Orthodontic Emergencies

Limestone Hills Orthodontics
October 18, 2019

Table of Contents

Rodrigo F. Viecilli, DDS, PhD

Orthodontist Austin TX

You probably won’t experience a true orthodontic emergency, but Dr. Viecilli provides emergecy orthodontic care in Austin TX. For instance, getting hit on the face and getting your braces stuck on your lips is an emergency. Emergencies of this type are rare. Our office only charges for true emergencies outside of business hours.  Dr. Viecilli will come see you when available for a fee. There are, however, minor issues that do happen from time to time, and you can come during our business hours for comfort adjustments, so it’s important for you to know how to handle them. They are not an emergency and do not require you to come to the office after hours.

Common Issues

The following orthodontic emergencies and their treatments are listed in the order from least severe to most severe. Only the most severe emergencies may require immediate attention by Dr. Viecilli.

Broken or Lost Retainer

Dr. Viecilli will usually suggest a removable Essix (clear plastic tray) type of retainer because what patients call a permanent retainer is not permanent at all. Those wire retainers are nowadays mostly used to keep spaces closed in the upper front teeth which tend to reopen easily.  Clear plastic retainers are more hygienic, don’t bend or unbend to inadvertently move teeth and are the choice most modern orthodontists recommend. And some people can wear them only once a week eventually to keep the teeth in place. If you have a broken or lost retainer, you have to call the practice a book a full examination before making a new retainer. The consultation is free.

Food Caught Between Your Teeth

This is not an emergency, but it can be uncomfortable or embarrassing. It’s easily fixed 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 or toothpick to dislodge food caught between your teeth and your braces.

Ligatures Coming 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 your wire ligature is sticking out into the lip but is not loose, you can bend it back down with a Q-tip or pencil eraser so it doesn’t irritate your lip. 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 office. If a rubber or wire ligature is lost, tell the office so we can advise whether you should be seen.


It’s normal for you to have discomfort for a day or two after braces or retainers are adjusted, but it can make eating uncomfortable.

This discomfort is very normal and only for a short time.

Try eating soft foods and rinse the mouth with warm salt water.

Mouth Sores

You may be susceptible to mouth sores. While your braces don’t cause them, they may be made worse by irritation from braces.

One or several areas patches of sores may appear on the cheeks, lips or tongue. This is not an emergency, but may be very uncomfortable for you.

Get quick relief by applying a small amount of topical anesthetic (such as Orabase or Ora-Gel) directly to the area with sores using a cotton swab.

You can reapply as needed.

Irritated Lips or Cheeks

Sometimes new braces can irritate your mouth, especially when you’re eating. A small amount of non-medicinal relief wax makes an excellent buffer between the metal and your 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.

Then, you can eat more comfortably. If you accidentally swallow the wax, it’s not a problem. The wax is harmless.

Protruding Wire

Occasionally, the end of a wire will work itself out of place and irritate your 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 Irritated of Lips or Cheeks above for instructions on applying relief wax.)

You’ll need to make the office aware of the problem.

In a situation where the wire is extremely bothersome and you can’t see the doctor anytime soon, you may, as a last resort, clip the wire.

Reduce the possibility swallowing the snipped piece of wire by using folded tissue or gauze around the area.

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.

Loose Brackets, Wires, or Bands

If your braces come loose in any way, call the doctor to determine the 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 you’ve eaten one of those hard or crunchy foods you are instructed to avoid, or if the mouth is struck while at play.

We 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 [Dr.], who will determine the course of action.

If the loose bracket has rotated on the wire and is sticking out and you can’t come to our office immediately, 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.

You Swallow a Piece of Your Appliance

This is rare, but when it does happen, it can be alarming but stay calm.

If you’re coughing excessively or having difficulty breathing, you may have inhaled the piece into your airways or lungs.

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 your 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 could have been inhaled, call and leave a voicemail and text the office immediately.

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