Emergency care

Orthodontic emergencies are extremely rare and you are unlikely to experience any major problems during treatment. However, if any difficulties do arise this handy guide will help you to know what to do. 

Food caught between teeth

Although this is not an emergency, it can still be uncomfortable and embarrassing. Use dental floss to remove food caught between teeth or an interdental brush to dislodge anything caught between the teeth and braces.

Loose ligatures

Ligatures are the small rubber bands or fine wires which hold the bracket to the wire. If a ligature becomes loose, you may be able to reattach it or remove it completely using sterile tweezers. To prevent a wire ligature from sticking to your lip and causing irritation, bend it back using the rubber on the end of a pencil. However, when one ligature becomes loose or breaks others might follow, so let your orthodontist know as soon as possible. 

Discomfort

It’s normal to feel a little bit of discomfort for a few days after braces or retainers are adjusted, particularly when eating. The level of discomfort will vary from patient to patient. Eat soft foods and rinse your mouth with warm salt water to soothe any discomfort or irritation. Mild painkillers, such as those you would take for a headache, can also be used to help relieve any discomfort.

Mouth sores

During treatment some patients may be susceptible to mouth sores, which could be a consequence of the irritation caused by braces. Ulceration can occur on the cheeks, lips or tongue and become uncomfortable. Try rinsing your mouth with warm salt water to alleviate any sores. If they persist ask your pharmacist for advice on medication to soothe the ulcerated surface.

Irritation of lips and cheeks

After a set of new braces are fixed you may feel a slight irritation in your mouth, especially when eating. There is a non-toxic relief wax available which creates a strong barrier between the metal braces and the mouth. To apply, simply roll up a small piece of wax into a ball (the size of a small pea), flatten it and place it over the area of irritation. It is not a problem if the wax is accidentally swallowed, as it is harmless. A sore mouth gel can be applied to any ulcers or abrasions for comfort-ask any pharmacy.

Protruding wire

If the end of a wire becomes loose it could cause irritation to the surrounding soft tissue. Use the rubber end of a pencil to push the wire until it is flat against the tooth. If the wire cannot be moved into a comfortable position cover it with relief wax and inform your orthodontist about the problem. Only in extreme cases, when the wire is causing a large amount of irritation and you are not able to see your orthodontist, should you resort to cutting the protruding wire with a sharp pair of clippers. If you need to do this, fold a tissue around the area to reduce the possibility of swallowing the snipped piece of wire. You could still try using relief wax to provide comfort to the irritated area. If the wire is protruding but not causing discomfort, is best left until your next appointment.

Loose brackets, wires or bands

Brackets are the parts of braces attached to each tooth with a special adhesive. They can become dislodged if you eat hard or crunchy foods. If the loose bracket has rotated on the wire and is sticking out, you can alleviate discomfort by using a pair of sterile tweezers to slide the bracket along the wire until it is between two teeth. Once you’ve done this, rotate the bracket back to the proper position and slide it to the centre of the tooth. Be careful not to swallow the bracket or cause further damage. Remember - broken brackets can prolong your treatment. Please call us as soon as possible as a new bracket will need to be bonded to the tooth.

Piece of appliance is swallowed

This is very rare, but if it happens stay calm and seek the assistance of a friend or family member who should then follow these guidelines. If you are able to see the piece, you may carefully attempt to remove it. Do not attempt this if there is any chance you could cause more harm. If the circumstances allow, examine the patient's braces for problems that may result from the missing piece, such as looseness or irritation, and treat as outlined above. If the patient is wheezing, coughing excessively or has difficulty breathing, the piece could have been inhaled.  If you think this is the case, seek medical advice, and you can notify your orthodontist at a later date.

Loose teeth

Do not be surprised if your teeth feel loose during orthodontic treatment. Teeth can often feel loose due to the way in which the teeth are being moved into their new position. This is perfectly normal and they won't fall out!

Out of Hours Number: 111 (NHS England)


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