Braces Emergencies

Protruding Wire

Occasionally, the end of a wire will work itself out of place and irritate your mouth. Use a cotton swab or pencil eraser to push the wire so that it’s flat against the tooth. If the wire cannot be moved into a comfortable position, cover it with relief wax. Call our office and let us know about the problem. In a situation where the wire is extremely bothersome and you’re not able to get in right away for an appointment, as a last resort, you can 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.

Ligatures Come Off

Tiny rubber bands or small, fine wires, known as ligatures, hold the wire to the bracket. 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, simply remove it with sterile tweezers. If the wire ligature is sticking out into the lip but is not loose, it may be bent back down with a cotton swab or pencil eraser to eliminate the irritation. Of course, when one ligature pops off or breaks, others may follow. Be sure to examine all ligatures. Call our office about missing or broken ligatures so we can let you know if you or your child needs to be seen by Dr. Kothari.

Food Caught Between Teeth

This is not an emergency, but can be a little uncomfortable or embarrassing for the braces-wearing patient. It’s 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 toothpick to dislodge food caught between teeth and braces.

Sensitive Teeth

It’s normal for a patient to have discomfort for a day or two after braces or retainers are adjusted. But it can make eating uncomfortable. Eat soft foods and swish a saltwater rinse (1/2 teaspoon of salt dissolved in a glass of warm water) in your mouth as needed. You can also take an over-the-counter pain reliever if nothing else helps.

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 can appear. This is not an emergency, but may be very uncomfortable. To get relief, apply a small amount of topical anesthetic, such as Orabase or Orajel, directly to the ulcerated surface using a cotton swab. Reapply as needed.

Irritation of Lips or Cheeks

Sometimes new braces can be irritating to the mouth, especially when you’re 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. Don’t worry if you accidentally swallow the wax; it’s harmless.

Loose Brackets, Wires or Bands

If the braces have come loose in any way, call our office so Dr. Kothari can determine the appropriate next steps. Brackets are the parts of 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’ve eaten one of those hard or crunchy foods you’re supposed to avoid, or if you get hit in the mouth while at play. (That’s why we recommend wearing a mouthguard.) If the bracket is off center, the adhesive may have failed. If the loose bracket has rotated on the wire and is sticking out and you can’t immediately get to our office, you can do a temporary fix to alleviate discomfort and prevent further damage. But take care to prevent swallowing or other injury. To put the bracket back in place, use sterile tweezers to slide the bracket along the wire until it is between two teeth. Rotate the bracket back to the proper position, then slide it back to the center of the tooth.

Piece of Appliance is Swallowed

This is very rare, but when it does happen, it can be fairly alarming. First and foremost, remain calm. If you’re coughing excessively or having difficulty breathing, the piece could have been aspirated. If you are able to see the piece, carefully attempt to remove it or have a friend or family member do it for you. But do not make the attempt if you could cause harm. If appropriate under the circumstances, check your braces for problems that may result from the missing piece, such as looseness or irritation, and treat as specified on this page. If you are unable to see the piece and believe it may be have been aspirated, call Dr. Kothari immediately.