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Common Appliance Issues
Orthodontic emergencies are usually very simple fixes to something that may be bothering the patient. Usually, it's a broken brace, loose wire, or something poking the gum or cheek.
Below are some at-home solutions to some common appliance issues.
Food Caught Between Teeth
This is not an emergency, but can be a little uncomfortable or embarrassing for the patient in braces. It's easily fixed with a piece of dental floss.
Tye 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.
Ligatures Came 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 Q-tip 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. Missing or broken ligatures should be brought to the attention of the patient’s parent or guardian, who should then inform our doctors. If a rubber or wire ligature is lost, notify the parent or guardian so that we may advise whether the patient should be seen.
Some patients complain of sore or achy teeth during treatment and it does take some time for lips, cheeks, and teeth to get used to your new braces. This soreness can usually be resolved with a Tylenol or Advil and sticking to soft foods like soup or mashed potatoes.
Irritation of Lips or Cheeks
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. Let the patient know that 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. (See Irritation of Lips or Cheeks above for instructions on applying relief wax.) The patient’s parent or guardian will need to make your doctor aware of the problem.
Loose Brackets, Wires, or Bands
If the braces come loose in any way, the parent or guardian needs to be notified, and they should call your doctor to determine 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 the patient ate one of those hard or crunchy foods orthodontic patients are instructed to avoid, or if the mouth is struck while at play. (Encourage all patients, especially those with braces, to wear a protective mouth guard while playing sports.)
If the bracket is off center, the adhesive may have failed. In this instance, it is best to immediately notify your doctor, who will 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 our office, you can do a temporary fix to alleviate discomfort and prevent further damage, but take care to prevent swallowing or another 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.
A Piece of an Appliance Is Swallowed
This is rare, but when it does happen, it can be fairly alarming to the patient. Encourage your 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. 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 be have been aspirated, the parent or guardian and we should be notified immediately.