Emergency Care

If you are experiencing severe pain or a painful problem with your orthodontic appliances that can not be resolved by yourself, please give our office a call during office hours to schedule an appointment to address the problem.  Prolonged periods of time with broken appliances may disrupt your treatment plan and/or extend your overall treatment time.  Until you are able to be seen in our office you may be able to handle the emergency yourself.

Handling Orthodontic Emergencies

With the following tools and supplies on hand, you will be prepared to handle the most common orthodontic emergencies.

  • Non-medicated orthodontic relief wax
  • Dental floss
  • Sterile tweezers
  • Small, sharp clipper
  • Q-tips
  • Interproximal brush
  • Toothpicks
  • Non-prescription pain reliever (acetaminophen or ibuprofen)
  • Topical Anesthetic (such as Orabase or Ora-Gel)

Food Caught Between Teeth

This is not an emergency, but can be a little uncomfortable or embarrassing for the braces-wearing patient.  It is easily fixed with a piece of dental floss.  Try tying a small knot in the middle of the floss to help remove the food.  Or use an interproximal brush or tooth pick to dislodge food caught between teeth and braces.

Lost Wire or Ligature

lost wire

If a rubber ligature should come off, you may be able to put it back in place using sterile tweezers.  If a wire ligature comes loose, simple remove it with sterile tweezers.  If the wire ligature is sticking out into the lip is not loose, it may be bent back down with a Q-tip or pencil eraser to eliminate the irritation.  Of course, when one ligature pops off or breaks, others may follow.


It’s normal to have discomfort for a day or two after braces or retainers are adjusted.  but it can make eating uncomfortable.  This discomfort is both normal and temporary.  Soft foods are recommended.  Warm salt water rinses and over-the-counter pain relievers such as acetaminophen or ibuprofen may be effective.

Mouth Sores

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

Irritation in Mouth

irritationSometimes new braces can be irritating to the mouth, especially when the patient is eating.  A small amount of non-medicinal relief wax makes an excellent buffer between metal and mouth.  Simply pinch off a small piece and roll it into a ball the size of a small pea.  Flatten the ball and place it completely over the area of the braces causing irritation.  If the wax is accidentally ingested it’s not a problem.  The wax is harmless.

Protruding Wire

protruding wireOccasionally 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 push 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 Mouth above for instructions on applying relief wax.)

In a situation where the wire is extremely bothersome and you are unable to be seen in our office soon, as a last resort, you may clip the wire.

Reduce the possibility of swallowing the snipped piece of wire by using folded tissue or gauze around the area.  Use a pair of sharp clippers and snip off the protruding wire.  Relief wax may still be necessary to provide comfort to the irritated area.

Loose Brackets or Bands

OrthoEmergency-FLYER-lglBrackets are the parts of the braces attached to teeth with a special adhesive.  They are generally positioned in the center of each tooth.  The bracket can be knocked off if you eat hard or crunchy foods orthodontic patients are instructed to avoid, or if the mouth is struck while at play.  We highly recommend patients, especially those with braces, to wear a protective mouth guard while playing sports.  Generally a loose bracket or band can be left in place until you are seen in our office.  Please give us a call and we will make you an appointment to reattach the loose appliance if indicated.