True
Emergencies
Trauma
to teeth
• |
If a tooth has been knocked out, do not clean off the
tooth. |
• |
Call your family dentist and our office immediately to inform
of what has happened. |
• |
Upon locating the tooth, hold the enamel end
of the tooth, not the pointed end/root. |
• |
Do not rinse the tooth in
water. Do not scrub the root. You may remove large debris. If possible,
put tooth back in socket where tooth was and hold in place with gauze or
washcloth. If it is not possible to replace the tooth in its socket, put
the tooth into cup of milk or saline solution, or put the tooth between
the cheek and gum. Do not put the tooth in plain water. |
• |
Apply an ice
pack to the affected soft tissue area to reduce swelling |
• |
Do not let
the tooth dry out. A tooth can often be saved if cared for properly and
reimplanted within an hour. |
Broken
tooth:
• |
Clean the injured area and apply an ice pack to the
effected soft tissue area to reduce swelling. |
• |
Save the tip of the
tooth (for possible reattachment) and call your dentist right
away. |
Piece
of the Orthodontic Appliance is Swallowed or Aspirated
• |
If you are able to see the
piece, you may carefully attempt to remove it. But do not make the attempt
if you would cause the patient harm. |
• |
Encourage the patient to remain
calm. If the patient is coughing excessively or having difficulty
breathing, the piece could have been aspirated (drawn into the lung). |
• |
If there is no coughing or difficulty in breathing, and you suspect
the piece has been swallowed, call the patient’s orthodontist for advice
and instructions. |
• |
If you are unable to see the piece and believe it
may be have been aspirated, call 911 and the orthodontist immediately. The
patient should be taken to an urgent care facility for an x-ray to
determine the location of the piece. A physician will have to determine
the best way to remove it. |
Other
Problems: Bracket is Knocked Off
Brackets (see diagram) are the
parts of braces attached to teeth with a special adhesive. If the bracket
is off center and moves along the wire, the adhesive has likely failed.
Usually this can be left in place until seen in our office.
If the
loose bracket has rotated on the wire and is sticking out, attempt to turn
it back into its normal position. You may wish to put orthodontic wax
around the area to minimize the movement of the loose brace (see “How to
apply wax” below).
Note: Save
any pieces of your braces that break off and bring them with you to your
repair appointment
The
Archwire is Poking
If the end of an archwire is
poking in the back of the mouth, attempt to put wax over the area to
protect the cheek. If the wire is extremely bothersome and the patient
cannot come in soon, the wire may be clipped with an instrument such as
fingernail clippers. Reduce the possibility of swallowing the snipped
piece of wire by using folded tissue or gauze around the area to catch the
piece you will remove. 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.
How to
apply wax:
• |
Take a small piece of wax and roll it into a ball. |
• |
DRY the wire or the bracket very well. If the area is wet, the wax
will keep falling off. |
• |
Gently press the wax on the wire or
bracket. |
• |
If you have run out of wax, you can pick some up from our
office or at the nearest pharmacy. If the wax is accidentally swallowed
it’s not a problem; it is harmless. |
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Picture
showing the end of the archwire too long that may poke the
cheek |
Picture
showing rolling a small
piece of wax into a ball |
|
|
Picture
showing wax placed on the
end of the archwire |
Picture showing clipping the end of the archwire with nail
clippers
(place gauze at the end of the
wire to catch the piece that is
cut off) |
The
Archwire is bent or has come out of the last bracket Gently grab the
wire with a pair of tweezers and try to straighten it out. If the wire has
come out of the last bracket, and is not poking the gums or the cheek,
simply let it be. If it is poking the gums, gently grab it with a pair of
tweezers and move it above or below the bracket to get it away from the
gums. You may need to apply some wax on it to provide comfort.
|
|
Picture showing archwire come out
of the bracket |
Picture showing use of tweezers to
replace archwire into the
brackets |
Ligature Wire or Metal Tie is Poking Lip or Cheek 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. Make the orthodontist aware of the problem.
|
|
Picture showing metal ligature
sticking out |
Picture showing the eraser end of a
pencil being used to push
the
ligature back in place |
Irritation of Lips or Cheeks
Sometimes new braces can be
irritating to the mouth. A small amount of orthodontic wax makes an
excellent buffer between the braces and lips, cheek or
tongue.
Mouth Sores or Ulcers
People who have mouth
sores during orthodontic treatment may gain relief by applying a small
amount of topical anesthetic (such as Orabase or Ora-Gel) directly to the
sore area using a cotton swab. Reapply as needed.
Discomfort
It's normal to have discomfort for three to five days after braces
or retainers are adjusted. Although temporary, it can make eating
uncomfortable. Eat soft foods and rinse the mouth with warm salt water.
Over-the-counter pain relievers, acetaminophen or ibuprofen, are
effective.
Lost
Ligature (Rubber or Wire)
Tiny rubber rings known as alastic or
"o" ligatures, are often used to hold the archwire into the bracket or
brace. If a ligature is lost, this can usually wait till the next
appointment. The same holds true for wire ligatures.
Lost
Spacer/Separator
If the space is lost, try to replace it with
floss. If it is lost the day prior to the appointment, do not worry about
it.
If you would like to watch a video on how it is done, please click on the link below:
http://www.youtube.com/watch?v=Qfw5H6EGAhE
I cannot turn my upper expander
If you would like to watch a video on how it is done, please click on the link below:
http://www.youtube.com/watch?v=5Cuc6tQ0YGc
What if
the Lip Gets Caught on a Brace?
Call the office immediately. Apply
ice to the affected area until you have the opportunity to been seen by
our office staff or your family dentist.
Broken or cracked
retainer
This is not an emergency. However, we want to prevent
your teeth from shifting so call us the next business day to schedule a
professional repair. Bring all pieces of the broken retainer to the
appointment. Please note that it is necessary for the patient to come to
the appointment along with the broken retainer.
Food
Caught Between Teeth
This is not an emergency. It can be resolved
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 brush (Proxabrush)
to dislodge food caught between teeth and braces.
Swollen
or bleeding gums
This is usually caused by improper brushing and
flossing.Brush after every meal, using minimal toothpaste and floss once a
day. Use warm salt water rinses to decrease the inflammation. Disclosing
tablets are helpful to show where plaque remains after brushing. If there
is associated pain, please call the office.
|
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Picture showing proper brushing
technique (note that the
bristles
of the toothbrush are brushing
the teeth at the gum
line) |
Picture showing use of the Proxabrush |
|
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Picture showing flossing |
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Supplies to handle most orthodontic problems
With these
supplies on hand, you will be prepared to handle the most common problems
with braces.
• |
Non-medicated orthodontic relief wax |
• |
Dental floss |
• |
Sterile tweezers |
• |
Small, sharp clippers suitable for cutting
wire (such as a fingernail clipper) |
• |
Q-tips |
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Salt |
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Interproximal brush |
• |
Non-prescription pain reliever (acetaminophen or
ibuprofen or any over-the-counter medication typically used for a
headache) |
• |
Oral topical anesthetic (such as Orabase or Ora-Gel) |
If you
are in pain, please call our office immediately.
If it is not an emergency, but you are not sure, please type a message here to email to us |
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Remember, brackets can become
loose as a result of chewing on hard, sticky or chewy foods or objects as
well as from physical contact from sports or rough housing.
Be
sure to wear a protective mouth guard while playing sports! Should you
have an orthodontic emergency after office hours, please call the office
number and leave a message on the emergency line.
We have staff on
call seven days a week from 7 AM to 9 PM to assist you. |
