Emergency Care

There are only a few true orthodontic (or dental) emergencies. They include:

• Trauma or injury to the teeth, face, or mouth
• Infection or swelling of the gums, mouth, or face
• Severe, unmanageable discomfort or pain in these areas

In any of these situations, you should seek help as soon as possible — our team is always on call after hours and happy to help patients of record. If you are experiencing a true medical emergency, or dental trauma, please go to an emergency room if that's your best option. Generally, however, the place to start is with us, and we will guide you. Your local dentist is available to help as well with any problems outside of orthodontics. If, for example, you have a fractured tooth, your dentist will treat the immediate problem and arrange for the tooth's restoration; afterward, your orthodontic treatment plan can be adjusted as needed. Likewise, severe pain or swelling could be a sign of infection or disease, which a dentist or periodontist can best treat.

Fortunately, most orthodontic problems are minor but may still cause discomfort or irritation. Some common orthodontic problems are loose or broken brackets, bands, or wires, misplaced or poking archwires, brackets, or ties, and general tooth pain or loosening.

In general, it's best to try and soothe the immediate cause of the discomfort and then call our office to schedule an appointment; that way, we can allot sufficient time to take care of you.

This problem is often caused by eating hard, sticky candy or food or by playing with your braces. If the band or bracket is still attached to the wire, leave it as is — but don't connect any elastics to it! You can cover it with orthodontic wax if it's irritating the inside of your mouth. If it has come off, save it. In either case, call our office to let us know what happened, and we will schedule a visit. Be sure to bring any loose parts with you to the appointment!

As the teeth start to move, the wire that connects them (archwire) may begin poking near the back of the mouth or irritating the cheeks. You can move the wire into a better position with a pencil eraser or a Q-Tip. If the wire doesn't move, you may be able to cut the end off with a nail clipper sterilized in alcohol — but before doing so, please call our office for guidance or instructions. Often, you can also use tweezers to gently move a misplaced wire or a tie that's causing problems.

When wires or brackets cause irritation, covering the metal parts with wax will often help ease the discomfort. As with any of these problems, call our office, and we'll schedule a time to see you.

It's normal for teeth to become slightly loosened during orthodontic treatment — that shows they're moving! Sometimes, this movement may be accompanied by tenderness, especially after braces are placed or adjusted. For minor soreness, you can use your regular over-the-counter pain reliever. A twice-a-day salt-water rinse may also help: Mix one teaspoon of salt in an 8-ounce glass of warm water and rinse for 30 seconds. A warm washcloth or heating pad placed on the outside of the jaw can also offer some relief.

Some discomfort is to be expected when you first get braces or after an adjustment. Even Invisalign® can cause considerable aching and soreness at times during treatment. Most often, an over-the-counter medication as approved by your doctor and parents can alleviate most pain associated with treatment. If the pain does not subside with an over-the-counter pain receiver, contact our office to evaluate the situation.

A cut, laceration, or bleeding can happen while playing sports, roughhousing, or from an accident while wearing braces. Contact our office right away for advice on how to handle the situation. Depending on the severity, we can provide at-home remedies that often remediate the problem. If, despite your best efforts, the bleeding does not subside, you may need to visit the emergency room.

If you have received soft tissue damage that has resulted in bleeding in the mouth, there are a few things you can try at home to stop the bleeding before going to the emergency room:

1. Rinse your mouth with salt water. Put ½ a teaspoon of salt into a cup of warm water. Stir until it dissolves. Swish the mixture in your mouth for 30 seconds and spit it down the sink.
2. Apply pleasure to the area inside the mouth that is bleeding with a clean, moistened gauze or a tea bag that has been soaked in water. Black or green tea can contain tannins that promote blood clotting to help stop the bleeding and can cause blood vessels to shrink.
3. Use a cold compress outside the mouth to help relieve swelling, reduce pain, and contribute to the bleeding subsiding.

If your tooth gets knocked out from a blunt trauma while wearing braces, this does constitute a dental emergency and requires immediate assistance. Adult teeth knocked out of the socket can often be saved if immediately attended to. Should this happen, if possible, gently place the tooth and root back in the socket or the vestibule of the mouth and head to your dentist's office right away.

There are a few causes of toothache. If you have a severe toothache, swish warm water in your mouth to clean the area and use dental floss to remove any food or debris that may be causing pain. You can use over-the-counter medications to help reduce pain while waiting to see the dentist.