can keep wearing the tray as long as it fits onto and stays on your teeth. Just change to your next tray on your specific schedule. This situation does not require you to call our office.
Straightened teeth can quickly relapse without a retainer. Contact our office for a replacement if you lost your removable retainer, or if your removable or fixed retainer broke or is damaged.
Temporary Anchorage Device (TAD) Emergencies
TAD emergencies are quite rare. If your TAD is loose or damaged, please call us right away for further instructions. We can determine if we need to see you or adjust your treatment plan.
It is common for a separator to fall out or break, especially if it is being picked at. Unfortunately, there is not much you can do for self-care. Call us and Dr. Reichard will let you know if we need to replace the separator or if you can continue treatment without it.
Headgear discomfort is most often caused by not wearing the headgear as instructed by Dr. Reichard. Double-check you are following Dr. Reichard’s instructions for applying and wearing. If the facebow is bent or if the headgear no longer fits properly, call our office for assistance.
General Dental Injuries and Emergencies
Immediately ice the injured area and contact your family dentist as soon as possible. An x-ray of the involved tooth or teeth is usually needed to determine the extent of injury. It is best to contact your family dentist first, as we may not have the necessary anesthesia and/or materials to adequately treat injuries like displaced, fractured or knocked out teeth. If your orthodontic appliance is dislodged or displaced from the injury, call us after you’ve seen your family dentist so Dr. Reichard can determine if we need to adjust or replace your appliance.