Emergency Care
Braces Diagram
Lost O-Tie
An O-tie, often a small, colorful band or a slender wire (ligature), serves to secure the orthodontic wire within the bracket or brace. Should the O-tie become dislodged, it can usually be repositioned using sanitized tweezers. If a wire ligature becomes unfastened, it can be safely extracted with tweezers. In cases where the wire ligature protrudes against the lip but remains secure, it may be gently bent downward using a Q-tip or pencil eraser to alleviate any discomfort.
Shifting Or Poking Wire
At times, the end of a wire may protrude from the end bracket or extend beyond the back bracket, potentially causing discomfort. Even a small piece of wire can lead to irritation. If the wire has emerged from the end bracket, using a Q-tip or sterile tweezers, attempt to gently push the wire flat against the tooth. If repositioning the wire proves challenging, covering it with wax can provide relief. To ensure the wax stays in place, it is essential to dry the area with a Q-tip before application. If the issue persists, please contact our office during the next business day.
Mouth, Lip Or Cheek Irritation
Occasionally, braces or wires may cause irritation to the mouth, particularly in the initial stages of treatment. Using a small amount of wax can effectively create a protective barrier between the metal and the mouth. Before applying the wax, ensure the area is dry using a Q-tip. Then, pinch off a small piece and roll it into a ball about the size of a small pea. Flatten the ball and place it entirely over the troublesome area of the braces. Applying wax, especially before bedtime, allows your mouth to rest from irritation. Each patient receives wax at the onset of treatment in the orthodontic kit. In the event of loss or depletion, additional wax can be obtained at any drug store.
Mouth Sores
Certain patients may experience occasional mouth sores, and while braces themselves don't cause them, they can be triggered or worsened by irritation from the braces. Ulcerations may appear on the cheeks, lips, or tongue, causing discomfort though not constituting an emergency. Swift relief can be attained by applying a small amount of topical anesthetic, such as Orabase or Ora-Gel, directly to the ulcerated surface using a cotton swab; reapply as necessary. If the discomfort persists after a couple of days, please contact our office during regular business hours for further assistance.
Loose Bracket, Band, Or Appliance
If a bracket or appliance has become loose in any way and it is during normal business hours, please call our office. If it is after hours please do the following:
Brackets are integral components of braces affixed to teeth with a special adhesive, typically positioned centrally on each tooth. If a bracket becomes displaced, it may be due to the patient consuming hard or crunchy foods, or during vigorous play. It is advisable, especially for individuals with braces, to wear a protective mouth guard while participating in sports.
If a loose bracket has rotated on the wire and is protruding, causing discomfort, and it is after hours, you can use cuticle scissors to carefully clip the o-tie (colorful tie that holds bracket to wire), the bracket can be discarded. Exercise caution to avoid swallowing.
If an appliance has become loose, please contact our office during normal business hours.
Loose Tooth with Bracket
Have your child sit upright with their head tilted slightly forward. Wash your hands and use clean cuticle scissors, good lighting, and a folded piece of gauze.
This small elastic ring is called an O-tie. It holds the orthodontic wire inside the bracket.
First, use gauze to maintain a firm hold on the loose tooth and bracket. Do not allow the bracket or tooth to drop toward the back of your child’s mouth.
Using a pair of clean cuticle scissors, clip the O-tie to release the bracket and tooth from the wire.
Once the O-tie is removed, the bracket can be lifted away from the orthodontic wire. The bracket will remain attached to the baby tooth. Maintain control of the tooth and bracket and remove them from the mouth immediately. Remove the O-tie as well.
Do not pull forcefully, bend or cut the orthodontic wire, or continue if your child cannot remain still. If the O-tie is made of metal, the bracket will not release easily, or you are unsure about any step, stop and call our office.
Never allow the tooth, bracket, or O-tie to fall toward the throat.
If your child begins coughing, choking, wheezing, or having difficulty breathing, call 911 immediately.
Swallowed Bracket
While rare, if a situation arises where a piece of the braces becomes dislodged, it can be quite alarming for the patient. Encourage your patient to remain calm. If the patient is coughing excessively or having trouble breathing, there is a possibility that the piece may have been aspirated.
If your child begins coughing, choking, wheezing, or having difficulty breathing, call 911 immediately.
Bite Ramp Comes Off
Call and schedule an emergency appointment during normal business hours
Broken Power Chain
This situation does not constitute an emergency. You can address a loose chain by using sterilized nail clippers to carefully clip it. Then, proceed to attend your next scheduled appointment. However, if your upcoming appointment is for a deband, kindly contact our office during regular business hours to arrange an emergency appointment for prompt assistance.
Expander Stuck/Instructions
If you encounter difficulty advancing the expander, it's possible that a full turn was not completed on the previous day or week. Attempt to insert the key into the hole located anteriorly in the mouth and pull the mechanism forward. Once you've successfully pulled it forward, proceed to advance it with a complete turn and an additional turn for the day.
Another potential issue could be the presence of debris in the hole, hindering smooth movement. In such cases, inspect for any foreign material and clear the hole before attempting to advance the expander again.