Orthodontic Emergencies: What to Do at Home

As your teeth move, an orthodontic wire may occasionally begin to extend beyond the last bracket or irritate your cheek or gums.

What you can do

First, try placing orthodontic wax over the end of the wire. Dry the area with a tissue or paper towel first so the wax will stick more easily.

If you do not have orthodontic wax available, you can temporarily cover the sharp area with a small piece of wet paper towel or a small piece of sugar-free gum.

If the wire is still very uncomfortable and you are unable to cover it, you may carefully trim the wire with clean nail clippers or small wire cutters.

If you need to cut the wire

1. Wash your hands and clean the nail clippers or wire cutters.
2. Cut the wire as close as possible to the last bracket that is still securely attached to the tooth.
3. Carefully remove the loose piece of wire.
4. Place orthodontic wax over any remaining sharp area if needed.

If you are unable to manage any wire issue comfortably at home, please call our office for assistance.

Sometimes the orthodontic wire can slide out of the last bracket or molar tube.

If you can easily do so, you may try to gently guide the wire back into the opening using clean tweezers.

If you cannot reinsert it, place orthodontic wax over the wire to prevent it from irritating your cheek.

If the wire is long, sharp, and cannot be made comfortable with wax, you may trim the excess wire with clean nail clippers or wire cutters as described in Poking or Loose Wire.

If you are unable to manage any wire issue comfortably at home, please call our office for assistance.

Sometimes a small steel tie (the thin wire that helps hold the archwire in place around a bracket) can come loose and poke out.

If this happens, you may try to gently push it back into place using a clean pencil eraser or clean tweezers.

If it continues to bother you, cover the area with orthodontic wax and contact our office if needed.

If you are unable to manage any wire issue comfortably at home, please call our office for assistance.

Sometimes a bracket can become loose from the tooth while still remaining attached to the orthodontic wire.

If the bracket is loose but not causing discomfort, leave it in place.

If the bracket is moving around or irritating your cheek or lip, or a hook or part of the bracket breaks and leaves a sharp or rough edge, place orthodontic wax over the bracket for comfort. If you do not have wax available, you can temporarily use a small piece of wet paper towel or sugar-free gum.

Call our office during normal business hours. We will let you know whether it needs to be repaired before your next scheduled appointment.

If your expander becomes loose, what you should do depends on whether it is loose on one side or has come completely out.

If the expander is loose on one side

You may be able to gently seat the loose band back over the tooth by pressing it into place.

If you are able to seat it back over the tooth, leave it in place and call our office during normal business hours for further instructions.

If you cannot seat the loose band back over the tooth, do not force it into place. Please call our office so we can determine whether you need to be seen.

Do not continue turning or activating an expander while it is loose unless our office specifically instructs you to do so.

If the expander comes completely out

Save the expander and bring it with you to your appointment. Call our office during normal business hours to schedule an appointment so the expander can be reinserted.

Brackets, hooks, or wires can occasionally irritate the inside of the cheek or lip, particularly when braces are first placed.

Place orthodontic wax over the part of the braces that is rubbing against the area.

Warm salt-water rinses 2–3 times per day may also help keep the area clean and comfortable while it heals.

To make a salt-water rinse, mix approximately 1 teaspoon of salt into 8 ounces of warm water, gently rinse, and spit it out.

If the sore is worsening rather than improving, or the orthodontic appliance continues to traumatize the area despite using wax, contact our office.

It is normal for your teeth to feel sore or tender for a few days after braces are placed or following certain orthodontic adjustments.

Eating soft foods for the first few days can help while your teeth adjust. You may also use an over-the-counter pain reliever as directed, if needed.

This soreness should gradually improve over the next few days.

If you lose or break your current aligner:

• If you have additional aligners remaining, wear the next aligner in your sequence, then contact our office during normal business hours to let us know what happened and receive further instructions.
• If you do not have another aligner available, return to your previous set of aligners to prevent your teeth from shifting, and call our office during normal business hours for instructions.

If your retainer is lost or broken, contact our office during normal business hours so we can determine whether it needs to be repaired or replaced.

Because teeth can shift when retainers are not worn, please contact us promptly rather than waiting until your next routine appointment.

If a Herbst crown becomes loose, gently seat the crown back over the tooth, avoid chewing on that side, and call our office during normal business hours so we can schedule an appointment to recement it.

If one of the Herbst arms comes apart, see if you can gently slide the rod back into the piston portion. If you are unable to reconnect it, or if the arm has detached from the stainless steel crown, please call our office for an appointment. If a piece comes completely out, save it and bring it with you to your appointment. If any part of the appliance is sharp or irritating your cheek, cover the area with orthodontic wax if possible.