If you’ve got braces in your mouth, you’re eventually going to have an emergency. An orthodontic emergency occurs when something doesn’t go exactly as expected. The most common orthodontic emergencies are those related to problems with the braces themselves.
The most common orthodontic emergency occurs when something on the braces themselves rubs against the lips, cheeks, or tongue. This could be a wire, a steel ligature tie, the edge of a band or bracket, or some other gadget that your orthodontist has placed into your mouth. Even if everything is OK with your braces, you can expect some discomfort as your lips, cheeks, and tongue become acclimated during your first month. Similar to when you fall and scrape your knee, your mouth will toughen up (callous) during the first month and the braces will be more comfortable the rest of your treatment. Your orthodontist will give you soft wax that you can place over the part of the braces that is irritating you. Use it only after you develop a sore to allow healing. Using it preventively will not allow the mouth to toughen up and you’ll be uncomfortable your entire treatment.
Wire-poke emergencies occur when a part of your braces sticks out or is too long and irritates your mouth. Even if you can place wax over these irritations, if they are sticking out or too far, they need to be fixed. Sometimes you can tuck the end of a flimsy wires or steel ligature tie up against your teeth with the eraser of a pencil. If you can’t eliminate the poke yourself, or it the wire sticking out the back of your braces is too long, you’ll need to get into see your orthodontist on the next business day. Place wax over the poke until you can get in to the office.
The second most common problem is a loose bracket or band. If you have a problem within the first 24 to 48 hours of getting your braces on, it is probably due to an issue with the bond between the bracket and the tooth or it may be that a tooth in one arch is hitting a bracket in the other arch and dislodging it. In either case you need to call your orthodontist and get the loose bracket fixed within a day or two. If your braces have been on for a while and a bracket comes loose, you probably ate something hard or sticky that caused the problem. Your orthodontic team gave you instructions at the beginning of your treatment on the kinds of foods and habits to avoid while wearing braces. The more compliant you are with those guidelines, the faster your treatment will go. You should inspect your braces every night after you brush to make sure they are in good repair. Signs that something is loose include a bracket which moves on the wire or the obvious movement of a tooth that was once straight (i.e. one tooth gets longer than those next to it or it moves in front of or behind the adjacent teeth).
Losing an O-ring or having a chain break are both emergencies that need to be dealt with within a couple days of being discovered. Do not wait for your next appointment! Not only do they move the teeth, they also attach the teeth to the wires. O-rings and chains are easily replaced. The changes that will occur if they are not replaced can add months to your treatment. Inspect each tooth to make sure there is something attaching it to the wire when you are checking for loose brackets each night. Although some orthodontic emergencies cause discomfort, missing O-rings and broken chains do not. Don’t wait until your teeth get crooked again before coming in to get your braces repaired.