Handling Orthodontic Emergencies

True orthodontic emergencies are rare, but when they occur we are available to you. As a general rule, you should call our office when you experience severe pain or have a painful appliance problem you can't take care of yourself. We'll be able to schedule an appointment to resolve the problem.

You might be surprised to learn that you may be able to solve many problems yourself temporarily until you can get to our office. If there is a loose piece that you can remove, put it in a plastic bag or envelope and bring it with you to your next appointment. If your braces are poking you, put soft wax on the piece that's sticking out. If the wire slides to one side, you can pull it back to the other side with needle-nosed pliers, replacing it in the tube on the back tooth.

After alleviating your discomfort, it is very important that you still call our office as soon as possible to schedule a time to repair the problem. Allowing your appliance to remain damaged for an extended period of time may result in disruptions to your treatment plan.

General soreness

When you get your braces on, you may feel general soreness in your mouth, and teeth may be tender to biting pressures for three to five days. Stick to a soft diet until your teeth do not hurt to chewing. Irritated gums and other sore spots 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. An alternative (better tasting) mouthwash is the Healthy Gums Rinse by The Natural Dentist. Placing Orabase on the affected area may also help relieve discomfort; Orabase can be found in a pharmacy. If the tenderness is severe, take Acetaminophen (Tylenol) or whatever you normally take for headache or similar pain. Aspirin, Ibuprofen (Motrin, Advil) and Naproxen Sodium (Naprosyn, Anaprox) actually slow the tooth movement, so it is not advisable to use them frequently while wearing braces.

The lips, cheeks, and tongue may become irritated for one to two weeks as they learn a new posture and become accustomed to the surface of the braces. You can put wax on the braces to lessen this. We'll show you how!

Protruding Wire

Sometimes as your teeth shift, the ends of the wire will start poking out the back of the molar brackets and begin irritating the cheeks.  This problem may be resolved by covering it with a small pea-sized amount of wax.  Call the office for an appointment if you cannot resolve the problem.

Broken Bracket (Loose Bracket)

If the braces have come loose in any way, the parent/guardian needs to be notified, and they should call the office during normal business hours to determine appropriate next steps.

Brackets are a part of the braces attached to the teeth with special adhesive. The bracket can be knocked off by eating hard, crunchy, or sticky foods you are instructed to avoid.

If a loose bracket has rotated on the wire and is sticking out, you can do a temporary fix to alleviate discomfort and prevent further damage. Use sterile tweezers to slide the bracket along the wire until it is between two teeth. Rotate the bracket and slide back to proper position against the tooth.


Sometimes discomfort is caused by not wearing the headgear as instructed by your orthodontist. Please refer to the instructions provided by your orthodontist. If the facebow (metal piece) is bent, please call our office during normal business hours for assistance. The headgear should hurt less the more it's worn, so be sure you get in the prescribed number of hours.

Loose appliance

If your appliance is poking you, place wax on the offending part. Call our office as soon as possible to discuss next step.

Wire out of Bracket

The arch wire fits in the horizontal slots in each bracket. The wire is secured to all of the brackets, and occasionally, simply by the act of biting and chewing, the end of the wire will work itself out and cause irritation.  The best way to alleviate the discomfort is to push the wire back down.  Use a Q-tip or pencil eraser to push the wire back so it's flat against your tooth. If you can't get the wire back to a comfortable position, cover it with relief wax. Call the office so we can schedule your next appointment.

Mouth Sores

Some patients are susceptible to episodes of mouth sores. While braces do not cause them , they may be precipitated or exacerbated by an irritation from braces.  One or several areas of ulceration of the cheeks, lips, or tongue may appear.  This is not an emergency, but may be uncomfortable. Prompt relief may be achieved by applying a small amount of topical anesthetic (Orabase or Ora-gel)

Irritation of Lips of Cheeks

Sometimes new braces can be irritating to the mouth, especially when eating. A small amount of non-medical relief wax on the irritated area will help.

Learn More About Life With Braces

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