Brushing and flossing become even more important when wearing braces to prevent plaque build-up, staining, and decay. Proper dental hygiene practices help remove food particles and keep bacteria growth in check. Special brushes reach under the wires and allow patients to dislodge food particles before they have a chance to build-up and turn into plaque.
This is not an emergency, but can be a little uncomfortable or embarrassing for the braces-wearing patient. It is 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 (“Christmas tree”) brush or toothpick to dislodge food caught between teeth and braces.
It is normal for a patient to have discomfort for a day or two after braces or retainers are adjusted, but it can make eating uncomfortable. This discomfort is both normal and temporary. Soft foods are encouraged and the patient can rinse the mouth with warm salt water for soft tissue irritation. Ibuprofen (Advil or Motrin) is recommended for mild tooth soreness.
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 may appear. This is not an emergency, but may be very uncomfortable for the patient. Prompt relief may be achieved 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 needed.
Sometimes new braces can be irritating to the mouth, especially when the patient is 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. The patient may then eat more comfortably. If the wax is accidentally ingested, it’s not a problem. The wax is harmless.
Occasionally, the end of a wire will work itself out of place and irritate the patient’s mouth. Use a Q-tip or pencil eraser to push the wire so that it is flat against the tooth. If the wire cannot be moved into a comfortable position, cover it with relief wax. Dr. Jones should be made aware of the problem.
In a situation where the wire is extremely bothersome and the patient will not be able to see the orthodontist anytime soon, you may, as a last resort, clip the wire.
Reduce the possibility of the patient 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.
If the braces have come loose in any way, contact Dr. Jones to determine the appropriate steps. If necessary an “SOS” appointment may be scheduled.
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 the patient has eaten one of those hard or crunchy foods orthodontic patients are instructed to avoid, or if the mouth is struck while at play. (Patients should wear a protective mouth guard while playing sports.)
If the bracket is off center, the adhesive may have failed. Call our office to determine the course of action.
If the loose bracket has rotated on the wire and is sticking out and the patient cannot immediately be taken to the orthodontist, 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.
This is rare, but when it does happen, it can be fairly alarming to the patient. Encourage the patient to remain calm. If the patient is coughing excessively or having difficulty breathing, the piece could have been aspirated.
If you are able to see the piece, you may carefully attempt to remove it. But do not make the attempt if you could cause harm.
If appropriate under the circumstances, examine the patient’s braces for problems that may result from the missing piece, such as looseness or irritation, and treat as specified above.
If you are unable to see the piece and believe it may have been aspirated, notify us immediately.
Occasionally the aligners may crack. If this occurs, continue to wear the trays if not uncomfortable, and call the office to schedule a visit. Patients with attachments may have one or more come loose on occasion. While this is not an emergency, please call the office so Dr. Jones may check the appliance. If the aligners are rubbing, you can trim the edges with a small pair of scissors.
This website provides guidelines regarding dental and orthodontic emergencies. If you need to reach us after hours, you may call our Tallahassee office at 850-893-5177 and our answering machine will advise you of the appropriate number to call. Please have the name and phone number of your local pharmacy ready in case we need to call in any prescriptions.