common orthodontic emergencies:


Remember that loose and broken braces are most often caused by eating the wrong foods. Our original estimate of your total treatment time assumes no appliance breakage. Loose and broken braces prolong treatment!

  1. Poking wire or bracket: Roll a small piece of wax that was provided to you at the beginning of your orthodontic treatment into a small ball and press it onto the part that is poking you. If the wire is sticking our more on one side than the other, try to push the side that is not poking into the tube until the wire is even on both sides. Usually, you will notice this when the wire slides more on one side than the other. If the wire is still poking, try to place a small piece of wax that was provided to you.

    Understanding Parts of Braces Pocking or Wire Sticking Out

  2. Broken wire: Press the wire towards your teeth very gently with a pencil eraser. If the wire is loose or you have a loose piece, carefully remove it and place it in a “Zip Lock” bag and bring it to the office.
  3. Loose or Broken Bracket or band: If the bracket or band is still attached to the wire, contact the office immediately for an appointment to have the bracket or band bonded again. If the bracket or band is loose and in your hand, place in a “zip locks” bag and bring it back to the office.
  4. Colored “O” ring is missing: As long as you have other rings still present, usually there is no problem, however you should contact the office to have the “O” ring replaced.
  5. Headgear not fitting - don’t wear the headgear until the next appointment.
  6. Severe trauma with loose teeth - call the doctor immediately or your family dentist or an oral surgeon as soon as possible.
  7. Broken retainer – do not wear the retainer if it does not fit well. Call the office to schedule an appointment to have the repairs done or if necessary a new one to be made. Do not wait for several weeks as the teeth may shift requiring additional treatment at additional cost and time.
  8. Small cuts: To help a cut heal, rinse your mouth with a mixture of 1 teaspoon of salt and 1 cup of warm water. Call our office during our regular business hours for an appointment to have us check the orthodontic problem.

getting used to braces:

When you first get your braces, you may feel some discomfort or mild pain or soreness of the associated teeth. We recommend that you eat soft foods for the first few days until you get used to the braces. Your lips, cheek, tongue and teeth may be sore for a few days – usually 2-4 days. If any symptoms get worse or lasts more that 2-4 days, you must contact the office. Using over-the-counter pain relief medications may be helpful. Placing wax around the sore spots or sharp edges of the appliances may also be helpful.

pain or soreness in the teeth:

After braces are placed in the mouth it is normal for the teeth to be sore for about 2 or 3 days. Some irritation to the cheeks and tongue is also normal. If you feel anything sharp is poking you or any sores are developing, try using the wax we provided or call our office if the wax doesn't help.
Sore teeth during orthodontic treatment are normal and results from the forces placed on the teeth to move them. You are most likely to experience sore teeth for a few days after your braces are first placed and occasionally after routine orthodontic visits. An anti-inflammatory such as Ibuprofen is very good at reducing the soreness. Over-the-counter pain relief medications such as Advil, Motrin or Tylenol are helpful. Please read the dosage instructions prior to taking these medications. Also, avoid hard or chewy foods while your teeth are sore. If you experience intense pain or if the soreness persists longer than you think is normal, please call Dr. Patel immediately.


allergic reactions:

Allergic reactions during orthodontic treatment are very uncommon but they can occur. Some patients may be allergic to the metal in some appliances or to the elastics or to the latex gloves worn by Dr. Patel and his staff. If unusual or unexplained symptoms such as inflammation, redness in your mouth or a skin rash appear, please call Dr. Patel for advice. If you experience severe life threatening reactions, please call 9-1-1 immediately.

sore places in the cheeks:

Your braces and some other orthodontic appliances can sometimes irritate the inside of the cheek, especially during the first few days you have your braces. A sore spot may develop due to the brackets, archwires or tubes pressing again the cheeks. To help the sore spot heal and to help your cheeks get used to your braces, place wax on the part of your braces that is causing the sore spot. If the wax does not help or if the sore spot seems to get worse, please call the office. Rinsing your mouth with a cup of warm water and teaspoon of salt can also be soothing and helpful. If you teeth get sore suddenly in the middle of the month, give us a call. It is unusual for the teeth to get sore several weeks after your last office visit.

sore places on the lips:

During the first week of your braces your lips may be irritated from the brackets on your front teeth. A sore spot may develop on your lip. Cover the part of your braces that is causing the sore spot with wax and lubricate your lips with Vaseline or Chap Stick. If these steps do not help or if the sore spot seems to get worse, please call the office. Rinsing your mouth with a cup of warm water and teaspoon of salt can also be soothing and helpful.

sore places on the tongue:

Some of your orthodontic appliances may have parts that may be towards the tongue surfaces causing some sore spots on the tongue. To help the sore spot heal better and to let your tongue get used to your braces, place wax on the part of the braces that is causing the sore spot. If the wax does not seem to help or if the sore spot gets worse, please call the office. Rinsing your mouth with a cup of warm water and teaspoon of salt can also be soothing.

loose bands or bonded appliances:

If an orthodontic band or a bonded appliance comes loose it can cause irritation and soreness in the surrounding tissues. Do not use the headgear or elastics, if you have loose bands or brackets. Please call the office for an appointment for repair or replacing the brackets or bands.

loose or poking wires or brackets:

Loose brackets usually stay attached to the archwires in a majority of the cases. Sometimes the bracket may move or slide back and forth on the archwire and cause a sore spot in the cheek. If tissue irritation occurs, cover the loose bracket with orthodontic wax to help the sore place heal. If a bracket becomes loose, it usually remains connected to the main wire by a little rubber colored ring. Eyebrow tweezers can be used to reposition the brace if it flips around the wire and becomes a source of irritation or try to position the loose bracket back in its normal position and then call our office for an appointment.

If a piece of your braces breaks, save the piece, place it in a “zip lock” bag and call our office for an appointment.

If the main wire has come out of the tube on your back tooth, attempt to reinsert the wire with a pair of needle-nosed pliers or tweezers. If the wire is not sticking you, place a piece of wax over the area.

If the wire cannot be tucked away, cover the end of the wire with a small piece of wax or a piece of sugarless gum until you can see Dr. Patel for an adjustment. Please call the office for a special appointment.

If the main wire has come out of the tube or slot on your back molar tooth, attempt to reinsert the wire with a pair of needle-nosed pliers or tweezers. If the wire is not sticking you, place a piece of wax over the area. If the wire is sticking you and wax does not help, the wire can be cut with a small wire cutter or toenail clipper close to the back of the last brace. This is a last resort if professional help is unavailable and you are willing to take the risk of possibly aspiration “swallowing in” of the loose piece.

lost spacers or separators:

In case a rubber spacer falls out, take two pieces of dental floss and insert them through the spacer. Pull on both pieces of floss to stretch the spacer, then slide the spacer back and forth between the two teeth where it belongs. Once the bottom half of the spacer slips under the tight spot between the teeth, release and remove the floss and the spacer will fit back properly. If you cannot place the spacers back in your mouth, please call the office for an appointment. You can avoid loosing spaces by avoiding sticky foods and temporarily avoiding flossing between the teeth that has the spaces.

loose or broken retainers or removable appliances:

The metal or plastic parts of retainers or removable appliances may break or get bent. This can cause the retainers not fit properly. Should the retainers not fit well, please stop wearing the appliances and call Dr. Patel for an earlier appointment. If a retainer cracks, remove the retainer from your mouth and place all the pieces in a “zip lock” bag and bring the “zip lock” bag to our office for professional repair of the broken appliance.

loose or broken headgear:

If your headgear tends to come off at night while you are sleeping or if the facebow breaks call Dr. Patel to schedule an earlier appointment and do not wear the headgear or the facemask, until it has been inspected and adjusted or repaired or replaced by Dr. Patel.

wax :

Orthodontic wax is used to cover loose or broken parts of your braces, hooks, newly placed braces, and other orthodontic appliances that may cause soft tissue irritation or sore spots. To use your wax, take a small piece about the size of a pea. Shape it into a ball with your fingers and apply the wax directly to the part of the braces causing the sore spot. Press it around the part and smooth it with your fingers. Wax is harmless and can be applied to your braces as often as is needed, as long as the wax is not large enough to cause a choking hazard.

NOTE: If you happen to run out of wax, sugar free gum can temporarily serve as a good alternative.

swallowed parts:

One of the risks associated with orthodontic treatment that you assume, is aspiration or “swallowing in” or “inhaling” of small orthodontic appliances. If you swallow part of your orthodontic appliances such as a bracket, band or rubber band, it will more than likely will pass through your bowel system and be relatively harmless. However, if you swallow a part of your braces and have difficulty breathing or choking, please call 9-1-1 and seek immediate medical help. Remain calm if you swallow a piece of your appliance. This will usually go into the stomach, passing out of the body in a bowel movement. X-rays may be necessary by your attending physician or the medical facility, to determine the location of the swallowed and additional medical intervention may be necessary.

swollen gums:

It is very important to keep your teeth and gums free of plaque and food debris during orthodontic treatment and having regular dental checkups and cleanings by your family dentist. Poor oral hygiene may result in swollen and bleeding gum tissue. Please contact your family dentist should you experience swollen gums. Gentle and thorough brushing, rinsing with warm salt water and mouthwash will help temporarily before you see your family dentist. Also, using dental floss to check the swollen area to see if food debris may be trapped under a band or bracket is helpful. Orthodontic tooth movement may also cause swollen gums. If the steps above do not help the situation, please call Dr. Patel or contact the office for an appointment.

unusual movement of your teeth:

Your braces are designed to move your teeth. However, undesired tooth movement can occur when part of your braces are broken or damaged or your wires are bent or you missed you last scheduled follow-up orthodontic appointment. If this is the case, please call Dr. Patel to schedule an appointment as soon as possible.


Bleeding of gums indicates that the gums are swollen and more than likely due to poor oral hygiene. You must contact you family dentist to have a dental checkup and dental cleaning. If you cut your gums, tongue or the inside of your cheek, apply finger pressure to the bleeding site for several minutes. If the bleeding does not clot, call your orthodontist or family dentist.

temporomandibular joint (tmj) pain:

Temporomandibular Joint (TMJ) also referred to as Temporomandibular Disorders TMD), is a dysfunction of the jaw joint, located directly in front of the ear. TMD can occur whether or not a person has had orthodontic treatment. TMD may be caused or contributed by a variety of factors such as: stress; joint disease; oral habits such as clenching or grinding the teeth; automobile accidents; and trauma to the mouth. The symptoms of TMD may include but are not limited to: clicking or popping in the joint; pain in front of the ears; inability to fully open the mouth; joint pain; ear problems; neckaches and headaches. If during or after treatment should you ever experience any of the symptoms or signs of TMD, notify your Orthodontist immediately. Failure to do so may affect the outcome of your treatment and cause additional complications.

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