How to Handle Orthodontic Emergencies

Common Issues & Quick Fixes

• Loose or Broken Bracket: If a bracket slides on the wire or pops off, slide it gently to the center of the tooth. Put a tiny bit of orthodontic wax over it for comfort. Avoid hard or sticky foods. Save the broken bracket, and call our office to schedule a repair.
• Poking or Loose Wire: For a wire irritating your cheek, use a clean pencil eraser or cotton swab to push it flat against the tooth. If it’s still sharp, cover the end with wax. You can carefully clip a very long wire with clean nail clippers (cover the clipped piece with gauze first to prevent swallowing). Then call us to adjust it.
• Lost or Broken Elastics (Rubber Bands): Replace any missing rubber bands right away as instructed. Wash your hands and use a new elastic in the correct position. If you run out or can’t tell where to put it, call for replacements. Missing elastics for a day or two won’t hurt alignment, but don’t skip several days.
• Lost/Cracked Aligner or Retainer: Stop wearing a warped or broken retainer/aligner (it could hurt or shift teeth). If you have your previous one and it still fits, wear that temporarily. Otherwise, call to get a new one made. Wearing an ill-fitting one can move teeth incorrectly.
• Soreness After Adjustment: Some tooth or jaw soreness after a tightening is normal. Rinse your mouth with warm salt water and stick to soft foods (yogurt, smoothies). Take over-the-counter pain medicine as needed. If pain or swelling is severe or lasts more than a few days, call us.

Severe Pain & Trauma

• Severe Pain/Swelling: If you have intense pain, swelling, fever, or signs of infection (like bad smell), call the office immediately. You may need antibiotics or urgent care.
• Knocked-Out Tooth: Time is critical. Pick up the permanent tooth by the crown (top part), not the root. Rinse it gently and try to put it back in the socket. Hold it there by biting down gently. If you can’t reinsert it, keep it moist in milk or between your cheek and gums. Go to a dentist or ER within 30–60 minutes. Save the tooth – fast action can save it.

Emergency First-Aid Steps (5 Steps)

1. Stay calm: Check for heavy bleeding or trouble breathing. If those are present, call 911 immediately.
2. Inspect: Use a mirror to see what’s wrong (loose bracket, poking wire, missing part).
3. Home remedies: Use wax to cover sharp wires, push brackets back as above, take pain relievers, rinse with salt water.
4. Protect: Avoid eating hard foods. Brush gently around appliances.
5. Call us: Describe the problem. We’ll tell you if you need to come in right away or if it can wait until the next business day.

24-Hour Timeline After Trauma

• 0 hours: Control any bleeding with clean gauze; rinse mouth with water.
• 0.5 hour: If a tooth was knocked out, rinse and reinsert it (if possible).
• 1 hour: Get to a dentist/ER (within 30–60 mins is best).
• 2–24 hours: Follow all post-care instructions. Keep a soft diet and monitor swelling. Notify our office about the injury so we can plan to fix any appliance damage.

Emergencies at a Glance (Table)

Prevention Tips

• Diet: Cut hard/crunchy foods (nuts, ice, popcorn) into small bites. Avoid sticky candy.
• Mouthguard: Always wear a sports mouthguard with braces to prevent injuries.
• Keep a kit: Have wax, floss, mirror, and gauze on hand in case of emergencies.
• Oral hygiene: Brush/floss carefully to avoid extra problems.