How to Handle an Orthodontic Emergency

Man pulling lips apart to show traditional braces

You or your child is getting braces, and you have many questions about how it all works and what to expect. One typical concern of first-time orthodontic patients is what to do in the event of an emergency.

Good news! True orthodontic emergencies are rare. It doesn’t mean that you shouldn’t have an action plan for urgent issues, however. Knowing what to do will help to ease any anxiety going into the treatment process.

It is good to discuss with your orthodontist what actions you should take. As we are here during the week during normal business hours, it is possible to have an emergency after hours. If you are experiencing an orthodontic emergency, we have an emergency contact to walk you through what steps you should take.

If you are experiencing severe pain or rapidly losing blood, you should go to your local emergency room or emergency dentist immediately. Usually, one of the following situations will apply:

Acute Orthodontic Emergencies

An acute injury is a traumatic injury that happens suddenly. An acute injury is one of those emergency situations that will require immediate attention.

Traumatic Injury

If you sustain a blow to the mouth as a result of a sports injury or accident, the damage could require urgent care. Depending on the nature of the accident, you might need to immediately visit your local emergency room and notify our office (and your general dentist) of the incident.

Head straight to the ER if you are cut and bleeding heavily from the mouth, as you may need stitches. Likewise, if you are bleeding from the head or have any symptoms of a concussion. Left untreated, a concussion can be a serious medical condition.

A trip to the emergency dentist is required if you have:

  •     Chipped a tooth
  •     Cracked a tooth
  •     Lost a tooth
  •     Sustained a gum injury

These problems can be potentially serious and cannot be ignored, but are best addressed immediately by a dentist rather than an ER doctor.

If you’ve lost a tooth or part of a tooth, bring it to the emergency dentist, but try to handle it as little as possible. In some cases, the dentist often can re-implant the tooth if he sees you within an hour of the accident.

Swallowed appliance

If you’ve swallowed a piece of an appliance such as a bracket or a band, have someone shine a flashlight into your mouth and throat.

If the piece can’t be seen and you’re experiencing excessive coughing or having trouble breathing, it’s possible it was aspirated, or, breathed into your lungs. Immediately go to the nearest emergency room.

If you’re not having trouble breathing, chances are the appliance will pass through your digestive system without causing a medical issue. It is wise to call the office and tell us that you have swallowed the appliance, so we can have you come in to get a new appliance.

What If I’m Not Sure?

If you are uncertain about whether your situation requires emergency care, call your orthodontist’s office immediately.

If you are not able to reach someone right away, visit your local emergency room if there is any doubt about the urgency of your symptoms. The staff there can help determine whether it’s safe to wait to make an appointment with the orthodontist, and possibly can provide pain medication to help symptom relief while you wait.

Standard Orthodontic Emergencies

A more typical orthodontic “emergency” is a problem that will hinder your course of orthodontic treatment or cause discomfort. It does not pose an immediate threat to your physical or oral health but needs to be addressed possibly sooner than your next regularly scheduled appointment.

Food Stuck in Bums

This typically will not constitute a call to the orthodontist, but can in severe cases where the food gets lodged into the bracket or the gum and all your attempts to remove it have failed. This scenario should be avoidable if you discontinue food you shouldn’t be eating while you’re wearing braces.

Poking Wire

pencil eraser to fix poking orthodontic wiresYour orthodontist will check before the end of your first and regularly scheduled visits to make sure no wires are poking or irritating your gums. However, as teeth move, there can be excess wire causing it to poke the inside of your mouth.

A wire that is poking your gums is typically a problem you can fix on your own, without having to schedule an additional appointment.

The first thing to try is to apply wax to the piece of wire that is sticking out. If you are out of wax, try a cotton ball. You can even sterilize a pair of nail clippers and trim the wire yourself.

Additionally, you can sanitize the eraser from a pencil and use the eraser to push the wire in a direction so that it is flush with your bracket and no longer poking your cheek.

If none of these methods help, or the wire is protruding to the point that it is cutting your skin, you should call your orthodontist’s office and schedule a visit to address the situation.

Broken or Loose Brackets or Bands

Eating hard or sticky foods, or playing with your braces, can break your bracket or (if you have them) the bands around your molars. This is why the orthodontist will emphasize that you need to avoid certain foods and habits while you wear braces.

If an accident occurs, it won’t be a major reason that your treatment time gets off track. You should call the orthodontist’s office to see if you need treatment before your next regularly scheduled appointment.

In the meantime, just leave the bracket where it is. If it’s uncomfortable, or if you have the temptation to play with it, cover it up with some wax.

Lost Aligner

A misplaced or broken set of aligners does not mean that you have to start over. Just make sure to contact your orthodontist as soon as possible to order a set of replacement aligners, as spending significant time without them will slow the treatment process. Any time you spend not wearing your aligners is time your treatment is not progressing.

Should you lose an aligner, make sure to wear the previous week’s aligner to hold the tooth movement we have done while waiting for your replacement aligners.

Irritation/Ulcer in the Mouth

It is normal to experience some ulcerations inside of your lips or cheeks when you first get your braces on, or after an adjustment. The orthodontist will provide wax that you can place over brackets that may be irritating your mouth. You can also try over-the-counter anti-inflammatory medications, such as ibuprofen. However, if these grow larger or persist, then call your orthodontist’s office. They will be able to give you more specific instructions on how to clean and care for the sore.

Call our office as soon as possible if you break or loosen any of your appliances. Please do not come directly to the office—by calling us, you will allow us to create a time to see you. Even if you have a regular appointment scheduled, call us immediately to notify us if you need an appliance repaired.



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