If you are in severe pain, have bleeding that cannot be stopped, or have an infectious swelling, those are true emergencies that need to be addressed right away, and it is recommended that you call the after-hours number to reach our office. In the event of an emergency and you cannot get ahold of us, do not hesitate to call 911 or visit the emergency room.
True dental emergencies are rare in orthodontics. Most orthodontic emergencies are issues that can be addressed at home to make the patient more comfortable until they can be handled the next day the office is open. Below are common examples and methods to address them:
Wire or tie poking/Long wire: Try to push the wire in towards the tooth with a pencil eraser if possible. If not, you can clip the excess wire with fingernail clippers and place wax on the end to make sure it isn’t rough feeling on the cheek. If you cannot push it in or cut it, add a significant amount of wax to shield and protect your cheek until you can be seen in our office.
Separator (spacer) fell out: Wait until the next business day and call the office to set up a time to have it replaced.
Missing colored tie: Place wax on the bracket to hold the wire in place and contact the office the next business day.
Loose bracket: If able, keep the bracket in place on the wire (it may slide back and forth) and call us the next business day. If the bracket comes off the wire, that is okay. Just discard the damaged bracket. Always call the office the next business day to tell us when a bracket has come loose as missing brackets will impede treatment progress if not replaced within a reasonable timeframe.
Elastics (rubber bands): Sometimes discomfort is caused by not wearing your elastics as instructed by your orthodontist. Elastics are typically worn full time with the exception of eating meals and brushing your teeth. The elastics should hurt less the more they are worn, so be sure you get in the prescribed number of hours. Taking long breaks from wearing your elastics allows the teeth to shift back towards their original position causing more discomfort than when worn continuously. Each patient’s elastic prescription varies so please refer to the specific instructions provided by Dr. Courtney. If the hook or wire is bent, preventing you from wearing your elastics, please call our office the next business day for assistance. If you lose your package of elastics or need more prior to your regularly scheduled visit, please stop by the office during business hours and we will be happy to give you more.
Headgear: Sometimes discomfort is caused by not wearing the headgear as instructed by your orthodontist. Please refer to the instructions provided by Dr. Courtney. If the facebow (metal piece) is bent, please call our office for assistance. The headgear should hurt less the more it’s worn, so be sure you get in the prescribed number of hours.
Spring appliance has come unattached: Sometimes this happens when yawning or opening the mouth really wide. To reattach, just compress the spring up toward the upper tooth, open very wide, and guide the lower metal rod into the center of the spring again, then bite down.
Broken or lost retainers: If it is salvageable continue to wear the retainer until you can contact us the next business day and get an appointment for a new set. It is important to not delay too long because the teeth can shift.
Typically, soreness of the teeth begins about 4 hours after the initial placement of braces. Peak discomfort occurs within 24 to 48 hours and then begins to subside. You may experience mild discomfort after each reactivation appointment, but the soreness is usually not as severe as after the initial placement. Soreness caused by orthodontic treatment is best handled with over-the-counter pain medicine such as Tylenol (acetaminophen) or Motrin (ibuprofen). Any gum discomfort can be relieved by rinsing with 1 teaspoon of salt in 8 ounces of warm water. The cheeks, lips and tongue may become irritated for the first couple weeks as you get used to your appliances. During this time, placing a small ball of wax on those areas will help.