True orthodontic emergencies are rare, but when they do occur, we are available to you. As a general rule, you should call our office when you experience severe pain, break part of your appliance, or have a problem with an appliance that you can’t take care of yourself. Although some discomfort can be expected immediately after an adjustment, you should not be in pain! When you call after business hours, you will be directed to an emergency phone number. You might be surprised to learn that you may temporarily solve many problems by yourself.

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

Irritating Wires

Poking metal wires can usually be tucked back, away against the tooth or under the archwire, and away from the gums and cheek. You can use the end of a toothbrush, the eraser end of a wooden pencil, or a Q-tip. If irritation to the lips or mouth continues, place wax or wet cotton on the wire, to reduce the annoyance. If you need to cut a wire, use a small fingernail clipper that has been washed and sterilized in alcohol. Be careful not to swallow the small section of wire. Please avoid using pliers that may break appliances, cause harm to teeth or gums, or create greater problems.

Loose Bands or Brackets

If your bracket or band is still attached to the wire, you should leave it in place and put wax on it. If you are not due for a visit within a few days, please call for an emergency visit. If you do have an upcoming appointment, it is very important that you call us ahead of time so we can ensure we have extra time to accommodate your emergency.

Loose Tie

If a color tie or stainless steel tie comes off, call the office to schedule an appointment. Although this is not an emergency, it may need to be replaced prior to your next scheduled appointment.


Troubleshooting Your Expander

How Do I Turn the Expander?

There should be one hole visible, towards the front of the mouth. Carefully insert the key into the hole and gently wiggle the key to ensure that it is fully seated.

While keeping the key securely in the hole, push toward the back of the mouth (in the direction of the arrow on the expander), until the next key hole is visible at the front of the mouth. Remove the key by wiggling it down toward your tongue, and be careful not to “unturn” the screw. Gently remove the key from the mouth.

I Can’t Find the Hole at the Front of the Expander

It is likely that the previous activation was not complete or the screw has been unturned.

To correct this, insert the key into the hole facing the back of the expander and continue the activation until the next hole is completely visible at the front of the mouth. To ensure that you stay on schedule, you should then perform another complete activation.

The Expander Seems to be Loose on One Side

If you think the expander may be loose, stop activating it. Please call the office immediately and schedule an appointment to have it checked and re-cemented if needed. Keep the area clean until we can examine it.

Accidents or Trauma

We recommend a protective mouthguard when you play contact sports. Be sure to avoid mouthguards that custom-form to your teeth because these will resist any tooth movements we are trying to achieve. You can find “braces-specific” mouthguards at Jerry’s Sports in Santa Cruz.

In case of any accident involving the face, check your mouth and the appliances immediately. If teeth are loosened or the appliances are damaged, call at once for an emergency appointment.

A blow to your teeth can be serious, especially if you can see that a tooth has been moved or the appliances bent. Although lips could be cut, the braces may actually keep a tooth from being knocked out. If you have had facial trauma that has resulted in tears of facial/oral tissues or if teeth have been chipped, broken, loosened, or knocked out — urgently call your general or pediatric dentist, as time is critical for knocked out or severely loose teeth.

If your tooth has been knocked out, there is a one-hour window of opportunity to re-implant it with reasonable success. Do not scrub or wipe the tooth off. It can be gently rinsed and then transported in a salt solution (saline), milk, or a pool of saliva (in a cup or retained in the mouth) to keep the tooth moist.

Your family dentist is properly prepared with appropriate anesthetic, reparative materials, appropriate X-rays, etc. to do initial treatment and perhaps re-implant the tooth, splint it, and prescribe appropriate antibiotics and pain relief medications. Alternatively, you may go to your local hospital emergency room, where a dentist or oral surgeon on staff may be able to assist you in a timely fashion.