emergency care

Actual Sayre Orthodontics Patients

Emergency Care

 

Table of contents:

Braces

Appliances

Direct Injuries to Mouth or Teeth

 


It is important for our patients to recognize minor orthodontic problems and understand how to solve them until it is convenient to return to our office.

Braces

Parts of Braces

Parts of Braces

Parts of Braces

Generalized Soreness

When you get your braces on and after regular appointments, you may feel general soreness in your mouth and teeth may be tender to biting pressures for three to five days. This can be relieved by rinsing your mouth with a warm salt-water mouthwash. Dissolve one teaspoonful of salt in eight ounces of warm water, and rinse your mouth vigorously. Placing Orabase on the affected area may also help; this can be found in your local pharmacy. If the tenderness is severe, take ibuprofen or whatever you normally take for headache or similar pain. The lips, cheeks, and tongue may also become irritated for one to two weeks as they toughen and become accustomed to the surface of the braces. You can put the wax we gave you on the braces to lessen discomfort during this process.

Brackets

PROBLEM: Loose bracket. Not secured on the tooth, and sliding along the wire.

Loose Bracket

Loose Bracket with Wax

SOLUTION: Apply wax to secure the bracket next to an adjacent bracket. If it is the last bracket in the back, you can remove the bracket and bring it with you to your appointment. You can attempt to cut the wire if it is poking or you can place wax over the end of the wire.

DO NOT attach elastics to a loose bracket. Call the office the next business day to let the office know about the broken bracket. **Please keep in mind that even if you have a regular scheduled appointment, it is important to call our office so that we may allow extra time, or schedule a separate appointment to fix the bracket.**


PROBLEM: Bracket off last molar tooth, causing wire to poke cheek.

Broken Bracket Wire Poking

Broken Bracket Wire Poking Clip Wire

Broken Bracket Wire Poking With Wax

SOLUTION: Clip wire with fingernail clippers (if wire is flexible), OR clip with small sterilized wire clippers. Apply wax over end of wire. Warm saltwater rinses two to three times per day.


Wire Hooks

PROBLEM: Hook is poking lip.

Poking Wire Ligature Tie

Tick In Wire With Pencil Eraser

Wax over Poking Wires

SOLUTION: You can use a pencil eraser to tuck the hook towards the gums. If it is a molar hook place wax over it until it stops poking. Warm saltwater rinses two to three times per day.


PROBLEM: Gums are swollen around hook.

SOLUTION: Brush gums three times per day with a wet (no toothpaste) toothbrush. Discontinue elastic wear until tissue is not as swollen.


PROBLEM: Hook is wiggly.

SOLUTION: Continue to wear elastics, mobility is normal.


PROBLEM: Hook is no longer attached to the bracket.

SOLUTION: Call the office to schedule an appointment.


Hooks on Molar Brackets

PROBLEM: Hooks on molar bracket poking.

Poking Hook

Tick In Wire With Pencil Eraser

SOLUTION: Apply wax over the hook. Warm saltwater rinses two to three times per day.


Buttons for Elastics

PROBLEM: Button is causing a sore on the tongue.

SOLUTION: Apply wax and use warm saltwater rinses two to three times per day.


PROBLEM: Button is no longer attached to the tooth.

SOLUTION: Call the office to schedule an appointment.


Wires

PROBLEM: Wire poking or sticking out of the last bracket.

Wire Poking - Too Long

SOLUTION: 1. Attempt to slide wire back in to the tube on the opposite side or,

Try to Slide Wire Back Around

Wire Has Slid Around

2. Attempt to clip the wire with fingernail clippers (if wire is flexible) OR clip with small sterilized wire clippers or,

Clipe Wire that has slid and is too long

3. Apply wax, warm salt-water rinses as needed.

Wax on Wire


PROBLEM: Wire is out of the tube.

Wire out of tube

SOLUTION: Place wire back in the tube or clip the wire behind the last tooth that the wire goes through.

Slide Wire Back In Tube

Place wire back in the tube

Clip Wire with Nail Clipper

Lace and Ligature Ties


PROBLEM: Twist tie is poking lip.

Poking Ligature Tie

Pencile Eraser to Tuck in Ligture Tie

SOLUTION: Use the end of a pencil eraser to tuck the tie away from the lip.


PROBLEM: Broken lace poking lips.

Broken Lace

Remove the Broken Lace

SOLUTION: Tuck the poking part away from the lip if lace is under the wire. If lace is on top of the wire, remove the broken lace.


Stops

PROBLEM: Sharp and rubbing lip.

Normal Stop Placement

Poking Stop

Wax to prevent stop from sliding

SOLUTION: Apply wax, can attempt to file with a nail file, use warm saltwater rinses two to three times per day to help with irritation of the lips.


PROBLEM: Stop is sliding around wire.

Loose Stop On Wire

Wax to Prevent Sliding

SOLUTION: Apply wax around the stop to secure it into place.


Chain

PROBLEM: Chain is broken and irritating the cheek.

Broken PC

Clip Chain

SOLUTION: Clip chain with a pair of scissors and call the office the next business day to schedule an appointment.


Biteplate

PROBLEM: Can’t wear because it impairs speech.

SOLUTION: Practice speaking as much as possible and continue to wear your biteplate 24/7.


PROBLEM: Biteplate will not stay in the palate when eating or talking.

SOLUTION: Apply a small amount of denture adhesive (ex: Fixodent or Polydent) to the biteplate and place in the palate.


Bite Blocks/Turbos

PROBLEM: Bite block/turbo is worn down and you are biting on brackets.

Bite Blocks / Turbo

SOLUTION: Be careful when eating; call the office to schedule an appointment.


PROBLEM: One of the bite blocks has come off.

SOLUTION: This is okay and as long as you are not having any discomfort and you have one still attached, there is no reason to do anything. If you are having discomfort, please call the office to schedule an appointment.


PROBLEM: Patient is only biting down on one bite block/turbo.

SOLUTION: This is normal and as long as you are not having any discomfort, there is no reason to do anything. If you are having discomfort, please call the office to schedule an appointment.


Appliances

Carriere

PROBLEM: Upper part of Carriere has detached from the tooth closest to the front but is still attached to the back tooth.

Normal Carriere

Front End of Carriere Loose

Carriere with wax on front

SOLUTION: Do not attach elastics. Apply wax to the loose part of the Carriere and call the office to schedule an appointment.


PROBLEM: Back part of Carriere has detached from the back tooth but is still attached to the tooth closest to the front.

back End of Carriere Loose

Carriere with wax on front

SOLUTION: Do not attach elastics. Apply wax to the loose part of the Carriere and call the office to schedule an appointment.


Lower Lingual Holding Arches (Space Maintainers)

PROBLEM: Bar behind the teeth has detached from the molar band.

Broken Lower Lingual Holding Arch

space-maintainers with wax

SOLUTION: Wiggle the bar with firm pressure until it breaks free from the opposing molar band. Apply wax to sharp areas around tongue. Call the office on the next business day to make an appointment.


Palate Expanders

It is important to turn the expander all the way back until the key cannot turn any further. Make sure you do not turn the expander in the opposite direction (forward) while removing the key.

Normal Rapid Palletal Expander

PROBLEM: Expander key will not go into the hole. Last turn was not completed all the way and therefore the hole is not completely open.

Rapic Palletal Expander Loose

How to Turn RPE

RPE Cannot Get Key In Hole

RPE how to fix if cant find the hole

SOLUTION: Find the last hole from previous turn and complete the push back towards patient’s throat.


PROBLEM: Food stuck in the roof of mouth.

SOLUTION: Brush the palate daily; purchase a Water Pik and rinse thoroughly.


PROBLEM: Space opening between two front teeth.

SOLUTION: This is normal; it will close within a few weeks.


PROBLEM: Impaired speech.

SOLUTION: Practicing talking and placing tongue at the roof of your mouth.


PROBLEM: Bands on the expander are irritating the cheeks.

SOLUTION: Warm saltwater rinses two to three times per day. Apply wax as needed.


PROBLEM: A band has become loose and unattached from the tooth.

SOLUTION: Push the band back around the molar tooth and call the office to schedule an appointment.


Permanent Retainer

Lower Lingual 3x3

PROBLEM: Permanent retainers are glued to the back of your teeth, and over time can become loose or broken. Check daily for any loose pieces of glue.

Lower Lingual 3x3 glue off

SOLUTION: Continue to wear your clear retainer over it at night. Call the office to schedule an appointment to have it repaired. Gum tissue will become inflamed and swollen around the retainer without proper brushing and flossing.


Direct Injuries to the Mouth or Teeth

Following a direct injury to the mouth or teeth, whether undergoing orthodontic care or not, you should be seen by your family dentist as soon as possible. Usually an X-ray of the involved tooth or teeth is needed to determine the extent of the injury. If a tooth has been fractured or broken, it is best to contact your family dentist first, since we may not have the necessary materials needed to treat these injuries. If orthodontic appliances are dislodged or displaced, we will need to replace or adjust them as soon as possible. Please call our office immediately after seeing your family dentist. If you are unable to reach your family dentist or an alternate emergency facility, call our office and we will assist you in locating someone to care for the injury.