smile blog

Missing bands, loose brackets, protruding wires, gum irritation… while you won’t need to be rushed to the hospital in an ambulance for these emergencies, they can still be incredibly painful and require immediate, prompt care. If a bracket pops off in the middle of a Tuesday afternoon, it’s easy to head straight to your orthodontist and be better by dinner. But if the same issue occurs on a weekend when the office is closed or while you’re on a trip out of town, panic may set in. How do I address this problem? Good news: a few simple supplies commonly found at home can remedy many of the problems until an orthodontist is able to provide immediate care.First, assemble your orthodontic emergency kit. Common tools and supplies include:

• Non-medicated orthodontic relief wax to address wire and bracket irritation
• Dental floss to remove stuck food particles
• Sterile tweezers for fixing ligatures
• Small, sharp clipper
• Q-tips
• Salt
• Toothpicks
• Topical anesthetic
• Salt

Here’s what to do in the event of an orthodontic emergency:

1. Ligature comes off

A ligature is the technical name for the tiny rubber bands that hold the wire to the brackets. If a rubber ligature pops off, you may be able to put it back in place using a pair of sterile tweezers. First, sterilize the tweezers in rubbing alcohol. Next, carefully use the tweezers to return the ligature to its proper position. If a wire ligature is sticking out (but is not loose), bend it down with a Q-tip or pencil eraser to eliminate irritation. Once you’ve resolved the immediate concern, notify your orthodontist. You may need a quick check up to ensure no other ligatures have come loose.

2. Protruding wire

Sometimes the end of a wire will come out of place, causing irritation to the inside of your mouth. Using a similar technique described above, use a Q-tip or pencil eraser to gently flatten the wire against the tooth. You can also apply dental wax to minimize discomfort. If the wire has become incredibly painful and is causing severe irritation of the gums and mouth tissue, another option is to clip the wire. This should be the last resort. Do not try to clip the wire yourself: have a parent, guardian or other adult assist you. First, reduce the possibility of accidentally swallowing the wire by folding tissue or gauze around the area. Next, use a pair of sharp clippers to snip off the protruding wire and then apply relief wax to the irritated area.

3. Loose bracket or wires

This is the most difficult orthodontic emergency to treat at home. In general, as soon as you notice any loosening of a bracket or wire, immediately call your orthodontist to schedule a check-up. Brackets are the metal part of the braces that attach to the center of teeth using a special adhesive. Brackets are typically positioned in the center of each tooth. Most brackets only become loose when they are knocked off from playing contact sports (e.g., you’re struck in the face with a ball or elbowed in the mouth) or from eating hard, crunchy foods (here’s a list to avoid just to be safe!). If the loose bracket has rotated and the wire is sticking out, you can temporarily reposition the bracket using sterile tweezers. Slide the bracket along the wire until it is between two teeth. Rotate the bracket back to its correct position before sliding the bracket back to the center of the tooth.Orthodontic emergencies are hardly a fun experience, but with the right tools on hand at home, you’ll be able to address much of this discomfort as quickly as possible. Always schedule a follow-up appointment with your orthodontist to discuss the problem. Not sure if metal braces and brackets are worth the discomfort and hassle? Another option is clear aligners from Invisalign, which discreetly straighten teeth without the need for brackets or wires.